In the realm of neonatal care, the nutritional strategies employed for preterm infants remain critically significant. Among these, the provision of Mother’s Own Milk (MOM) is widely regarded as the gold standard due to its unparalleled immunological and developmental benefits. However, circumstances frequently arise in Neonatal Intensive Care Units (NICUs) where mothers are unable to provide sufficient quantities of their own milk. In such scenarios, Donor Human Milk (DHM) is often suggested as an alternative. Yet, scientific uncertainty persists regarding whether DHM can truly mirror the protective and developmental advantages of MOM. A groundbreaking new study published in Pediatric Research confronts this uncertainty head-on by investigating the comparative short-term outcomes of preterm infants receiving DHM versus MOM.
The investigation conducted by Rahdar and colleagues meticulously evaluates how the intake of donor milk correlates with clinical progress in vulnerable preterm neonates. Preterm infants, defined as babies born before 37 weeks of gestation, often face numerous health challenges, including underdeveloped organ systems and heightened susceptibility to infections. The inherent biological complexity of human milk, rich in bioactive components such as antibodies, growth factors, and beneficial microbiota, plays a crucial role in mitigating these risks and supporting optimal growth trajectories. The crux of this study revolves around determining if DHM, which undergoes processing such as pasteurization and storage, retains enough of these bioactive elements to benefit preterm infants comparably to MOM.
Methodologically, the researchers carried out a prospective observational analysis within NICUs, tracking infants who received varying proportions of MOM and DHM during their hospitalization. The study population comprised preterm neonates with gestational ages ranging from extremely premature to late preterm, enabling a comprehensive overview of nutritional impacts across different developmental stages. Parameters scrutinized included incidence rates of complications such as necrotizing enterocolitis (NEC), sepsis, growth velocity, length of hospital stay, and markers of metabolic health. The rigorous data collection aimed to establish clear correlations and potential causative relationships influenced by the source of human milk intake.
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One of the pivotal considerations when examining DHM relates to its processing. Donor milk is typically subjected to Holder pasteurization—a heat treatment designed to eliminate pathogens but which also compromises certain heat-sensitive bioactive molecules. These include immunoglobulins, lactoferrin, and various enzymes critical for digestive and immune functions. MOM, by contrast, is often provided fresh or minimally processed, thereby preserving its functional integrity. This biochemical differentiation raises important questions about the relative efficacy of DHM in replicating the protective milieu that MOM offers to preterm infants during a critical window of development.
The observed outcomes in the study revealed nuanced distinctions. While both DHM and MOM contributed to improved short-term clinical parameters compared to formula feeding, infants fed predominantly with MOM showed statistically significant advantages in growth metrics and reduced incidences of infectious complications. Specifically, the risk of NEC—a severe gastrointestinal condition devastating to premature infants—was notably lower in the MOM group. These findings underscore the irreplaceable qualities inherent in fresh maternal milk and suggest that donor milk, while beneficial, cannot fully substitute for the biological sophistication of MOM.
Nonetheless, the utility of DHM should not be understated. As the research delineates, donor milk still outperformed standard formula feeds, confirming its role as a crucial therapeutic option when MOM is unavailable or insufficient. Moreover, the study advocates for ongoing refinements in DHM processing techniques aimed at preserving the delicate bioactive proteins and peptides that underpin many of its health-promoting functions. Emerging technologies such as high-pressure processing and ultraviolet irradiation hold promise as potential avenues to improve the quality and efficacy of donor milk without compromising safety.
In the broader context of neonatal healthcare, this investigation accentuates an urgent clinical need to prioritize the collection, processing, and equitable distribution of DHM, particularly in settings where lactation challenges are prevalent. Simultaneously, it underscores the necessity of lactation support interventions designed to maximize MOM availability. This dual approach ensures that preterm infants receive the highest possible quality of nutrition tailored to their complex physiological requirements.
Another compelling aspect explored by the authors involves the immunomodulatory consequences of feeding practices. MOM contains live maternal cells, microbiota, and a dynamic profile of immunoglobulins that adapt over time in response to neonatal exposure and maternal environment. DHM, processed and pooled from multiple donors, lacks this personalized adaptation, possibly explaining differences in clinical effectiveness. The study thus invites further research into enhancing donor milk’s bioactivity via innovative supplementation strategies or maternal milk banking practices better preserving these delicate components.
Complementing the short-term clinical outcomes, the research also highlights the potential long-term neurodevelopmental implications of early nutrition in preterm infants. While not the central focus of this particular study, the authors reference accumulating evidence linking MOM intake with improved cognitive outcomes. To this end, elucidating DHM’s impact on brain development remains an important pursuit in neonatal nutrition science, especially as survival rates improve and focus shifts toward optimizing quality of life.
A profound takeaway from this research lies in its methodological rigor and real-world applicability. By analyzing diverse NICU cohorts under routine clinical conditions, the findings offer robust insights into nutritional strategies that can be translated into practice guidelines without the constraints of tightly controlled experimental environments. Such evidence is invaluable for neonatologists, dietitians, and healthcare policymakers aiming to enhance care protocols with evidence-based feeding recommendations.
Emphasizing a multidisciplinary approach, the study calls for integration of neonatology, lactation science, microbiology, and biochemistry to tackle the challenges intrinsic to neonatal nutrition. The intersection of these fields promises innovations not only in donor milk processing but also in understanding the complex interplay between nutrition, immunity, and development during the critical neonatal period.
In conclusion, while Donor Human Milk remains a life-saving alternative to formula, especially in resource-limited settings, this insightful study by Rahdar et al. underscores that Mother’s Own Milk retains a superior position in promoting favorable short-term outcomes in preterm infants. Enhanced efforts in both supporting maternal lactation and refining donor milk preservation are imperative to close the gap in neonatal care efficacy. The evolving landscape of neonatal nutrition stands at the cusp of transformative advances, as science deepens our understanding of the molecular symphony orchestrated by human milk and its impact on humanity’s most vulnerable members.
Subject of Research: The relationship between Donor Human Milk (DHM) vs. Mother’s Own Milk (MOM) intake and short-term clinical outcomes in preterm infants hospitalized in NICUs.
Article Title: Short outcomes of donor milk and mother’s own milk for preterm infants.
Article References:
Rahdar, S., Hemati, Z., Yazdi, M. et al. Short outcomes of donor milk and mother’s own milk for preterm infants. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04208-5
Image Credits: AI Generated
DOI: https://doi.org/10.1038/s41390-025-04208-5
Tags: bioactive components in breast milkbreastfeeding alternatives for NICUclinical research on infant feedingdevelopmental outcomes for preterm infantsDonor Human Milk comparisonimmunological advantages of human milkMother’s Own Milk benefitsneonatal care strategiesNICU feeding practicespreterm infant health challengespreterm infant nutritionshort-term health effects of donor milk
