Premature infants are a heterogeneous group with widely differing needs for nutrition and immune
protection with risk of growth failure, developmental delays, necrotizing enterocolitis, and lateonset
sepsis increasing with decreasing gestational age and birth weight. Human milk from
women delivering prematurely has more protein and higher levels of many bioactive molecules
compared to milk from women delivering at term. Human milk must be fortified for small
premature infants to achieve adequate growth. Mother’s own milk improves growth and
neurodevelopment and decreases the risk of necrotizing enterocolitis and late-onset sepsis and
should therefore be the primary enteral diet of premature infants. Donor milk is a valuable
resource for premature infants whose mothers are unable to provide an adequate supply of milk,
but presents significant challenges including the need for pasteurization, nutritional and
biochemical deficiencies and a limited supply.