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

Feeding with formula milk, compared with donor breast milk appears to lead to higher rates of short-term growth in preterm or low birth weight infants, but is associated with an increased risk of developing necrotising enterocolitis.

A Cochrane review included 11 studies with a total of 1 809 subjects. Four studies compared standard term formula versus donor breast milk and 7 compared nutrient-enriched preterm formula versus donor breast milk. Only the 4 most recent studies used nutrient-fortified donor breast milk. Formula-fed infants had higher in-hospital rates of weight gain (MD 2.51, 95% CI 1.93 to 3.08 g/kg/day; 9 studies, n=1 028; statistical heterogeneity I²=90%), linear growth (MD 1.21, 95% CI 0.77 to 1.65 mm/week; 8 studies, n=820; statistical heterogeneity I²=68%) and head growth (MD 0.85, 95% CI 0.47 to 1.23 mm/week; 8 studies, n=894; statistical heterogeneity I²=74%). There was no evidence of an effect on long-term growth or neurodevelopment. Formula feeding increased the risk of necrotising enterocolitis (RR 1.87, 95% CI 1.23 to 2.85; 8 studies, n=1 605).

Comment: The quality of evidence is downgraded by inconsistency (statistical heterogeneity).

Ədəbiyyat

1. Quigley M, Embleton ND, McGuire W. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev 2018;(6):CD002971.