e-Library of Evidence for Nutrition Actions (eLENA)

Standard formula for low-birth-weight infants following hospital discharge

Every year, more than 20 million infants are born weighing less than 2.5kg – over 96% of them in developing countries. These low-birth-weight (LBW) infants are at increased risk of early growth retardation, infectious disease, developmental delay and death during infancy and childhood.

Most LBW is a consequence of preterm birth, small size for gestational age, or both.

Interventions to improve the feeding of LBW infants are likely to improve the immediate and longer-term health and well-being of the individual infant and have a significant impact on neonatal and infant mortality levels in the population.

WHO recommends that LBW infants should be fed mother's own milk. If these infants cannot be fed mother's own milk, they should be fed donor human milk (in settings where safe and affordable milk banking facilities are available or can be set up) or standard infant formula.

LBW infants are often small for their age when they are discharged from hospital. It has been suggested that feeding these infants with a nutrient-enriched formula rather than standard term formula might facilitate "catch-up" growth and improve development; however there is no consistent evidence to suggest that this is the case. Furthermore, the cost of nutrient-enriched infant formula is high and its availability in resource-limited settings is low.

WHO recommendations

LBW infants, including those with very low birth weight (VLBW), who cannot be fed mother's own milk or donor human milk should be fed standard infant formula.

LBW infants, including those with VLBW, who cannot be fed mother's own milk or donor human milk should be fed standard infant formula from the time of discharge until six months of age.

These recommendations are relevant for resource-limited settings.

These recommendations do not address sick LBW infants or infants with birth weight less than 1.0 kg.


These are two of several WHO recommendations on feeding of LBW infants. The full set of recommendations can be found in 'Full set of recommendations' and in the guideline, under ‘WHO documents’ below.

WHO documents

WHO documents

GRC-approved guidelines


Systematic reviews used to develop the guidelines
Related Cochrane reviews
Clinical trials

Last update:

14 December 2016 09:39 CET

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.