Initiation of Enteral Feeding with Mother’s Own Milk or Donor Human Milk in Very Preterm Infants: Impact on Bronchopulmonary Dysplasia and Other Prematurity-Related Morbidities

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Background: Bronchopulmonary dysplasia (BPD) is a major complication among preterm infants, and nutrition plays a crucial role in its prevention and management. While the nutritional superiority of human milk over preterm formula is well documented, comparisons of the protective benefits of mother’s own milk (MOM) versus donor human milk (DHM) in preterm infants are lacking. We aim to investigate if and how the use of MOM or DHM at the initiation of enteral feeding influences the development of BPD and other respiratory outcomes. Methods: This study evaluated the incidence of BPD and other prematurity outcomes in a cohort of 159 very preterm infants (≤32 weeks GA) who commenced enteral feeding with either MOM or DHM. Results: Enteral feeding was initiated with MOM in 75.5% of the infants and DHM in 24.5%. The incidence of BPD was 24.8% (39 infants), and 10.4% (16 infants) developed moderate-to-severe BPD. Univariate and multivariate analyses revealed no significant differences between the MOM and DHM groups in the rates of BPD, other respiratory outcomes, or key prematurity-related morbidities. Conclusions: Despite the unique bioactive properties of MOM, these findings suggest that DHM is a valid alternative that does not significantly increase the incidence of BPD or other clinical outcomes. Further studies are required to determine the relative contributions of milk volumes and feeding practices to the observed findings.

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