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Child health
Feeding preterm infants with formula rather than donor breast milk is associated with faster rates of short-term growth, but increased risk of developing necrotising enterocolitis
  1. Karen Tosh
  1. Correspondence to Karen Tosh, School of Nursing and Health Sciences, University of Dundee, Dundee DD1 4HJ, UK; k.tosh{at}

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Commentary on: Quigley M, Embleton ND, McGuire W. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2018;6:CD002971.

Implications for practice and research

  • Formula milk offers short-term benefits but may not result in any long-term benefits for growth or development over donor breast milk.

  • Formula milk appears to significantly increase risk of necrotising enterocolitis.

  • Further methodologically rigorous randomised controlled trials are required to support early enteral feeding strategies.


Artificial formulas and donor breast milk are used as supplements or alternatives for enteral feeding of preterm and low birthweight (LBW) infants when maternal breast milk is insufficient or unavailable. Formula milk offers a degree of certainty in nutritional delivery for infant growth and development; donor breast milk confers less certainty but provides other non-nutritive benefits.1 Effective strategies for early enteral feeding may help mitigate infective and inflammatory sequelae of conditions such …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.