Background: 

Growing evidence supports the superior benefits of exposure to mother's own milk (MOM) in reducing prematurity-related comorbidities. Neonatal exposure to donor human Milk (DHM) is a suitable alternative when MOM is insufficient or unavailable. However, the same protective composition and bioactivity in MOM are not present in DHM. Additional evidence is needed to justify and inform evidence-based practices increasing MOM provision while optimizing adequate use of DHM for premature infants.

Purpose: 

A systematic review of the literature was conducted to determine differences in neonatal outcomes among premature infants exposed to predominately MOM versus DHM.

Methods/Search Strategy: 

Databases including PubMed, CINAHL and Cochrane were searched (2020-2021) using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines. Evidence was classified using the John Hopkins evidence-based practice levels and quality of evidence.

Results: 

Eleven studies met inclusion criteria. Studied neonatal outcomes included (a) growth parameters (n = 8), (b) neonatal morbidities (n = 6), and (c) gut microbiome (n = 4). Overall, evidence suggests DHM exposure is beneficial but not equivalent to MOM feeding. Compared with DHM, greater doses of MOM are ideal to enhance protection primarily related to infant growth, as well as gut microbiome diversity and richness.

Implications for Practice: 

Standardized and evidence-based practices are needed to clearly delineate optimal use of DHM without undermining maternal and neonatal staff efforts to support and promote provision of MOM.

Implications for Research: 

Additional evidence from high-quality studies should further examine differences in neonatal outcomes among infants exposed to predominately MOM or DHM in settings using standardized and evidence-based feeding practices.

中文翻译：

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接触母乳和捐赠母乳的早产儿新生儿结局的差异

背景： 

越来越多的证据支持接触母乳 (MOM) 在减少早产相关合并症方面的优势。当 MOM 不足或不可用时，新生儿接触供体母乳 (DHM) 是一种合适的选择。然而，DHM 中不存在 MOM 中相同的保护成分和生物活性。需要更多的证据来证明和告知循证实践，增加 MOM 供应，同时优化早产儿 DHM 的充分使用。

目的： 

对文献进行了系统回顾，以确定主要暴露于 MOM 与 DHM 的早产儿的新生儿结局差异。

方法/搜索策略： 

包括 PubMed、CINAHL 和 Cochrane 在内的数据库使用 PRISMA（系统评价和荟萃分析的首选报告项目）指南进行了搜索（2020-2021 年）。使用约翰霍普金斯循证实践水平和证据质量对证据进行分类。

结果： 

11 项研究符合纳入标准。研究的新生儿结局包括 ( a )生长参数(n = 8)，( b )新生儿发病率(n = 6)，和 ( c )肠道微生物组(n = 4)。总体而言，证据表明 DHM 暴露是有益的，但不等同于 MOM 喂养。与 DHM 相比，更大剂量的 MOM 是增强主要与婴儿生长相关的保护以及肠道微生物组多样性和丰富度的理想选择。

实践意义： 

需要标准化和循证实践来明确描述 DHM 的最佳使用，同时不损害孕产妇和新生儿工作人员支持和促进提供 MOM 的努力。

研究意义： 

来自高质量研究的额外证据应进一步检查在使用标准化和循证喂养方式的环境中主要暴露于 MOM 或 DHM 的婴儿的新生儿结局差异。