{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:26:46Z","timestamp":1792204006324,"version":"4.4.0"},"reference-count":90,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T00:00:00Z","timestamp":1527724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>This systematic review and meta-analysis synthesised the post-1990 literature examining the effect of human milk on morbidity, specifically necrotising enterocolitis (NEC), late onset sepsis (LOS), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) and neurodevelopment in infants born \u226428 weeks\u2019 gestation and\/or publications with reported infant mean birth weight of \u22641500 g. Online databases including Medline, PubMed, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched, and comparisons were grouped as follows: exclusive human milk (EHM) versus exclusive preterm formula (EPTF), any human milk (HM) versus EPTF, higher versus lower dose HM, and unpasteurised versus pasteurised HM. Experimental and observational studies were pooled separately in meta-analyses. Risk of bias was assessed for each individual study and the GRADE system used to judge the certainty of the findings. Forty-nine studies (with 56 reports) were included, of which 44 could be included in meta-analyses. HM provided a clear protective effect against NEC, with an approximate 4% reduction in incidence. HM also provided a possible reduction in LOS, severe ROP and severe NEC. Particularly for NEC, any volume of HM is better than EPTF, and the higher the dose the greater the protection. Evidence regarding pasteurisation is inconclusive, but it appears to have no effect on some outcomes. Improving the intake of mother\u2019s own milk (MOM) and\/or donor HM results in small improvements in morbidity in this population.<\/jats:p>","DOI":"10.3390\/nu10060707","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T03:02:50Z","timestamp":1527822170000},"page":"707","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":392,"title":["A Systematic Review and Meta-Analysis of Human Milk Feeding and Morbidity in Very Low Birth Weight Infants"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6474-0505","authenticated-orcid":false,"given":"Jacqueline","family":"Miller","sequence":"first","affiliation":[{"name":"Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"Nutrition and Dietetics, Flinders University, Adelaide, SA 5001, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-4251","authenticated-orcid":false,"given":"Emma","family":"Tonkin","sequence":"additional","affiliation":[{"name":"Nutrition and Dietetics, Flinders University, Adelaide, SA 5001, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6737-7537","authenticated-orcid":false,"given":"Raechel A.","family":"Damarell","sequence":"additional","affiliation":[{"name":"Nutrition and Dietetics, Flinders University, Adelaide, SA 5001, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"McPhee","sequence":"additional","affiliation":[{"name":"Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"Neonatal Medicine, Women\u2019s and Children\u2019s Hospital, Adelaide, SA 5006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machiko","family":"Suganuma","sequence":"additional","affiliation":[{"name":"Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Suganuma","sequence":"additional","affiliation":[{"name":"Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippa F.","family":"Middleton","sequence":"additional","affiliation":[{"name":"Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"Adelaide Medical School, Discipline of Paediatrics, The University of Adelaide, Adelaide, SA 5006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3832-541X","authenticated-orcid":false,"given":"Maria","family":"Makrides","sequence":"additional","affiliation":[{"name":"Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"Adelaide Medical School, Discipline of Paediatrics, The University of Adelaide, Adelaide, SA 5006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel T.","family":"Collins","sequence":"additional","affiliation":[{"name":"Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"Adelaide Medical School, Discipline of Paediatrics, The University of Adelaide, Adelaide, SA 5006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/MPG.0b013e3181adaee0","article-title":"Enteral nutrient supply for preterm infants: Commentary from the european society of paediatric gastroenterology, hepatology and nutrition committee on nutrition","volume":"50","author":"Agostoni","year":"2010","journal-title":"J. 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