title: Donor human milk for very low birth weights: patterns of usage, outcomes, and unanswered questions.
abstract: OBJECTIVE
  Donor milk usage in the United States has increased substantially over the past 10 years. Between 2007 and 2011, donor milk use in level 3 and 4 neonatal ICUs increased from 25 to 45%.
  
  
  RESULTS
  Most centers have written protocols based on birth weight or gestational age, and give donor milk in an effort to prevent necrotizing enterocolitis. The evidence for protection against necrotizing enterocolitis using bovine-fortified donor milk vs. formula is limited, although the exclusive human milk diet seems to offer protection compared to diets containing formula. Adequate growth can be achieved with donor milk fortified with either bovine or human milk-derived fortifiers, but use of additional fortification and protein supplementation may be required. Several randomized trials of donor milk vs. formula are ongoing in the very low birth weight population in North America that can answer important questions.
  
  
  CONCLUSIONS
  Further research is needed before donor milk and the exclusive human milk diet are considered the standard of care.
authors.affiliation: Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Tarah T
authors.initials: TT
authors.lastname: Colaizy
mesh_terms: D004750:Enteral Nutrition / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000178:diet therapy / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D041943:Infant Formula / Q000706:statistics & numerical data*; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D017784:Milk Banks / Q000706:statistics & numerical data*; D008895:Milk, Human; D014481:United States