SynthesisAdvances in nutrition (Bethesda, Md.)2020
Human Milk-Derived Fortifiers Compared with Bovine Milk-Derived Fortifiers in Preterm Infants: A Systematic Review and Meta-Analysis.
Synthesis in Advances in nutrition (Bethesda, Md.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Exclusive human milk diet and mortality before discharge in premature and very low birthweight infants: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- Absence of Evidence of Beneficial Effects of Human Milk-Based Fortifier: A Bayesian Model-Averaged Meta-Analysis.Acta paediatrica (Oslo, Norway : 1992) · 2025Pooled it
- Pooled it
- Difference in the Intestinal Microbiota between Breastfeed Infants and Infants Fed with Artificial Milk: A Systematic Review.Pathogens (Basel, Switzerland) · 2024Pooled it
- Trial
- Gut microbiota development in very preterm infants following fortification of human milk.mSystems · 2025Trial
- Current enteral feeding practices for premature infants in neonatal intensive care units in the Middle East and North Africa.JPGN reports · 2026Article
- Bovine colostrum as a human milk fortifier for very preterm infants with slow feeding advancement: a randomized controlled trial.Pediatric research · 2026Article
- Narrative review of human milk fortifiers for preterm infants.Frontiers in pediatrics · 2026Review
- Risk factors associated with the development of necrotizing enterocolitis in preterm infants on an exclusive human milk diet: a single-center case-control study.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Benefits of an Exclusive Human Milk Diet in a Very Preterm Infant With an Ileostomy: A Case Report.Cureus · 2025Article
- EGF and IgA in maternal milk, donor milk, and milk fortifiers in the neonatal intensive care unit setting.PloS one · 2025Article
- Bovine Colostrum in Pediatric Nutrition and Health.Nutrients · 2024Review
- Strategies for the Fortification of Human Milk in Preterm Infants: A Systematic Review.Cureus · 2024Review
- Is choline deficiency an unrecognized factor in necrotizing enterocolitis of preterm infants?Pediatric research · 2024Review
- Unexpected decrease in necrotizing enterocolitis morbidity during the COVID-19 pandemic-A single-centre retrospective study.Frontiers in pediatrics · 2024Article
- Human Milk Feeding and Direct Breastfeeding Improve Outcomes for Infants With Single Ventricle Congenital Heart Disease: Propensity Score-Matched Analysis of the NPC-QIC Registry.Journal of the American Heart Association · 2023Article
- Human milk feeding and direct breastfeeding improve outcomes for infants with single ventricle congenital heart disease: Propensity score matched analysis of the NPC-QIC registry.medRxiv : the preprint server for health sciences · 2023Article
- Hyaluronic Acid 35 kDa Protects against a Hyperosmotic, Formula Feeding Model of Necrotizing Enterocolitis.Nutrients · 2022Article
- Using Nature to Nurture: Breast Milk Analysis and Fortification to Improve Growth and Neurodevelopmental Outcomes in Preterm Infants.Nutrients · 2021Review
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This systematic review assessed outcomes after using human milk-derived fortifier (HMF) compared with bovine milk-derived fortifier (BMF) in preterm infants. Six randomized controlled trials (RCTs) were included. Meta-analysis using a random-effects model showed the following results: 1) lower risk of necrotizing enterocolitis (NEC; ≥Stage II) (RR: 0.38; 95% CI: 0.15, 0.95; P = 0.04, I2 = 9%; n = 334, 4 RCTs) and surgical NEC (RR: 0.13; 95% CI: 0.02, 0.67; P = 0.02, I2 = 0%; n = 209, 3 RCTs) in the HMF group; 2) no significant difference in mortality (RR: 0.40; 95% CI: 0.14, 1.15; P = 0.09, I2 = 0%; n = 334, 4 RCTs); 3) lower weight gain in the HMF group [mean difference (MD) = -1.08 g · kg-1 · d-1; 95% CI: -1.96, -0.21 g · kg-1 · d-1; P = 0.02, I2 = 0%; n = 241, 4 RCTs]; 4) no differences for length (MD = -0.11 cm/wk; 95% CI: -0.26, 0.04 cm/wk; P = 0.14, I2 = 68%) and head circumference (MD = -0.02 cm/wk; 95% CI: -0.08, 0.05 cm/wk; P = 0.59, I2 = 23%); and 5) no significant difference in late-onset sepsis (RR: 0.96; 95% CI: 0.56, 1.67; P = 0.90, I2 = 63%; n = 334, 4 RCTs). The beneficial effects of HMF for NEC were no longer significant in sensitivity analyses after excluding studies with high risk of bias. Quality of evidence as per Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis was low to very low, and hence the confidence in these results is low. In summary, fortification of milk in preterm infants with HMF compared with BMF decreased the risk of NEC but was associated with lower weight gain. Given the low quality of evidence, adequately powered and well-designed RCTs without the influence of industry are required in this field.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.