Preterm infant formulas with glucose polymers and reduced lactose content increase the risk of necrotizing...

Area of Science:

• Neonatal Medicine
• Gastroenterology
• Pediatric Nutrition

Background:

• Necrotizing enterocolitis (NEC) is a critical gastrointestinal disease in preterm infants, causing significant mortality and morbidity.
• Despite extensive research, the exact mechanisms linking commercial preterm formulas (PTF) to NEC remain unclear.
• PTF are suspected to increase NEC risk compared to breast milk due to compositional differences.

Purpose of the Study:

• To review the causal relationship between commercial preterm formulas (PTF) and necrotizing enterocolitis (NEC) in preterm infants.
• To identify specific components in PTF that may increase NEC risk.
• To highlight missing protective elements from breast milk in PTF.

Main Methods:

• Comprehensive review of existing animal studies investigating PTF and NEC.
• Analysis of human clinical trials examining the effects of PTF on preterm infants.
• Comparison of the composition of PTF and human breast milk.

Main Results:

• Breast milk contains protective elements absent in PTF, such as lactose.
• PTF often replace 50%-60% of lactose with glucose polymers, a potentially pathogenic agent.
• Both missing protective factors and the presence of specific ingredients in PTF contribute to NEC risk.

Conclusions:

• Glucose polymers in PTF, unlike lactose in breast milk, may act as a pathogenic agent, increasing NEC risk.
• Further research is needed to identify all protective breast milk components to supplement PTF.
• Identifying and removing harmful ingredients like glucose polymers from PTF is crucial for reducing NEC incidence.