e-Library of Evidence for Nutrition Actions (eLENA)

Donor human milk for low-birth-weight infants

Every year, more than 20 million infants are born weighing less than 2500 g – over 96% of them in developing countries. These low-birth-weight infants are at increased risk of neonatal morbidity and mortality.

WHO recommends that low-birth-weight infants should be fed mother's own milk. When a mother's own breast milk is not available, the alternatives are either expressed breast milk from a donor mother or formula milk. Available evidence shows that compared with formula, donor human milk is associated with lower incidence of the severe gut disorder, necrotising enterocolitis, and other infections during the initial hospital stay after birth.

WHO recommendations

WHO recommends that low-birth-weight infants, including those with very-low-birth-weight, who cannot be fed mother's own milk should be fed donor human milk.

This recommendation is relevant for settings where safe and affordable milk-banking facilities are available or can be set up.

The full set of recommendations for feeding of low birth-weight infants can be found in the guideline, Guidelines on optimal feeding of low birth-weight infants in low- and middle-income countries , under ‘WHO documents’ below.

WHO documents

GRC-approved guidelines


Systematic reviews used to develop guidelines
Related Cochrane reviews
Other related systematic reviews
Clinical trials

Last update:

10 October 2014 12:28 CEST

Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee


There is not yet any implementation information related to this intervention in GINA

Essential Nutrition Actions

This intervention is supported by Essential Nutrition Actions targeting the first 1000 days of life.