Breast milk and neonatal necrotising enterocolitis

Area of Science:

• Neonatalogy
• Pediatric Gastroenterology
• Public Health Nutrition

Background:

• Necrotising enterocolitis (NEC) is a severe gastrointestinal emergency in preterm infants.
• Dietary interventions play a crucial role in infant health outcomes.
• Breast milk is recognized for its protective properties in neonates.

Purpose of the Study:

• To investigate the association between infant diet and the incidence of necrotising enterocolitis in preterm infants.
• To compare the risks of NEC among exclusively formula-fed, partially breast-fed, and exclusively breast-fed preterm infants.
• To identify other risk factors for NEC in this population.

Main Methods:

• Prospective multicentre study involving 926 preterm infants.
• Infants were formally assigned to specific early diets.
• Data collected on diet, NEC development, mortality, gestational age, and other clinical factors.

Main Results:

• NEC developed in 5.5% of infants; mortality was 26% in confirmed cases.
• Exclusively formula-fed infants had 6-10 times higher NEC rates than those fed breast milk alone.
• Breast milk (maternal or donor) significantly reduced NEC risk, even when combined with formula.

Conclusions:

• Exclusive formula feeding in preterm infants is associated with a substantially increased risk of necrotising enterocolitis.
• Breast milk, including pasteurised donor milk, is protective against NEC.
• A decline in breast milk use in neonatal units may contribute to preventable NEC cases and deaths.