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The Role of Donor Milk and Human Milk Banks in Promoting Maternal and Infant Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 6929

Special Issue Editors

Prof. Dr. Guido E. Moro

E-Mail Website
Guest Editor
Italian Association of Donated Milk Banks (AIBLUD), Milan, Italy
Interests: human milk; breast milk; nutrition; nutrition assessment
Prof. Dr. Enrico Bertino

E-Mail Website
Guest Editor
Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Interests: human milk composition; donor human milk; nutrition of preterm newborns; fortification of human milk; infant auxology; anthropometry
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Alessandra Coscia

E-Mail Website
Guest Editor
Neonatal Unit, Department of Pediatric and Adolescence Science, University of Turin, I-10126 Turin, Italy
Interests: human milk composition; donor human milk; nutrition of preterm newborns; fortification of human milk; infant nutrition

Special Issue Information

Dear Colleagues,

Given the evidence accumulating in recent decades underpinning its clinical benefits, human milk (HM) is indisputably the gold standard for feeding all neonates. Its unique macronutrient composition with optimal bioavailability, and the myriad bioactives exerting health promotion throughout life, make it particularly vital for preterm infants. Very preterm infants are exposed to specific challenges in neonatal intensive care units (NICUs) with high mortality and/or morbidity rates. HM feeding has been found (i) to have a protective effect against most of these challenges, such as necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and bacterial sepsis; (ii) to decrease mortality; and (iii) to improve both neurocognitive development and surrogate markers of cardiovascular disease. New neuroimaging studies searching for the impact of HM on brain volumes, structures, and the connectome reveal exciting dose-dependent improvements with HM use.

The current Special Issue aims to welcome original works and literature reviews further exploring the complexity of human milk composition and the mechanisms underlying the beneficial effects associated with breastfeeding, inviting all to explore “The amazing world of Human Milk Banking”.

Prof. Dr. Guido E. Moro
Prof. Dr. Enrico Bertino
Prof. Dr. Alessandra Coscia
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • human milk
  • human milk banking
  • donor milk
  • preterm infant feeding
  • breast milk
  • infant nutrition

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Published Papers (4 papers)

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Research

9 pages, 1179 KiB  
Communication
Three Years of Human Milk Banking: Assessing the Impact on Lactation Rates at Discharge in VLBW Preterm Infants in an Italian Reference NICU
by Federica Mongelli, Andrea Calandrino, Francesco Vinci, Cristina Traggiai, Daniela Rebora, Elena Maggiora and Luca Antonio Ramenghi
Nutrients 2025, 17(9), 1440; https://doi.org/10.3390/nu17091440 - 25 Apr 2025
Viewed by 248
Abstract
Background: Human milk (HM) offers critical short- and long-term benefits for preterm and very low birth weight (VLBW) infants. In 2021, a human milk bank (HMB) was established at the IRCCS Giannina Gaslini Institute, aiming to improve HM feeding rates in this vulnerable [...] Read more.
Background: Human milk (HM) offers critical short- and long-term benefits for preterm and very low birth weight (VLBW) infants. In 2021, a human milk bank (HMB) was established at the IRCCS Giannina Gaslini Institute, aiming to improve HM feeding rates in this vulnerable population. Methods: We retrospectively analyzed feeding data from 442 VLBW infants (BW < 1500 g) admitted between 2018 and 2024. Data were drawn from the Vermont Oxford Network and Italian Neonatal Network registries. Feeding modalities—exclusive HM, infant formula milk (IM), and mixed feeding (MF)—were recorded and analyzed before and after HMB introduction. Results: Before 2021, MF was predominant, with exclusive HM rates below 10%. Following HMB implementation, exclusive HM feeding increased significantly, reaching 47.2% in 2024 (p < 0.0001). Regression analysis showed a positive trend for HM (+4.84%/year, p = 0.05), and a declining trend for IM (−1.96%/year) and MF (−2.88%/year). Projections suggest HM rates may exceed 58% by 2030. Conclusions: The introduction of the HMB was associated with a significant shift in feeding practices, increasing HM use and reducing IM exposure among VLBW infants. These findings underscore the importance of institutional strategies such as donor milk availability, lactation support, and maternal education in optimizing neonatal nutrition. Ongoing efforts are essential to sustain and extend these improvements beyond NICU discharge, ensuring the long-term benefits of human milk for preterm infants. Full article
(This article belongs to the Special Issue The Role of Donor Milk and Human Milk Banks in Promoting Maternal and Infant Health)
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22 pages, 1173 KiB  
Article
Impact of Enteral Nutrition on Clinical Outcomes in Very Low Birth Weight Infants in the NICU: A Single-Center Retrospective Cohort Study
by Pasqua Anna Quitadamo, Laura Comegna, Alessandra Zambianco, Giuseppina Palumbo, Maria Assunta Gentile and Antonio Mondelli
Nutrients 2025, 17(7), 1138; https://doi.org/10.3390/nu17071138 - 25 Mar 2025
Viewed by 1261
Abstract
Background/Objectives: Maternal milk feeding in the NICU (neonatal intensive care unit) for very low birth weight (VLBW) infants mitigates the effects of preterm birth. This single-center retrospective study analyzed data from VLBW infants born between 2005 and 2019 and investigated the impact [...] Read more.
Background/Objectives: Maternal milk feeding in the NICU (neonatal intensive care unit) for very low birth weight (VLBW) infants mitigates the effects of preterm birth. This single-center retrospective study analyzed data from VLBW infants born between 2005 and 2019 and investigated the impact on morbidity of exposure to Mother’s Own Milk (MOM), donor human milk (DHM), preterm formula (PF), during NICU hospitalization. The assessed outcomes included necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and late-onset sepsis (LOS). The study also examined the impact of a human milk-based feeding protocol on these outcomes, adjusting for confounding factors. Methods: Statistical analysis involved correlation tests and odds ratios to assess associations between feeding types and outcomes. Results: Surgical NEC occurred in 10% of infants fed exclusively with PF, 1.3% of those fed with DHM, and was completely absent in infants fed exclusively or partially with MOM. ROP across all stages was observed in 24.3% of cases, with severe ROP at 4.7%, and PF feeding was associated with a higher risk of severe ROP; the incidence of LOS was lower in infants fed human milk (−22%/−66%) compared to 10% in formula-fed infants. BPD affected 25.5% of infants, with moderate-to-severe BPD in 22.2%. The association between NEC, LOS, and feeding was statistically significant, even after adjusting for covariates. The type of milk had a significant impact on the incidence of severe forms of all outcomes (p < 0.001). The rate of exclusive MOM feeding increased over time, reaching 45% in 2018–2019. Conclusions: These findings highlight the role of human milk in preventing NEC and LOS, in reducing the risk of severe ROP and BPD, and in promoting MOM feeding, with rates increasing significantly when DHM is available. Full article
(This article belongs to the Special Issue The Role of Donor Milk and Human Milk Banks in Promoting Maternal and Infant Health)
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15 pages, 729 KiB  
Article
Clinical Impact of Supplementation with Pasteurized Donor Human Milk by High-Temperature Short-Time Method versus Holder Method in Extremely Low Birth Weight Infants: A Multicentre Randomized Controlled Trial
by Nadia Raquel García-Lara, Diana Escuder-Vieco, Marta Cabrera-Lafuente, Kristin Keller, Cristina De Diego-Poncela, Concepción Jiménez-González, Raquel Núñez-Ramos, Beatriz Flores-Antón, Esperanza Escribano-Palomino, Clara Alonso-Díaz, Sara Vázquez-Román, Noelia Ureta-Velasco, Javier De La Cruz-Bértolo and Carmen Rosa Pallás-Alonso
Nutrients 2024, 16(7), 1090; https://doi.org/10.3390/nu16071090 - 8 Apr 2024
Cited by 2 | Viewed by 2111
Abstract
Nosocomial infections are a frequent and serious problem in extremely low birth weight (ELBW) infants. Donor human milk (DHM) is the best alternative for feeding these babies when mother’s own milk (MOM) is not available. Recently, a patented prototype of a High-Temperature Short-Time [...] Read more.
Nosocomial infections are a frequent and serious problem in extremely low birth weight (ELBW) infants. Donor human milk (DHM) is the best alternative for feeding these babies when mother’s own milk (MOM) is not available. Recently, a patented prototype of a High-Temperature Short-Time (HTST) pasteurizer adapted to a human milk bank setting showed a lesser impact on immunologic components. We designed a multicentre randomized controlled trial that investigates whether, in ELBW infants with an insufficient MOM supply, the administration of HTST pasteurized DHM reduces the incidence of confirmed catheter-associated sepsis compared to DHM pasteurized with the Holder method. From birth until 34 weeks postmenstrual age, patients included in the study received DHM, as a supplement, pasteurized by the Holder or HTST method. A total of 213 patients were randomized; 79 (HTST group) and 81 (Holder group) were included in the analysis. We found no difference in the frequency of nosocomial sepsis between the patients of the two methods—41.8% (33/79) of HTST group patients versus 45.7% (37/81) of Holder group patients, relative risk 0.91 (0.64–1.3), p = 0.62. In conclusion, when MOM is not available, supplementing during admission with DHM pasteurized by the HTST versus Holder method might not have an impact on the incidence of catheter-associated sepsis. Full article
(This article belongs to the Special Issue The Role of Donor Milk and Human Milk Banks in Promoting Maternal and Infant Health)
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19 pages, 800 KiB  
Article
Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study
by Manuela Cardoso, Daniel Virella, Ana Luísa Papoila, Marta Alves, Israel Macedo, Diana e Silva and Luís Pereira-da-Silva
Nutrients 2023, 15(6), 1533; https://doi.org/10.3390/nu15061533 - 22 Mar 2023
Cited by 7 | Viewed by 2565
Abstract
The optimal method for human milk (HM) fortification has not yet been determined. This study assessed whether fortification relying on measured HM macronutrient content (Miris AB analyzer, Upsala, Sweden) composition is superior to fortification based on assumed HM macronutrient content, to optimize the [...] Read more.
The optimal method for human milk (HM) fortification has not yet been determined. This study assessed whether fortification relying on measured HM macronutrient content (Miris AB analyzer, Upsala, Sweden) composition is superior to fortification based on assumed HM macronutrient content, to optimize the nutrition support, growth, and body composition in infants born at <33 weeks’ gestation. In a mixed-cohort study, 57 infants fed fortified HM based on its measured content were compared with 58 infants fed fortified HM based on its assumed content, for a median of 28 and 23 exposure days, respectively. The ESPGHAN 2010 guidelines for preterm enteral nutrition were followed. Growth assessment was based on body weight, length, and head circumference Δ z-scores, and the respective growth velocities until discharge. Body composition was assessed using air displacement plethysmography. Fortification based on measured HM content provided significantly higher energy, fat, and carbohydrate intakes, although with a lower protein intake in infants weighing ≥ 1 kg and lower protein-to-energy ratio in infants weighing < 1 kg. Infants fed fortified HM based on its measured content were discharged with significantly better weight gain, length, and head growth. These infants had significantly lower adiposity and greater lean mass near term-equivalent age, despite receiving higher in-hospital energy and fat intakes, with a mean fat intake higher than the maximum recommended and a median protein-to-energy ratio intake (in infants weighing < 1 kg) lower than the minimum recommended. Full article
(This article belongs to the Special Issue The Role of Donor Milk and Human Milk Banks in Promoting Maternal and Infant Health)
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