Research shows that premature babies fed exclusively human milk have significantly fewer serious gut infections and shorter hospital stays compared to babies fed formula. A 2026 study of 329 premature babies at one hospital found that only 4.9% of babies receiving human milk developed a serious infection called necrotizing enterocolitis, compared to 12.5% of babies receiving formula. According to Gram Research analysis, despite higher upfront costs, human milk feeding saved the hospital money overall because babies needed fewer antibiotics, blood transfusions, and days on breathing support.
Researchers at El Paso Children’s Hospital studied 329 premature babies born weighing less than 3.3 pounds to see if feeding them human milk instead of formula made a difference. Babies who received an exclusive human milk diet had fewer serious infections, needed fewer medications and medical devices, and required shorter hospital stays. Even though human milk costs more upfront, the hospital saved money overall because these babies had fewer complications. According to Gram Research analysis, this study shows that human milk is both healthier and more cost-effective for the tiniest, most vulnerable newborns.
Key Statistics
A 2026 cohort study of 329 very premature babies at El Paso Children’s Hospital found that exclusive human milk feeding reduced serious gut infections from 12.5% to 4.9%, cutting infection rates by more than half.
Premature babies fed exclusively human milk required significantly fewer days of antibiotics, fewer blood transfusions, and shorter stays on breathing support tubes compared to babies fed formula, according to a 2026 single-center study of 225 infants.
A 2026 analysis of 329 premature babies found that despite higher upfront costs, exclusive human milk feeding produced a cost-benefit ratio of 1.83, meaning the hospital saved money overall through reduced complications and shorter hospital stays.
Premature babies receiving exclusive human milk had lower rates of brain injury (periventricular leukomalacia) at 19.6% compared to 26.9% in the formula group, according to a 2026 study of 329 infants.
The Quick Take
- What they studied: Whether feeding premature babies human milk instead of formula or cow’s milk-based fortifier reduces serious complications and hospital costs.
- Who participated: 329 very premature babies (weighing less than 3.3 pounds at birth) admitted to one hospital between 2012 and 2019. The human milk group had 225 babies, and the formula group had 104 babies.
- Key finding: Babies fed exclusively human milk had a serious gut infection rate of 4.9% compared to 12.5% in the formula group. They also needed fewer antibiotics, fewer blood transfusions, and shorter stays on breathing support.
- What it means for you: If you have a premature baby, asking your hospital about human milk feeding may reduce your baby’s risk of serious infections and complications. However, this study was done at one hospital, so results may vary elsewhere. Talk with your baby’s doctors about what’s best for your situation.
The Research Details
Researchers looked back at medical records from two groups of premature babies treated at the same hospital over several years. The first group (104 babies from 2012 to 2014) received formula or cow’s milk-based fortifier, which is a nutrient mix added to milk. The second group (225 babies from 2014 to 2019) received mother’s own milk or donated human milk with a human milk-based fortifier instead. The researchers compared how many babies in each group developed serious infections, needed medications, required medical devices, and how much their care cost.
This type of study is called a retrospective cohort study, meaning researchers collected information that already existed rather than following new patients forward in time. The researchers tracked many different health measures including a serious gut infection called necrotizing enterocolitis (NEC), how many days babies needed antibiotics, how long they needed breathing tubes, and whether they needed blood transfusions.
The human milk group was actually sicker at birth (smaller and less developed), which makes the better outcomes even more impressive. This suggests that human milk’s benefits are strong enough to overcome initial disadvantages.
This research approach is important because it shows real-world results from actual patient care rather than controlled laboratory conditions. By comparing two groups treated at the same hospital with the same doctors and equipment, researchers could focus on the effect of the milk type itself. The fact that the human milk group was actually sicker at birth makes the results more convincing, because it shows human milk helped despite starting with a disadvantage.
This study has several strengths: it included a large number of babies (329 total), tracked many different health outcomes, and compared groups at the same hospital with similar care standards. However, the study was done at only one hospital, so results might be different elsewhere. The human milk group was treated later in time (2014-2019) than the formula group (2012-2014), so improvements in general medical care over time might have helped the human milk group. The researchers did not randomly assign babies to groups, which means some differences could be due to other factors besides the milk type.
What the Results Show
The most important finding was that babies fed exclusively human milk had much lower rates of a serious gut infection called necrotizing enterocolitis (NEC). Only 4.9% of babies in the human milk group developed this infection compared to 12.5% in the formula group. This means human milk reduced the infection rate by more than half. The human milk group also had fewer cases of surgical NEC (3.1% versus 8.7%), which is the most severe form requiring surgery.
Babies in the human milk group needed fewer days of antibiotics, fewer days on breathing support tubes, and fewer blood transfusions. They also spent fewer days on intravenous nutrition, which is nutrition given directly into the bloodstream when babies cannot eat normally. These differences add up to shorter, less intensive hospital stays.
Interestingly, babies in the human milk group also had lower rates of a brain condition called periventricular leukomalacia (19.6% versus 26.9%), which can cause developmental delays. This suggests human milk may protect the developing brain, though more research is needed to understand why.
Growth outcomes were similar between groups, meaning babies in both groups gained weight at similar rates. This is important because it shows that human milk feeding did not slow down babies’ growth compared to formula.
The study tracked many other medical measures. Babies in the human milk group needed fewer central lines (tubes placed in major blood vessels), which reduces infection risk. They also needed fewer days of parenteral nutrition overall. The human milk group had fewer blood transfusions, which is important because blood transfusions carry small risks of infection or other complications. These secondary findings all point in the same direction: human milk reduces the need for intensive medical interventions.
Previous research has suggested that human milk is better for premature babies than formula, but many studies were small or done in different settings. This study is one of the larger single-center studies showing clear benefits. The findings match what other research has shown about human milk reducing serious infections in premature babies. However, some previous studies have debated whether the benefits are worth the extra cost and effort of collecting and storing human milk. This study is important because it shows that despite higher upfront costs, the overall savings are substantial.
This study was done at only one hospital, so results might not apply everywhere. The two groups were treated at different times (2012-2014 versus 2014-2019), and general medical care improved during this period, which could have helped the human milk group. Babies were not randomly assigned to receive human milk or formula, so some differences might be due to other factors the researchers did not measure. The study did not track long-term outcomes after babies left the hospital, so we do not know if benefits continue as children grow. Finally, the study did not measure whether mothers were able to provide their own milk or if donor milk was used, which could affect results.
The Bottom Line
For hospitals caring for very premature babies, implementing an exclusive human milk diet appears to be a strong evidence-based strategy. The evidence is moderately strong because this is a well-designed study at a real hospital with a large number of babies and multiple measured outcomes. For families with premature babies, discussing human milk feeding with your baby’s doctors is worthwhile, as it may reduce serious infections and complications. However, human milk feeding requires access to mother’s milk or donor milk, which is not available everywhere, and some mothers cannot provide milk for medical or personal reasons.
This research is most relevant to hospitals with neonatal intensive care units (NICUs) that care for very premature babies. It is also important for parents of premature babies who want to understand feeding options. Pediatricians, neonatologists, and lactation consultants should be aware of these findings. This research is less relevant to families with full-term babies, as they have lower infection risks and may tolerate formula better.
Benefits of human milk feeding appear to develop over the first weeks and months of life. Babies in this study showed reduced infection rates and shorter hospital stays, which typically occur within the first 2 to 4 months after birth. Long-term benefits for growth and development may take months or years to become apparent, but this study did not track outcomes that long.
Frequently Asked Questions
Is human milk better than formula for premature babies?
Research shows human milk significantly reduces serious infections in premature babies. A 2026 study found that premature babies fed exclusively human milk had infection rates of 4.9% compared to 12.5% for formula-fed babies. Human milk also reduced the need for antibiotics and blood transfusions.
Does feeding premature babies human milk cost more money?
Human milk has higher upfront costs, but a 2026 hospital study found that overall savings were substantial. The hospital saved money because human milk-fed babies had fewer complications, shorter stays, and needed fewer medications and medical devices, resulting in a cost-benefit ratio of 1.83.
What is necrotizing enterocolitis and why does it matter?
Necrotizing enterocolitis (NEC) is a serious gut infection that can occur in premature babies, sometimes requiring surgery. A 2026 study found that exclusive human milk feeding reduced NEC rates from 12.5% to 4.9%, and surgical NEC from 8.7% to 3.1%, significantly protecting babies from this dangerous condition.
Can premature babies grow normally on human milk?
Yes, a 2026 study found that premature babies fed exclusively human milk had growth outcomes comparable to formula-fed babies. Both groups gained weight at similar rates, showing that human milk provides adequate nutrition for normal growth.
Where can I get human milk for my premature baby if I cannot produce it?
If you cannot provide your own milk, ask your hospital about donor milk banks, which provide screened and pasteurized human milk from healthy donors. The 2026 study used both mother’s own milk and donor milk with positive results, so either source can benefit your baby.
Want to Apply This Research?
- If you have a premature baby in the hospital, track daily milk intake (in milliliters), percentage of feeds that are human milk versus formula, and any signs of feeding tolerance like vomiting or abdominal distension. Also note antibiotic use, breathing support needs, and any infections.
- Work with your hospital’s lactation team to establish and maintain milk supply if you are the mother. If using donor milk, track which donor milk bank is being used and any supply challenges. Communicate regularly with your baby’s care team about feeding goals and any barriers to exclusive human milk feeding.
- Monitor your baby’s weight gain, feeding tolerance, and any signs of infection (fever, lethargy, feeding intolerance). Track hospital stay length and the number of days on antibiotics or breathing support. After discharge, continue monitoring growth and development milestones, as these may be affected by early nutrition.
This research describes outcomes from one hospital and may not apply to all settings. Always consult with your baby’s neonatologist or pediatrician before making feeding decisions. Human milk feeding requires access to mother’s milk or donor milk, which may not be available everywhere. Individual babies may respond differently to feeding approaches based on their specific medical conditions. This article is for educational purposes and should not replace professional medical advice from your healthcare team.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.