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  "id": "maternal:donor-human-milk",
  "owner": "maternal",
  "kind": "intervention",
  "slug": "donor-human-milk",
  "name": "Donor human milk for very low birth weight infants",
  "aliases": [],
  "atlases": [
    "maternal"
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  "summary_plain": "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.",
  "summary_technical": "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.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-15",
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  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "newborn"
      ],
      "care-area": [
        "breastfeeding"
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  "payload": {
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    "mechanism": null,
    "components": null
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    "current": [],
    "conflicting": [],
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    {
      "release_id": "c7fb95f1d15a7d13",
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      "category": "effect",
      "statement": "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.",
      "context": {
        "id": "maternal:ctx-domino-vlbw-infants-ontario",
        "label": "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_note": "Newborn period, with neurodevelopment assessed at 18 months' corrected age",
        "life_stage_terms": {
          "maternal": [
            "newborn"
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        "gestational_age_max_days": null,
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        "postnatal_age_status": null,
        "followup_description": "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.",
        "eligibility": {
          "inclusion": [
            "Very low birth weight infants",
            "Recruited within 96 hours of birth"
          ],
          "exclusion": [
            "Not stated in the source that was read"
          ]
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      "evidence_stage": "interventional",
      "certainty": "not_assessed",
      "certainty_method": null,
      "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.",
      "editorial_state": "draft",
      "checked_at": "2026-10-15",
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