Eliminating Disparities and Optimizing Equity in Necrotizing Enterocolitis

Necrotizing enterocolitis is a devastating complication of prematurity with high mortality and lifelong morbidities. The burden of disease is inequitably distributed, with higher incidence and mortality in racialized, socioeconomically disadvantaged, and geographically marginalized populations. These disparities reflect structural inequities in maternal health, preterm birth risk, quality of care, and access to protective interventions such as mother's own milk and donor human milk. Reducing necrotizing enterocolitis disparities requires multilevel solutions spanning health policy, equitable perinatal regionalization, investment in underresourced hospitals, and evidence-based neonatal care. Improving access to mother's own milk and pasteurized donor human milk are potentially the highest yield interventions.