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VLBW: Donor Milk versus Exclusive Formula (2020)

Intervention
In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula intake on mortality?
- Conclusion
  In one small RCT, there was no difference in incidence of death between infants exclusively receiving donor milk with human milk-based fortifier compared to those receiving preterm formula after 1-2 months.
- 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 effect of greater than or equal to 75% donor milk vs. exclusive formula intake on mortality?
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on late onset sepsis, NEC and ROP?
- Conclusion
  In one small RCT, there was no difference in incidence of late onset sepsis, necrotizing enterocolities (NEC) or retinopathy of prematurity (ROP) between infants exclusively receiving donor milk with human milk based fortifier compared to those receiving preterm formula after 1-2 months.
- 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 effect of greater than or equal to 75% donor human milk intake vs. exclusive formula on late onset sepsis, NEC and ROP?
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on weight?
- Conclusion
  Evidence suggests no effect of exclusive, fortified donor milk on weight gain compared to exclusive preterm formula after approximately 2-6 months.
- Grade: II
  - 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 effect of greater than or equal to 75% donor milk intake vs. exclusive formula on weight?
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on length?
- Conclusion
  Evidence suggests no effect of exclusive, fortified donor milk on weight gain compared to exclusive preterm formula after up to six months in VLBW preterm infants. However, heterogeneity of results was high.
- 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 effect of greater than or equal to 75% donor milk intake vs. exclusive formula on lenght?
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on head circumference?
- Conclusion
  Evidence suggests no effect of exclusive, fortified donor milk on weight gain compared to exclusive preterm formula after approximately 2-3 months.
- 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 effect of greater than or equal to 75% donor milk intake vs. exclusive formula on head circumference?
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on feeding tolerance?
- Conclusion
  Infants who received fortified donor milk exclusively for 2-3 months had significantly fewer days until reaching full enteral nutrition compared to those receiving preterm formula exclusively.
- 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 effect of greater than or equal to 75% donor milk intake vs exclusive formula on feeding tolerance?
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on bone mineral content?
- Conclusion
  One RCT suggests no effect of exclusive, fortified donor milk on bone mineral compared to exclusive preterm formula after six months.
- 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 effect of greater than or equal to 75% donor milk intake vs exclusive formula on bone mineral content?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Lapillonne A, Glorieux F, Salle B, Braillon P, Chambon M, Rigo J, Putet G, Senterre J. Mineral balance and whole body bone mineral content in very low-birth-weight infants. Acta Paediatrica (Oslo, Norway : 1992). Supplement 1994; 405:117-22
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on protein utilization?
- Conclusion
  In one small RCT, infants receiving preterm formula had greater nitrogen retention compared to infants receiving unfortified donor milk in a three day balance study.
- 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 effect of greater than or equal to 75% donor milk intake vs exclusive formula on protein utilization?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Roberts S, Lucas A. The effects of two extremes of dietary intake on protein accretion in preterm infants. Early Human Development 1985; 12:301-7
- Search Plan and Results: VLBW: Donor Milk vs Formula (2019)
In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of greater than or equal to 75% donor milk intake vs. exclusive formula on development?
- Conclusion
  No studies were identifed that evaluated the effect of greater than or equal to 75% donor milk intake versus exclusive formula on 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: Donor Milk vs Formula (2019)