Meta-analysis of the effects of donor human milk versus formula feeding on  complications, growth, and length of hospital stay in preterm infants

FANG Shuang; ZHU Libo; SHI Xiaojie; LIU Ling

doi:10.11852/zgetbjzz2025-1001

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (4) : 411-417. DOI: 10.11852/zgetbjzz2025-1001

Special Column on Nutrition/Feeding and Allergic Diseases

Meta-analysis of the effects of donor human milk versus formula feeding on complications, growth, and length of hospital stay in preterm infants

FANG Shuang^1,2, ZHU Libo², SHI Xiaojie^1,2, LIU Ling²

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Abstract

Objective To systematically evaluate the effects of donor human milk (DHM) versus formula feeding on complications, growth, and length of hospital stay in preterm infants, so as to provide reference for prioritizing nutritional support strategies for preterm infants. Methods Randomized controlled trials (RCT) comparing DHM feeding with formula feeding were searched from database inception to May 1st, 2025.Data were extracted and pooled using RevMan 5.4. Results A total of 18 articles were included.Meta-analysis results showed that compared with formula feeding, DHM feeding significantly reduced the incidence of necrotizing enterocolitis (NEC)(RR=0.65, 95%CI: 0.51 - 0.84), feeding intolerance (RR=0.63, 95%CI: 0.42 - 0.94), and infection (RR=0.84, 95%CI: 0.72 - 0.98), and shortened the time to full enteral nutrition (MD=-7.44, 95%CI: -8.48 to -6.39) and length of hospital stay (MD=-3.97, 95%CI: -5.10 to -2.85) (P＜0.05).However, growth rates were significantly lower in the DHM group(P＜0.05), including head circumference (MD=-0.06, 95%CI: -0.08 to -0.03), length (MD=-0.07, 95%CI: -0.10 to -0.05), and weight gain (MD=-0.61, 95%CI: -0.73 to -0.49).No significant differences were found in the prevalence rates ofbronchopulmonary dysplasia or retinopathy of prematurity (P＞0.05). Conclusions DHM feeding is associated with lower risks of NEC, feeding intolerance, and infection, and shorter time to full enteral nutrition and hospital stay compared with formula feeding.However, growth outcomes are less favorable, suggesting that appropriate fortification may be required to support growth in preterm infants, and further high-quality RCT are warranted to confirm these findings.

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donor human milk / formula milk / systematic review / preterm infants / Meta-analysis

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FANG Shuang, ZHU Libo, SHI Xiaojie, LIU Ling. Meta-analysis of the effects of donor human milk versus formula feeding on complications, growth, and length of hospital stay in preterm infants[J]. Chinese Journal of Child Health Care. 2026, 34(4): 411-417 https://doi.org/10.11852/zgetbjzz2025-1001

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