title: Introducing Donor Milk in a Neonatal Intensive Care Unit: A Developing Country's Perspective.
abstract: OBJECTIVE
  To replace 75 % of formula feeds by donor human milk (DHM) feeds in the first three days of life in neonates admitted to the neonatal intensive care unit (NICU).
  
  
  METHODS
  It was a prospective observational study in the NICU in a resource-limited set up in India. All neonates admitted during December 2013 and August 2014, were included in the study without any exclusion. Expressed DHM was administered within 2-3 h of manual expression without refrigeration or pasteurization. It was left standing at room temperature in a covered stainless steel container prior to use. Prospective entries of 2 hourly neonatal feeds, for first 3 d of life, (36 entries) were made in the charts. Main outcome was the desired percentage replacement of formula feeds.
  
  
  RESULTS
  Total 168 neonates were admitted to the NICU over the study period. Their median [Interquartile range (IQR); Range] gestation and birth weight was 37 (36, 38; 24-42) wk and 2300 (2100, 2700; 500-2950) g respectively. A total of 4136/6027 (68.6 %) charted feeds were of human milk and 1891(31.4 %) were of formula milk. Thus, 68.6 % of formula feeds were replaced by DHM. Neonates weighing ≤2 kg were at a lower risk of getting >25 % formula feeds.
  
  
  CONCLUSIONS
  A simple low cost method was effective in replacing a significant proportion of formula feeds by DHM in the first three days of life for neonates in a resource poor set up.
authors.affiliation: Department of Pediatrics, MIMER Medical College, Talegaon Dabhade, India. subhashdaga@yahoo.com.|Department of Pediatrics, Pacific Medical College and Hospital, Udaipur, Rajasthan, 313001, India. subhashdaga@yahoo.com.
authors.forename: Subhashchandra
authors.initials: S
authors.lastname: Daga
authors.affiliation: Department of Pediatrics, MIMER Medical College, Talegaon Dabhade, India.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Naktode
authors.affiliation: Department of Pediatrics, MIMER Medical College, Talegaon Dabhade, India.
authors.forename: Anushree
authors.initials: A
authors.lastname: Borade
authors.affiliation: Department of Pediatrics, MIMER Medical College, Talegaon Dabhade, India.
authors.forename: Savita
authors.initials: S
authors.lastname: Gawali
mesh_terms: D000818:Animals; D002648:Child; D003906:Developing Countries; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008895:Milk, Human; D011446:Prospective Studies
keywords: Breast feeding; Breast milk; Donor human milk; Neonatal intensive care; Newborn care; Preterm baby