Investigating Donor Human Milk Composition Globally to Develop Effective Strategies for the Nutritional Care of Preterm Infants

Donor human milk (DHM) is the recommended food for small vulnerable infants when mother's milk is not available, due to evidence that it protects against NEC. While DHM use is increasing around the world, there are significant knowledge gaps about DHM that imped clinical care. This project addresses DHM knowledge gaps through a study conducted with eight geographically diverse milk bank partners in high, middle, and low-income settings. We examine and compare a broad range of nutrients in milk from 600 approved milk bank donors around the world to create comprehensive, geographically diverse nutrient profiles for DHM (Aim 1). Milk bank-level practices for pooling donors are evaluated using simulation to identify effective strategies that can be used by milk banks to create more consistent nutrient profiles in DHM (Aim 2). Finally, we evaluate whether currently available commercial fortifiers meet nutrient recommendations when used with DHM and identify nutrients to enhance in the development of a DHM-specific fortifiers (Aim 3).