Meta-analysis of donor human milk versus formula milk for feeding very low birth weight and extremely low birth weight infants / 中华围产医学杂志

ABSTRACT

Objective To determine the effects of feeding donor human milk versus formula milk on very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI).Methods The Cochrane library,PubMed,EMBASE,Wanfang,CNKI and VIP database were searched for the randomized controlled trials (RCT) that compare donor human milk with formula milk in VLBWI and ELBWI from the establishment of database up to February 2014.The quality of the included studies was assessed.Meta analysis was performed using RevMan 5.2.9 software.The results were expressed by mean difference (MD) and 95％CI for continuous variables,RR and 95％CI for categorical variables.Results Only five trials were includedin quality evaluation,two trials were graded B,and the other three were graded C.Meta-analysis showed that,compared with the formula milk,feeding of donor human milk could reduce the risk ofnecrotizing enterocolitis (RR=0.36,95％CI0.18-0.73,P＜0.01),but not the risks of sepsis (RR=0.92,95％CI0.50 1.72,P=0.80),retinopathy of prematurity (RR=1.21,95％CI0.84-1.74,P=0.31) and in-hospital mortality (RR=0.66,95％CI0.18-2.37,P=0.52).The significantly lower rates in weight gains in neonatal period (MD=-6.58,95％CI-11.19 to-1.98,P＜0.01) and body length (MD=-0.30,95％CI-0.41 to-0.20,P＜0.01)were found in donor human milk compared with formula milk.No significant difference in head circumference (MD=-0.16,95％CI-0.33 to 0.01,P=0.13) was seen in comparison of donor human milk with formula milk.Conclusions Feeding with donor human milk can reduce the risk ofnecrotizing enterocolitis in VLBWI and ELBWI,but its effects on neonatal growth need to be further studied in large scale RCT.