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VLBW: Human Milk (Mothers' Milk and Donor) vs Exclusive Formula (2020)

Intervention
In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and ROP, NEC, and BPD ?
- Conclusion
  In one prospective multicenter cohort study, infants who received infant formula (type depended on center) compared to infants who received human milk exclusiviely (MOM and/or donor milk) reported a higher OR (95% CI) of BPD [2.59 (1.33, 5.04)], ROP [1.80 (1.05, 3.11)] and NEC [12.86 (2.84, 58.29)], though authors did not control for socio-economic status or maternal morbidities.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and ROP, NEC and BPD?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Spiegler J, Preub M, Gebauer C, Bendiks M, Herting E, Göpel W. Does breastmilk influence the development of bronchopulmonary dysplasia?. Journal of Pediatrics 2016; 169:76-80.e4
- Search Plan and Results: VLBW: Human Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and weight?
- Conclusion
  Very low birth weight (VLBW) preterm infants who received greater than or equal to 75% human milk had less weight gain compared to infants who received formula exclusively [MD (95% CI): -6.5 (-11.7, -1.3) g/kg/d; p=0.014].
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and weight?
- Search Plan and Results: VLBW: Human Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and length, head circumference and skin-fold measurements?
- Conclusion
  In one small prospective cohort study, there was no statistical differences in change in infant head circumference, length, mid-upper arm circumference or triceps skinfold according to if an infant received human milk exclusively (MOM or donor) or low birthweight formula after an average of 25 days. Infants receiving human milk exclusively had significantly less gain in subscapular skinfold measurement. There was no information from the located studies about body composition. -
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and length, head circumference and skin-fold measurements?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Brooke O, Onubogu O, Heath R, Carter N. Human milk and preterm formula compared for effects on growth and metabolism. Archives of Disease in Childhood 1987; 62:917-23
- Search Plan and Results: VLBW: Human Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and protein utilization?
- Conclusion
  Compared to infants receiving exclusively low birthweight or preterm infant formula, those receiving human milk (MOM and/or donor) had less absolute nitrogen retention [MD (95% CI): -98.8 (-152.5, -37.1) mg/kg/d)].
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and protein utilization?
- Search Plan and Results: VLBW: Human Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1.500g at birth), what is the association between greater than or equal to 75% human milk (mothers' and donor) intake vs. exclusive formula intake and mortality, GI health, bone mineral content, and development?
- Conclusion
  No studies were identified that evaluated the association between greater than or equal to 75% human milk (mothers' and donor) intake versus exclusive formula intake and mortality, GI health, bone mineral content, and development?
- Grade: V
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Search Plan and Results: VLBW: Human Milk vs Formula (2019)