Food and microbiological problems in the newborn: data and practice

We have reviewed the relationships of food, nutrition and feeding practices to various infections in the newborn. Tentative conclusions are made: (a) the initial use of human milk (raw or pasteurized) continues to offer advantages in the care of babies in intensive care; (b) attempts to mimic the microbiological effects of breast milk by manipulation of the composition of infant formulas have so far achieved little success, but this is a rapidly developing field; (c) we are wary of the widespread use of breast milk "fortifiers" until there is evidence that they do not adversely affect the protective properties of breast milk; (d) the doubtful advantages of nasojejunal feeding need to be weighed against the increased bacterial contamination of the upper small bowel; (e) systems monitoring in milk kitchens and the handling of feeds in the neonatal unit are an integral part of comprehensive neonatal care; (f) to limit nosocomial infection, particular attention to the faecal-food-oral route is necessary since there is potential for multiplication of initial contamination of food.