Send to

Choose Destination
J Pediatr Gastroenterol Nutr. 2018 Oct 12. doi: 10.1097/MPG.0000000000002168. [Epub ahead of print]

A Novel Donkey Milk-Derived Human Milk Fortifier in Feeding Preterm Infants: A Randomized Controlled Trial.

Author information

Neonatal Unit of Turin University, City of Health and Science of Turin, Via Ventimiglia 3, Turin 10126, Italy.
Institute of Sciences of Food Production, Italian National Research Council, Largo Braccini 2, 10095 Grugliasco (TO) Italy.
Research Centre for Engineering and Agro-Food Processing, Council for Agricultural Research and Economics (CREA), Strada delle Cacce 73, 10135 Turin, Italy.
Italian Association of Human Milk Banks, Via Libero Temolo 4, Milan 20126, Italy.
Laboratory of Medical Statistics, Biometry & Epidemiology "GA Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.



The purpose of the present randomized controlled clinical trial was to compare the use of donkey milk-derived fortifier with commercial bovine milk-derived fortifier in very preterm or very low-birthweight newborns, in terms of feeding tolerance.


This trial included 156 newborns born at <32 weeks of gestational age and/or with a birthweight ≤1500 g. Newborns were randomized 1:1 to receive enteral feeding with either a bovine milk-based fortifier (BF-arm), or a new, donkey milk-derived fortifier (DF-arm) for 21 days. The fortification protocol was the same for both study arms, and the two diets were designed to be isoproteic and isocaloric. Feeding tolerance was assessed by a standardized protocol.


The risk of feeding intolerance tended to be lower in DF-arm than in BF-arm, with a relative risk reduction of 0.63 (95% CI: -0.29, +0.90). The mean number of episodes per newborn of feeding intolerance and feeding interruptions (any duration) were consistently lower in the DF-arm than the BF-arm. Episodes of bilious gastric residuals and vomiting were significantly lower in the DF-arm. Time needed to reach full enteral feeding (150 ml/kg/d) and daily weight increase between the first day of exclusive enteral feeding (i.e., without administering intravenous fluids) and discharge were similar in the BF- and DF-arms.


These results suggest that donkey milk-derived fortifiers improve feeding tolerance when compared with standard bovine-derived fortifiers, with a similar auxological outcome.URL and Trial Identification Number:, ISRCTN70022881This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center