- Compared with donor breast milk, formula is associated with faster growth rates in preterm infants but at a cost of almost doubled risk for necrotizing enterocolitis.
Why this matters
- The cost-benefit balance of better growth vs enterocolitis risk is uncertain in these preterm infants for whom maternal breast milk is not available.
- Formula can be tougher for these babies to digest.
- This Cochrane review updates a 2014 review , but with little change in conclusions.
- All 11 included trials had methodological weaknesses, especially about blinding and randomization.
- Quality of evidence was moderate.
- Formula increases necrotizing enterocolitis risk vs donor milk (risk ratio,1.87; 95% CI, 1.23-2.85).
- Formula is tied to faster weight gain (mean difference, 2.51; 95% CI, 1.93-3.08 g/kg/day).
- Formula also was linked to faster gains in crown-heel length, head circumference.
- Older studies have found no difference at later timepoints in weight, length, head circumference, or in neurodevelopmental outcomes.
- Cochrane review of 11 randomized or quasirandomized controlled trials comparing formula vs donor feeding in 1809 infants.
- Funding: None disclosed.
- Limitations are related to those of the original studies.