Academic Journal
Human Milk-Derived Versus Bovine Protein-Based Fortifiers for Preterm Infants Fed Human Milk: A Systematic Review and Meta-Analysis.
| Τίτλος: | Human Milk-Derived Versus Bovine Protein-Based Fortifiers for Preterm Infants Fed Human Milk: A Systematic Review and Meta-Analysis. |
|---|---|
| Συγγραφείς: | Lin L; Liggins Institute, University of Auckland, Auckland 1023, New Zealand., Embleton ND; Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 4LP, UK., Van Den Akker CHP; Department of Pediatrics-Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, 1005 AZ Amsterdam, The Netherlands.; Amsterdam Reproduction and Development Research Institute, 1005 AZ Amsterdam, The Netherlands., Brown J; Covidence, Future Evidence Foundation, Melbourne 3000, Australia., Delgado Paramo L; Liggins Institute, University of Auckland, Auckland 1023, New Zealand., Cormack BE; Liggins Institute, University of Auckland, Auckland 1023, New Zealand.; Starship Child Health, Auckland City Hospital, Auckland 1023, New Zealand. |
| Πηγή: | Nutrients [Nutrients] 2026 Oct 07; Vol. 18 (19). Date of Electronic Publication: 2026 Oct 07. |
| Τύπος έκδοσης: | Journal Article; Systematic Review; Meta-Analysis; Comparative Study; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: MDPI Publishing Country of Publication: Switzerland NLM ID: 101521595 Publication Model: Electronic Cited Medium: Internet ISSN: 2072-6643 (Electronic) Linking ISSN: 20726643 NLM ISO Abbreviation: Nutrients Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Basel, Switzerland : MDPI Publishing |
| Ιατρικοί όροι (MeSH): | Milk, Human*/chemistry , Milk Proteins*/administration & dosage , Infant, Premature* , Food, Fortified* , Infant Formula*, Enterocolitis, Necrotizing/prevention & control ; Humans ; Infant, Newborn ; Animals ; Cattle ; Randomized Controlled Trials as Topic ; Infant Nutritional Physiological Phenomena ; Female ; Infant, Very Low Birth Weight |
| Περίληψη: | Background: Human milk-derived fortifiers (HumBMF) are an alternative to bovine protein-based fortifiers (BovBMF) for preterm infants, but their comparative effectiveness and safety remain uncertain. We evaluated the effects of HumBMF versus BovBMF in preterm or very low birth weight infants. Methods: Randomised controlled trials (RCTs) comparing use of HumBMF versus BovBMF to fortify human milk were identified through four databases and three trial registries (to 11 May 2026). At least two reviewers independently screened studies, extracted data, and assessed risk of bias. Fixed-effect meta-analyses and GRADE assessments were performed. Prespecified analyses separated trials comparing fortifier type alone, in which any mother's own milk (MOM) shortfall was supplemented with donor human milk (DHM) in both arms; and dual-intervention trials, in which MOM shortfall was also randomised to DHM in the HumBMF arm or preterm formula in the BovBMF arm. Results: Nine RCTs were included. In trials comparing fortifier type alone, there was no evidence that HumBMF reduced mortality (RR 0.60 (95% CI 0.29-1.23), low-certainty) or necrotising enterocolitis (NEC; RR 0.83 (0.39-1.78), very low-certainty). In dual-intervention trials, where MOM shortfall was supplemented with DHM rather than formula, NEC was lower (RR 0.45 (0.20-0.99), moderate-certainty). Conclusions: Current evidence does not demonstrate clinical advantages of HumBMF over BovBMF when added to the same human milk diet. Reductions in NEC occurred only where DHM also replaced preterm formula and cannot be attributed to fortifier type alone. Future research should distinguish the independent effects of fortifier composition from those of an exclusive human milk feeding strategy. |
| References: | Acta Paediatr. 2025 Dec;114(12):3309-3316. (PMID: 40729426) J Pediatr Gastroenterol Nutr. 1999 Sep;29(3):332-8. (PMID: 10468001) Nutrients. 2025 Oct 28;17(21):. (PMID: 41228457) Hosp Pediatr. 2025 Jul 1;15(7):616-622. (PMID: 40461048) J Perinatol. 2026 Apr 27;:. (PMID: 42045666) J Perinatol. 2024 Sep;44(9):1320-1324. (PMID: 38658693) Breastfeed Med. 2014 May;9(4):184-90. (PMID: 24588561) Cochrane Database Syst Rev. 2020 Jun 03;6:CD000343. (PMID: 35658821) J Pediatr Gastroenterol Nutr. 2025 Feb;80(2):336-344. (PMID: 39660504) Nutrients. 2020 Oct 06;12(10):. (PMID: 33036184) Cochrane Database Syst Rev. 2024 Sep 6;9:CD002971. (PMID: 39239939) Am J Clin Nutr. 2018 Jul 1;108(1):108-116. (PMID: 29878061) Nutrients. 2018 May 31;10(6):. (PMID: 29857555) JAMA Netw Open. 2023 Mar 1;6(3):e231165. (PMID: 36857051) Eur J Pediatr. 1993 Dec;152(12):1036-9. (PMID: 8131806) Breastfeed Med. 2016 Mar;11(2):70-4. (PMID: 26789484) Front Nutr. 2021 Jan 15;7:603090. (PMID: 33521036) Curr Dev Nutr. 2019 Nov 12;3(12):nzz129. (PMID: 32154499) BMJ. 2021 Mar 29;372:n71. (PMID: 33782057) Pediatr Res. 2026 Jul 18;:. (PMID: 42471466) Front Nutr. 2021 Jul 29;8:702888. (PMID: 34395496) J Pediatr. 2010 Apr;156(4):562-7.e1. (PMID: 20036378) Environ Plan A. 2021 Aug;53(5):958-976. (PMID: 34381290) J Perinatol. 2023 Sep;43(9):1113-1118. (PMID: 37085523) Adv Nutr. 2020 Sep 1;11(5):1325-1333. (PMID: 32277813) Nutrients. 2024 Mar 21;16(6):. (PMID: 38542821) J Pediatr Gastroenterol Nutr. 2023 Feb 1;76(2):248-268. (PMID: 36705703) EClinicalMedicine. 2024 Jan 02;68:102375. (PMID: 38545091) BMJ. 2019 Aug 28;366:l4898. (PMID: 31462531) Microb Cell Fact. 2021 May 28;20(1):108. (PMID: 34049536) Br J Nutr. 2022 Dec 28;128(12):2490-2497. (PMID: 35144698) JAMA Pediatr. 2013 Sep;167(9):836-44. (PMID: 23896931) Gut. 2021 Dec;70(12):2273-2282. (PMID: 33328245) Front Pediatr. 2019 Mar 22;7:76. (PMID: 30968003) J Paediatr Child Health. 2026 Mar;62(3):406-421. (PMID: 41503953) |
| Contributed Indexing: | Keywords: breast milk fortifier; donor human milk; multinutrient fortification; necrotising enterocolitis; preterm infant; systematic review |
| Substance Nomenclature: | 0 (Milk Proteins) |
| Entry Date(s): | Date Created: 20261016 Date Completed: 20261016 Latest Revision: 20261020 |
| Update Code: | 20261020 |
| PubMed Central ID: | PMC13666894 |
| DOI: | 10.3390/nu18193288 |
| PMID: | 42884739 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!