The Revolution of Breast Milk: The Multiple Role of Human Milk Banking between Evidence and Experience-A Narrative Review

Unlocking the Potential: A Systematic Literature Review on the Impact of Donor Human Milk on Infant Health Outcomes

Human mother milk is considered the most healthy and best source of nutrition for both premature and full-term infants, as it possesses many health benefits and is associated with its consumption. Some of the mothers are not able to produce an adequate quantity of milk to meet the required needs of the infants, particularly in cases involving premature births or facing challenges in breastfeeding. Especially for the most vulnerable premature infants, donor human milk (DHM) provides a helpful bridge for effective breastfeeding. Even with the advancement in baby formulas, no other dietary source can match the bioactive matrix of benefits found in human breast milk. This literature review discusses the risks associated with prematurity and explores the use of DHM in the care of premature infants. It helps prevent substantial preterm complications, especially necrotizing enterocolitis, bronchopulmonary dysplasia, and late-onset sepsis, which are more commonly seen in infants who are given formulated milk made from cow's milk. It gives insights into the benefits of DHM, such as immunological and nutritional benefits, which is a basic infant's need. When medical distress prevents mothers from producing enough breast milk for their infants, pasteurized human donor breast milk should be made accessible as an alternative feeding option to ensure infants remain healthy and nourished. A systematic literature search was conducted using PubMed and Google Scholar databases and other sources. A total of 104 articles were searched, of which 35 were included after identification, filters were applied, eligibility was checked, and references out of scope were excluded. Human milk banking should be incorporated into programs encouraging breastfeeding, highlighting lactation in mothers and only using DHM when required.

Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge

Mothers' own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for effects on outcome in the short and long term, especially neurological ones. We studied the use of MOM for infants weighing <1500 g for a period of 5 years, evaluating the trend over time and the impact of some variables on human milk feeding performance. Statistical comparisons concerned the rate of feeding with breast milk during a stay in an NICU and at discharge with respect to two types of variables: (1) maternal and neonatal characteristics (gestational age, birth weight, type of pregnancy (whether single or twin), maternal age) and (2) feeding characteristics (time of the start of minimal enteral feeding and availability of MOM, days until the achievement of full enteral feeding). Group comparisons were performed using ANOVA or t-test for continuous variables and Pearson chi-squared test or Fisher exact test for categorical variables. We observed an increase, between 2017 and 2021, in MOM use (p = 0.003). The availability of the own mothers' milk occurred, on average, on the fourth day of life and improved over the years. The start of minimal enteral feeding (MEF) with human milk averaged 1.78 days, and 54.3% of VLBWs received MEF with donor milk on the first day of life. The average percentage of feeding with the mothers' milk at discharge was 47.6%, with 36.1% of exclusive MOM and an increase from 45.8% in 2017 (33.3% exclusive) to 58.82% (41.18% exclusive) in 2021. The mean average daily growth of the weight improved (p < 0.001) during this period, and there was no statistical difference between infants fed with maternal milk and those fed with bank milk. Older maternal age, early-start feeding with maternal milk and low gestational age had a statistically significant impact on feeding with MOM at discharge.

Human Milk and Brain Development in Infants

Human milk is considered the most advantageous source of nourishment for infants. Even though there is no ideal composition of human milk, it still contains a unique combination of components that contribute to brain development. The aim of this review is to provide an overview on the possible correlation of human milk with the neurodevelopment of infants, with a special emphasis on myelination and epigenetic modifications. Research in human milk is a rapidly expanding field and cutting-edge technologies might contribute to identify specific mechanisms underlying the beneficial effects on human milk on neurodevelopment.