Impact of access to pasteurised donor human milk (PDHM) on rates of necrotising enterocolitis in neonatal Units in Australia 

27 October 2026

In 2018, Lifeblood commenced the establishment of a centralised milk service to provide pasteurised donor human milk (PDHM) to preterm infants in NICUs who did not have access to another source.   

International studies have shown that when sufficient mother’s own milk is unavailable, the utilisation of PDHM instead of infant formula is associated with reduced necrotising enterocolitis (NEC) and improved feed tolerance in infants born < 32 weeks' and/or < 1800 g. However, the benefits and risks of PDHM in different settings may vary.  

This Australian population-based cohort study evaluated the effect of reliable PDHM supply in neonatal units caring for infants born very and extremely preterm, with respect to the proportion of infants with NEC, as well as other clinical and breastfeeding outcomes at hospital discharge.   

The primary outcome was the proportion of infants born < 28 weeks' gestation who developed NEC in a time-period when NICUs were receiving Lifeblood PDHM, compared to when the NICUs were not receiving Lifeblood PDHM. NEC is a debilitating illness in preterm infants with a high risk of mortality and morbidity.  

Overall, the study found that reliable access to PDHM was associated with a decreased rate of NEC and retinopathy of prematurity for infants born < 28 weeks' gestation in Australian NICUs. The authors highlight that further work is needed to ensure that PDHM is always used as part of a strategy which emphasises maternal breastfeeding and lactation support.  

Data from 15 eligible Australian NICUs were included in the study. The results demonstrated significantly lower rates of NEC in infants born extremely preterm when PDHM was reliably available in the unit where admitted. After adjusting for confounding risks, the rate of NEC was 38% lower when Lifeblood PDHM was available (aRR 0.62, 95% CI 0.46–0.83).   

With respect to secondary outcomes, when Lifeblood PDHM was available:  

  • The rate of retinopathy of prematurity was 9% lower (aRR 0.91, 95% CI 0.83–0.99).  
  • The weight at discharge to home or at term was lower (2828.8 vs. 2939.56 g, p = 0.001).  
  • Breast milk feeding at discharge was lower (54.0% vs. 60.1%) however not statistically significant.   

Other secondary outcomes including median length of stay, infections and death before discharge were not associated with PDHM availability.   

The authors provide important insights into these findings in the Australian and international context.  

   

  • L. D. Klein, K. Lui, A. A. Chughtai, et al., “Impact of Access to Pasteurised Donor Human Milk on Rates of Necrotising Enterocolitis in Neonatal Units in Australia: A Cohort Study,” Journal of Paediatrics and Child Health 62, no. 9 (2026): 1611–1620, https://doi.org/10.1111/jpc.70472.  

 

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