BACKGROUND AND OBJECTIVE Human milk is beneficial for preterm infants, but pasteurized donor human milk (PDHM) is associated with slower growth than mother‘s own milk (MOM) or formula. We aim to quantify the effect of PDHM, compared with MOM and formula, on daily and in-hospital growth. METHODS We conducted a multicenter retrospective cohort study of infants born less than 34 weeks’ gestation between 2016 and 2024 across 5 newborn nurseries at Mass General Brigham. Daily enteral intake volumes and weights were analyzed. The primary exposure was feeding type (PDHM, MOM, formula). The primary outcome was daily weight gain (g/kg/d); the secondary outcome was the change in weight-for-age z score from birth to discharge (in-hospital growth). Multivariable linear models were fitted to adjust for gestational age, sex, birth weight-for-age z score, and hospital site. RESULTS A total of 2635 and 2719 infants contributed to the daily growth and in-hospital growth analysis, respectively. Volume-for-volume and after correcting for caloric fortification, PDHM was associated with 74% of the daily weight gain achieved with MOM (95% CI 70%-77%, P .0001), whereas formula supported 115% of MOM (95% CI 111%-119%, P .0001). Only infants in the highest quartile of PDHM exposure showed decreased in-hospital growth compared with those with no exposure to PDHM (–0.09, P = .005); no differences were seen in the lower quartiles. CONCLUSIONS PDHM is associated with slower daily weight gain than MOM, whereas formula supports faster growth. High PDHM exposure correlates with reduced in-hospital growth, underscoring the need for close growth monitoring and optimized donor milk fortification in preterm infants.
Chou et al. (Sun,) studied this question.