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Impact of human donor milk on maternal milk use at discharge: assessment using control charts
  1. Amy K Keir1,2,3,
  2. Laura Summers3,
  3. Jennifer Gillis3,
  4. Andrew J McPhee1,2,3,
  5. Alice Rumbold1,2
  1. 1 SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia
  2. 2 Adelaide Medical School and the Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
  3. 3 Women's and Babies Division, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
  1. Correspondence to Dr Amy K Keir, SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia 5006, Australia; amy.keir{at}

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The number of human milk banks is increasing around the world.1 In many countries, preterm infants born at <32 weeks’ gestation routinely receive donor milk as supplementary feeds. High-quality evidence supports this practice in reducing the risk of necrotising enterocolitis.2 However, there are concerns donor milk could displace lactation support with unintentional adverse effects on maternal breastfeeding rates on discharge home.1 A recent systematic review found small improvements in any breastmilk intake on discharge. Pooled estimates of four observational studies examining this outcome preintroduction and postintroduction of donor milk indicate a relative risk of 1.19 (1.05–1.35, p=0.005) for increased breast feeding when infants received donor milk.1 However, this is predominantly based on low-quality evidence.

In our single-centre tertiary-level perinatal centre in South Australia (averaging 1400 neonatal admissions per year), donor milk first became available in September 2018 for infants born <32 weeks or <1500 g. Dedicated lactation consultant support in our neonatal unit accompanied this new programme. Here we report an alternative and pragmatic method through the use of statistical process control methodology to assess whether the presence of a human milk bank impacts breast feeding …

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  • Contributors AKK had full access to all of the study data and takes responsibility for the data integrity and data analysis accuracy. Concept and design: AKK and AR. Acquisition, analysis or interpretation of data: all authors. Drafting of the manuscript: AKK. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: AKK.

  • Funding AKK receives funding from the Australian National Health and Medical Research Council (NHMRC) (APP1161379). The contents of this paper are solely the responsibility of the individual authors and do not reflect the views of the NHMRC.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.