e-Library of Evidence for Nutrition Actions (eLENA)


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Donor human milk for low-birth-weight infants

Intervention | Last updated: 20 June 2023


Every year, more than 20 million infants are born weighing less than 2.5kg – over 96% of them in developing countries. These low-birth-weight (LBW) infants are at increased risk of early growth retardation, infectious disease, developmental delay and death during infancy and childhood.

Most LBW is a consequence of preterm birth, small size for gestational age, or both.

Interventions to improve the feeding of LBW infants are likely to improve the immediate and longer-term health and well-being of the individual infant and have a significant impact on neonatal and infant mortality levels in the population.

WHO recommends that LBW infants should be fed mother's own milk. When a mother's own breast milk is not available, the alternatives are either expressed breast milk from a donor mother or formula milk. Available evidence shows that compared with formula, donor human milk is associated with lower incidence of the severe gut disorder, necrotising enterocolitis, and other infections during the initial hospital stay after birth.

WHO Recommendations


WHO recommends that LBW infants, including those with very low birth weight, who cannot be fed mother's own milk should be fed donor human milk.

This recommendation is relevant for settings where safe and affordable milk-banking facilities are available or can be set up.

This recommendation does not address sick LBW infants or infants with birth weight less than 1.0 kg.



Evidence


Systematic reviews used to develop the guidelines


Optimal feeding of low-birth-weight infants: technical review

Edmond K, Bahl R. Geneva: World Health Organization; 2006.


Related Cochrane reviews


Formula versus donor breast milk for feeding preterm or low birth weight infants

Quigley M, Embleton ND, McGuire W. ochrane Database of Systematic Reviews. 2019; Issue 7. Art. No.: CD002971.


Other related systematic reviews


Donor breast milk versus infant formula for preterm infants: systematic review and meta-analysis

Boyd CA, Quigley MA, Brocklehurst P. Archives of Disease in Childhood: Fetal and Neonatal Edition. 2007; 92:F169-F175.