Donor Milk vs. Formula in Extremely Low Birth Weight (ELBW) Infants

Inclusion Criteria:

   - Gestational age less than 29 weeks.

   - Admitted to the NICU at less than or equal to 72 hours of life

   - Survived at least 12 hours

Exclusion Criteria:

   - Chromosomal anomalies

   - Cyanotic congenital heart disease

   - Diagnosed intrauterine infection

   - Other congenital disorders known to impair neurodevelopment

   - NEC or IP prior to seeking consent

   - Decision documented to limit intensive care therapies

   - Congenital disorders that may affect feeding

Feeding Group Eligibility:

   - Sole Diet Group: Infants will be eligible for the sole diet feeding protocol if the
   mother declines to provide breast milk for the baby.

   - Supplemental Diet (minimal maternal milk) Group: Infants whose mothers initially
   choose to provide breast milk and begin pumping will be re-screened for eligibility at
   least weekly until the infant is 21 days old. If the mother stops expressing milk at
   any point prior to the infant's 21st day of life, her infant will be eligible for
   randomization. In addition, those whose mothers are providing less than 20% of the
   infant's dietary needs (averaged over past 5 days) when the infant reaches 21 days of
   age will be eligible for randomization at this point. No infant will be randomized
   after reaching 21 days.