Donor human milk banking in neonatal intensive care

Abstract

Donor human milk banking has been practiced for over 100 years and is used where a mother's own milk is unavailable for her infant. With this historical practice has come evidence for the clinical use of pasteurised donor human milk (PDHM) primarily to reduce the risk of necrotising enterocolitis (NEC) in the preterm very low birth weight infant. However, clinicians are not universal in their support for the use of donor human milk in these at risk patients. Some remain unconvinced at the evidence for benefit and some may remain concerned regarding the safety of the product. These safety concerns can only be addressed through the proper management of donor human milk banking. This chapter reviews the current evidence for the use of pasteurised donor human milk and examines how recent developments in management practice in human milk banking are addressing these concerns. When a mother's own milk is unavailable, PDHM remains a viable feeding option where an infant is at risk of NEC. With an ongoing focus on safety in practice and demonstration of benefits through research, donor human milk banking may remain relevant for another 100 years.