TABLE 2.
Summary of findings as per GRADE guidelines1
| Outcome | Estimate with BMF supplementation | Corresponding risk estimate with HMF supplementation | Relative effect (RR) (95% CI) | Participants, n | Quality of evidence as per GRADE |
|---|---|---|---|---|---|
| Definite NEC | 19 of 164 (11.58%) | 7 of 170 (4.11%) | 0.38 (0.15, 0.95), P = 0.04, I2 = 9% | 334 | Low |
| Surgical NEC | 11 of 103 (10.68%) | 1 of 106 (0.94%) | 0.13 (0.02, 0.67), P = 0.02, I2 = 0% | 209 | Low |
| Mortality | 12 of 164 (7.31%) | 4 of 170 (2.35%) | 0.40 (0.14, 1.15), P = 0.09, I2 = 0% | 334 | Very low |
| Sepsis | 49 of 164 (29.88%) | 49 of 170 (28.82%) | 0.96 (0.56, 1.67), P = 0.90, I2 = 63% | 334 | Very low |
| Weight gain, g/kg·d | 15.16 | 13.72 | −1.08 (−1.96, −0.21), P = 0.02, I2 = 0% | 241 | Very low |
| Length gain, cm/w | 0.93 | 0.83 | −0.11 (−0.26, 0.04), P = 0.14, I2 = 68% | 241 | Very low |
| Head circumference gain, cm/w | 0.84 | 0.83 | −0.02 (−0.08, 0.05), P = 0.59, I2 = 23% | 241 | Very low |
1The overall quality of evidence was deemed “low to very low” in view of the few RCTs, small sample size, wide CIs around the effect size estimate, inability to rule out publication bias, and high risk of bias in important domains in the included studies. BMF, bovine milk–derived fortifier; GRADE, Grading of Recommendations, Assessment, Development and Evaluation; HMF, human milk–derived fortifier; NEC, necrotizing enterocolitis.