Variability of Criteria for Pasteurized Donor Human Milk Use A Survey of U.S. Neonatal Intensive Care Unit Medical Directors

Background: Use of donor human milk (DHM) is increasing, but criteria for its use are not well defined. Materials and Methods: We conducted a 34-question Internet-based survey of medical directors of U.S. level 3 and level 4 neonatal intensive care units (NICUs), with the goal of describing specifics of policies developed to guide DHM use in U.S. NICUs. Respondents reported NICU characteristics and details of policies concerning DHM use. Policy-specified criteria for DHM use, if any, were described. Bivariate and multivariate analyses were used to identify NICU characteristics associated with DHM use. Results: Respondents returned 153 (33%) surveys, with use of DHM reported by 91 (59%). Donor human milk use was more likely with more than 100 annual admissions <1500 g at birth (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.1–4.7) and with Vermont-Oxford Network participants (OR, 4.6; 95% CI, 1.8–11.6). Among 72 NICUs reporting a written policy, criteria for providing DHM required birth weights vary...