Improving the quality of donor human milk to take advantage of more of the health benefits of mother's own milk composition

Purpose of review Pasteurized donor human milk (PDHM) is the recommended supplement when there is inadequate volume of mother's own milk (MOM) for very low birth weight (<1500 g, VLBW) infants. Differences in the composition of these milks may impact growth, morbidities or long-term development of infants. The aim of this review is to highlight current trends in understanding compositional differences between MOM and PDHM, technological advances in processing PDHM, and infant outcomes when VLBW infants are fed these milks. Recent findings Reported differences in the composition between MOM and PDHM are due to several factors including when and how milk is collected, sampled for analysis, and processed. Systematic reviews and primary research studies demonstrate that PDHM reduces the risk of necrotizing enterocolitis in VLBW infants but is also associated with slower postnatal growth. Work is ongoing to determine if alternative approaches to processing PDHM can improve milk composition and thereby infant growth and neurodevelopment and reduce morbidity. Summary PDHM is a key component of feeding VLBW infants when there is inadequate volume of MOM. Recent developments aim to optimize this source of nutrition and bioactive compounds for VLBW infants while further understanding limitations of its use.