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Updated: Jul 18, 2026
Breast Milk Enhances Growth of Enteroids: An Ex Vivo Model of Cell Proliferation
Published on: February 15, 2018
Special circumstances: trophic feeds, necrotizing enterocolitis and bronchopulmonary dysplasia
Regina M Reynolds1, Patti J Thureen
1University of Colorado Health Sciences Center, The Children's Hospital, 4200 E. 9th Avenue, B-195, Denver, CO 80262, USA. regina.reynolds@uchsc.edu
Insights
Feeding extremely-low-birth-weight infants involves many challenges. Breast milk and other strategies may help prevent necrotizing enterocolitis (NEC), but research is ongoing for optimal nutrition and lung development.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Critical Care Medicine
Background:
- Feeding extremely-low-birth-weight (ELBW) infants presents significant clinical challenges.
- Nutritional support is critical during the early postnatal period, impacting lung development and growth.
- Necrotizing enterocolitis (NEC) remains a serious concern in ELBW infants.
Purpose of the Study:
- To review current understanding and unresolved issues in feeding ELBW infants.
- To discuss strategies for preventing NEC in this vulnerable population.
- To highlight the importance of optimal nutrition for preventing bronchopulmonary dysplasia.
Main Methods:
- Review of existing literature on ELBW infant nutrition and NEC prevention.
- Analysis of the benefits of breast milk, antenatal steroids, and fluid restriction for NEC prevention.
- Identification of candidate therapies for NEC prevention requiring further investigation.
Main Results:
- Trophic feedings with breast milk or formula do not appear to increase NEC incidence.
- Breast milk, antenatal steroids, and fluid restriction show promise in NEC prevention.
- Suboptimal early postnatal nutrition is common and negatively affects lung development.
Conclusions:
- Further research, including large randomized trials, is needed to confirm NEC prevention strategies.
- Oral immunoglobulins, probiotics, fatty acids, and arginine are potential NEC prevention therapies.
- Addressing nutritional deficits is crucial for improving outcomes in ELBW infants, particularly regarding lung health.
Abstract:
There are many unresolved issues regarding how to feed the extremely-low-birth-weight (ELBW) infant. Trophic feedings of small volumes of breast milk or formula do not appear to increase the incidence of necrotizing enterocolitis (NEC). For prevention of NEC, breast milk, antenatal steroids and fluid restriction each confers a benefit. Because the incidence of NEC is relatively low, to determine if a particular prevention strategy is effective, large numbers of infants would need to be enrolled in a prospective, randomized controlled trial, and such trials are rare. Candidate therapies for NEC prevention that warrant further study include oral immunoglobulins, probiotics, long-chain polyunsaturated fatty acids and arginine. Suboptimal nutrition in ELBW infants is common in the early postnatal period. This is also the most critical time for the development of bronchopulmonary dysplasia, when even brief periods of malnutrition have significant effects on lung development and growth.
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