Maternal breast milk is the best source of enteral nutrition for preterm or low birthweight infants. With insufficient volumes of maternal breast milk, donor-expressed breast milk (DEBM) or artificial formula are two common alternatives. Despite publication of a recently updated Cochrane review1 demonstrating a decrease in the risk of necrotising enterocolitis (NEC) in babies receiving DEBM compared with those receiving formula, concerns about the methodological quality of some of the included studies, their applicability to current neonatal practices (the majority of included trials were carried out in the 70 s and 80 s), the slower in-hospital growth rates of those on DEBM and the fact that growth-restricted premature infants as well as unwell infants were generally excluded …