A Systematic Review on the Impact of Donor Characteristics and Donor Milk Handling on Infant Health and Growth

IF 9.2 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2026-04-01 Epub Date: 2026-02-19 DOI:10.1016/j.advnut.2026.100609

Daniel Klotz , Agnieszka Bzikowska-Jura , Marzia Giribaldi , Magdalena Babiszewska-Aksamit , Tanya Cassidy , Laura Cavallarin , Serena Gandino , Karolina Karcz , Chiara Peila , Carolyn Smith , Bartłomiej Walczak , Aleksandra Wesołowska

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Abstract

Global recommendations advocate the conditional use of donor human milk (DHM), yet evidence on the influence of donor characteristics and DHM treatment on premature infants’ health and growth is lacking. This study aimed to compare clinical outcomes of infants fed standard DHM compared with modified DHM-based on predefined variations. We performed a systematic review searching 14 databases alongside clinical trial registries, up to 8 March, 2024. Any study designs, but case or animal studies, conference proceedings, reviews, and gray literature were included. Findings were synthesized narratively and in tables. Of 14,979 screened studies, 14 met inclusion criteria comparing clinical effects of DHM from mothers who gave birth prematurely compared with at term, DHM that was treated with high-temperature pasteurization methods compared with standard holder pasteurization, and concentrated or homogenized DHM compared with standard DHM. Our analysis revealed a significant paucity of clinical data for several interventions and a complete lack of evidence for most of our research questions, indicating insufficient evidence to support the clinical use and efficacy of the aforementioned interventions. We found substantial evidence gaps in understanding how DHM treatments influence health and growth in premature infants. Research prioritizing clinical outcomes is essential to guide milk-banking policies.

The protocol was registered on PROSPERO as CRD42024522015.

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供体特征和供体奶处理对婴儿健康和生长影响的系统综述。

背景：全球建议提倡有条件地使用供体母乳（DHM），但关于供体特征和DHM治疗对早产儿健康和生长的影响的证据缺乏。目的：本研究旨在比较婴儿喂养标准DHM和基于预定义变化的改良DHM的临床结果。方法：我们对截至2024年3月8日的14个数据库以及临床试验注册进行了系统综述。该协议在PROSPERO上注册（CRD42024522015）。除病例或动物研究、会议记录、综述和灰色文献外的任何研究设计均被纳入。研究结果以叙述和表格形式综合。结果：在14,979项筛选研究中，14项符合纳入标准，比较早产与足月分娩母亲DHM的临床效果，高温巴氏灭菌方法处理DHM与标准巴氏灭菌方法处理DHM，浓缩或均质DHM与标准DHM的比较。我们的分析显示，一些干预措施的临床数据明显缺乏，而且我们的大多数研究问题完全缺乏证据，表明没有足够的证据支持上述干预措施的临床使用和疗效。结论：我们发现在理解DHM治疗如何影响早产儿健康和生长方面存在大量证据空白。优先考虑临床结果的研究对于指导母乳储备政策至关重要。系统评价或荟萃分析的注册中心和注册编号。该研究已在PROSPERO注册（CRD42024522015）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.