The Use of Pasteurized Donor Human Milk in Healthy Newborns and Lactation Outcomes After Hospital Discharge in the United States: An Integrative Review

Abstract

Background:

Pasteurized donor human milk (PDHM) is frequently used to supplement healthy, breastfeeding newborns in birth hospitals, with varied practices and limited postdischarge outcomes. This review examines the use of PDHM supplementation in healthy, noncritically ill newborns cared for in postpartum units and level 1 nurseries and aims to understand its effects on lactation after hospital discharge.

Methods:

We conducted an integrative review of both qualitative and quantitative studies that were conducted in the United States, in English, and reported the use of PDHM in healthy or noncritically ill infants, and where the primary setting was a mother–baby unit or level 1 nursery. Data sources included PubMed, CINAHL, Scopus, Web of Science, Embase, Emcare, and the Maternity and Infant Care Database. We included 18 articles published between 2014 and 2025 in the final review. Common characteristics were categorized, quantified, and compared across the studies.

Results:

Inductively derived categories are as follows: (1) indication for PDHM supplementation, (2) hospital-level characteristics, (3) breastfeeding outcomes, (4) maternal and infant demographic and socioeconomic characteristics, and (5) opinions on the use of PDHM when reported from clinical and patient perspectives. In addition, we specifically examined each article for examples of the protection of milk supply (interventions to support lactation and/or pumping recommendations).

Conclusions:

PDHM is preferable to formula for supplementation and has been associated with improved breastfeeding outcomes. However, evidence suggested that supplementation without interventions to protect milk supply may pose a risk to breastfeeding after discharge.