# Donor human milk for very low birth weight infants Intervention · id `maternal:donor-human-milk` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Newborn Browse, care area: Breastfeeding and lactation ## In plain language Milk donated by other mothers, pasteurised and given to very low birth weight babies when their own mother's milk is not enough. In the DoMINO trial in Ontario, Canada, babies who got donor milk did not score better on tests of thinking and learning at 18 months than babies who got preterm formula. ## Technical summary DoMINO (JAMA 2016; ISRCTN35317141): 363 very low birth weight infants randomised to nutrient-enriched donor milk or preterm formula as a supplement to mother's milk for 90 days or until discharge. The primary outcome, the Bayley-III cognitive composite at 18 months' corrected age, did not differ significantly (fully adjusted mean difference -2.0, 95% confidence interval -5.8 to 1.8). The authors say that if donor milk is used where mother's milk is plentiful, this outcome should not be a treatment goal. The page does not weigh other reasons for using donor milk. The paper was read as a PubMed abstract only. The recipient is the infant. ## Claims, with the population each applies to ## Context: Very low birth weight infants in four neonatal units in Ontario, Canada, fed donor milk or preterm formula as a supplement (DoMINO) Recipient: Newborn; Population: Very low birth weight (VLBW) infants recruited from four neonatal units in Ontario, Canada, within 96 hours of birth between October 2010 and December 2012, whose mother's milk was not enough. The abstract reports a mean birth weight of 996 g (SD 272) and a mean gestational age of 27.7 weeks (SD 2.6).; Care setting: Four neonatal units in Ontario, Canada (pragmatic, double-blind, randomised trial).; Geography: Ontario, Canada; Life stage: Newborn period, with neurodevelopment assessed at 18 months' corrected age; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Infants were fed donor milk or formula for 90 days or until discharge when mother's milk was unavailable; follow-up was completed in July 2015. ### In the DoMINO trial, very low birth weight infants recruited from four neonatal units in Ontario, Canada within 96 hours of birth received nutrient-enriched donor milk or preterm formula for 90 days or until discharge when mother's milk was unavailable. Of 840 eligible infants, 363 (43.2%) were randomised (181 to donor milk and 182 to preterm formula). The cognitive composite score on the Bayley-III at 18 months' corrected age, the primary outcome, was 92.9 in the donor milk group and 94.5 in the formula group (fully adjusted mean difference -2.0; 95% confidence interval -5.8 to 1.8). Language and motor composite scores also showed no statistically significant difference, nor did the mortality and morbidity index (43% in the donor milk group, 40% in the formula group) or changes in growth z scores. The authors conclude that donor milk compared with formula did not improve neurodevelopment at 18 months' corrected age. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Newborn; Population: Very low birth weight (VLBW) infants recruited from four neonatal units in Ontario, Canada, within 96 hours of birth between October 2010 and December 2012, whose mother's milk was not enough. The abstract reports a mean birth weight of 996 g (SD 272) and a mean gestational age of 27.7 weeks (SD 2.6).; Care setting: Four neonatal units in Ontario, Canada (pragmatic, double-blind, randomised trial).; Geography: Ontario, Canada; Life stage: Newborn period, with neurodevelopment assessed at 18 months' corrected age; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Infants were fed donor milk or formula for 90 days or until discharge when mother's milk was unavailable; follow-up was completed in July 2015. - Limitations: Only the PubMed abstract was read; the full text was not. This is a null primary result: donor milk did not improve the primary outcome. 299 of the surviving infants (92%) had neurodevelopment assessed. The authors add that if donor milk is used in settings with a high supply of mother's milk, this outcome should not be considered a treatment goal. The trial was registered as ISRCTN35317141. The trial tested donor milk as a supplement to mother's milk; it does not compare donor milk with mother's own milk. - Last checked: 2026-10-15 - Sources: 1. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, OBJECTIVE, sentence 1, fragment 1 of 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 2. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, OBJECTIVE, sentence 1, fragment 2 of 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 3. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, DESIGN, SETTING, AND PARTICIPANTS, sentence 1, fragment 1 of 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 4. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, DESIGN, SETTING, AND PARTICIPANTS, sentence 1, fragment 2 of 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 5. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, INTERVENTIONS, sentence 1. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 6. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, MAIN OUTCOMES AND MEASURES, sentence 1, fragment 1 of 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 7. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 8. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 1 of 5. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 9. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 2 of 5. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 10. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 3 of 5. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 11. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 4 of 5. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 12. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 5 of 5. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 13. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 1 of 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 14. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 2 of 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 15. Supports: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS AND RELEVANCE, sentence 1. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract. 16. Background: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS AND RELEVANCE, sentence 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract (context for the claim). 17. Background: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, TRIAL REGISTRATION, sentence 1. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract (context for the claim). 18. Background: Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 2. Retrieved 2026-10-15T13:48:55Z. Source state: Current. Snapshot hash: 9ea033d8c579bca0b6fb9264eb75992e9c3062f1c6a2d0f1b42cbbae1b67b851. How it applies: PubMed abstract (context for the claim). ## Connected pages - DoMINO: no neurodevelopment benefit at 18 months against preterm formula: Low birth weight (`maternal:low-birth-weight`) [a claim, not a settled fact; see claim `maternal:claim-domino-neurodevelopment-18-months` and its context] - Feeding of very low birth weight infants; DoMINO found no neurodevelopment benefit at 18 months (existing page): Care of the preterm or low-birth-weight infant (`maternal:preterm-lbw-care`) - When mother's own milk is not enough: Breastfeeding (`maternal:breastfeeding`) - Filed under this front: Newborn support: warmth, breathing, feeding (`maternal:front-newborn-support`) ## Provenance Content hash: cf82cd92b324fceba573d9e6aa05df1f1386afcc62c6e77c0f38068d38aab58d Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-15