title: Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants.
abstract: OBJECTIVE
  To compare the duration of parenteral nutrition, growth, and morbidity in extremely premature infants fed exclusive diets of either bovine milk-based preterm formula (BOV) or donor human milk and human milk-based human milk fortifier (HUM), in a randomized trial of formula vs human milk.
  
  
  METHODS
  Multicenter randomized controlled trial. The authors studied extremely preterm infants whose mothers did not provide their milk. Infants were fed either BOV or an exclusive human milk diet of pasteurized donor human milk and HUM. The major outcome was duration of parenteral nutrition. Secondary outcomes were growth, respiratory support, and necrotizing enterocolitis (NEC).
  
  
  RESULTS
  Birth weight (983 vs 996 g) and gestational age (27.5 vs 27.7 wk), in BOV and HUM, respectively, were similar. There was a significant difference in median parenteral nutrition days: 36 vs 27, in BOV vs HUM, respectively (P = .04). The incidence of NEC in BOV was 21% (5 cases) vs 3% in HUM (1 case), P = .08; surgical NEC was significantly higher in BOV (4 cases) than HUM (0 cases), P = .04.
  
  
  CONCLUSIONS
  In extremely preterm infants given exclusive diets of preterm formula vs human milk, there was a significantly greater duration of parenteral nutrition and higher rate of surgical NEC in infants receiving preterm formula. This trial supports the use of an exclusive human milk diet to nourish extremely preterm infants in the neonatal intensive care unit.
authors: Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Elizabeth A
authors: EA
authors: Cristofalo
authors: Richard J
authors: RJ
authors: Schanler
authors: Cynthia L
authors: CL
authors: Blanco
authors: Sandra
authors: S
authors: Sullivan
authors: Rudolf
authors: R
authors: Trawoeger
authors: Ursula
authors: U
authors: Kiechl-Kohlendorfer
authors: Golde
authors: G
authors: Dudell
authors: David J
authors: DJ
authors: Rechtman
authors: Martin L
authors: ML
authors: Lee
authors: Alan
authors: A
authors: Lucas
authors: Steven
authors: S
authors: Abrams
mesh_terms: D000818:Animals; D001942:Breast Feeding; D002417:Cattle; D004311:Double-Blind Method; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005260:Female; D005526:Food, Formulated; D006801:Humans; D041943:Infant Formula; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D008892:Milk; D010288:Parenteral Nutrition / Q000706:statistics & numerical data
keywords: BOV; Bovine milk–based preterm formula; HUM; Human milk fortifier; NEC; Necrotizing enterocolitis