{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:03:21Z","timestamp":1792191801851,"version":"4.4.0"},"reference-count":59,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n \n Human milk\u2010based fortifiers (\n HMBFs<\/jats:styled-content>\n ) have been adopted in neonatal care despite limited efficacy data. Our objective was to conduct a Bayesian re\u2010analysis of the current evidence on the protective effect of\n HMBF<\/jats:styled-content>\n against necrotising enterocolitis (\n NEC<\/jats:styled-content>\n , stage\n II<\/jats:styled-content>\n \u2010\n III<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We searched for randomised controlled trials (\n RCTs<\/jats:styled-content>\n ) comparing\n HMBF<\/jats:styled-content>\n versus bovine milk\u2010based fortifier (\n BMBF<\/jats:styled-content>\n ) in infants with gestational age <\u200932\u2009weeks or birthweight <\u20091500\u2009g. Bayesian model\u2010averaged (\n BMA<\/jats:styled-content>\n ) meta\u2010analysis was used to calculate Bayes factors (\n BFs<\/jats:styled-content>\n ). The\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n is the ratio of the probability of the data under the alternative hypothesis (\n \n H\n 1<\/jats:sub>\n <\/jats:styled-content>\n , presence of effect) over the probability of the data under the null hypothesis (\n \n H\n 0<\/jats:sub>\n <\/jats:styled-content>\n , absence of effect).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We included 3\n RCTs<\/jats:styled-content>\n (405 infants). The\n BMA<\/jats:styled-content>\n analysis did not show conclusive evidence in favour of\n \n H\n 1<\/jats:sub>\n <\/jats:styled-content>\n (\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n \u2009>\u20093) or in favour of\n \n H\n 0<\/jats:sub>\n <\/jats:styled-content>\n (\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n \u2009<\u20091\/3) for\n NEC<\/jats:styled-content>\n (\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n \u2009=\u20090.86), mortality (\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n \u2009=\u20091.07), late onset sepsis (\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n \u2009=\u20090.69), bronchopulmonary dysplasia (\n BPD<\/jats:styled-content>\n ,\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n \u2009=\u20090.92), or severe retinopathy of prematurity (\n ROP<\/jats:styled-content>\n ,\n \n BF\n 10<\/jats:sub>\n <\/jats:styled-content>\n \u2009=\u20090.75).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The extant corpus of\n RCTs<\/jats:styled-content>\n does not provide sufficient evidence to either confirm or exclude a potential effect of\n HMBF<\/jats:styled-content>\n compared with\n BMBF<\/jats:styled-content>\n on the risk of\n NEC<\/jats:styled-content>\n , mortality, sepsis,\n BPD<\/jats:styled-content>\n , or severe\n ROP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apa.70260","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T14:52:33Z","timestamp":1753800753000},"page":"3309-3316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Absence of Evidence of Beneficial Effects of Human Milk\u2010Based Fortifier: A Bayesian Model\u2010Averaged Meta\u2010Analysis"],"prefix":"10.1111","volume":"114","author":[{"given":"Maurice J.","family":"Huizing","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, MosaKids Children's Hospital, Maastricht University Medical Center (MUMC+), School for Oncology and Reproduction (GROW) Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Vizzari","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS ca' Granda Ospedale Maggiore Policlinico, NICU Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-5573","authenticated-orcid":false,"given":"Franti\u0161ek","family":"Barto\u0161","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4921-1437","authenticated-orcid":false,"given":"Giacomo","family":"Cavallaro","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS ca' Granda Ospedale Maggiore Policlinico, NICU Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria L.","family":"Gianni","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS ca' Granda Ospedale Maggiore Policlinico, NICU Milan Italy"},{"name":"Department of Clinical Sciences and Community Health University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1949-9123","authenticated-orcid":false,"given":"Eduardo","family":"Villamor","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, MosaKids Children's Hospital, Maastricht University Medical Center (MUMC+), School for Oncology and Reproduction (GROW) Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"S16","article-title":"Human Milk in Feeding Premature Infants: Consensus Statement","volume":"61","author":"Moro G.","year":"2015","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3182a3af0a"},{"key":"e_1_2_12_4_1","article-title":"Policy Statement: Breastfeeding and the Use of Human Milk","volume":"150","author":"Meek J. 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