For decades, researchers have tried to understand the cause of necrotizing enterocolitis (NEC), a dangerous disease that affects premature infants. Despite the best efforts of researchers, NEC remains one of the leading causes of infant death in hospitals. It is also the leading cause of emergency surgery among newborns. Consequently, new research focuses on preventing NEC from occurring in the first place, primarily by prioritizing human milk to reduce NEC.
Experts Recommend Prioritizing Human Milk to Reduce NEC Rates
In 2017, researchers analyzed 71 research reports, 11 position statements, and addressed five key questions. The results were published in the journal Maternal Health, Neonatology and Perinatology. The purpose of the scoping review was to analyze the effects of standardized feeding protocols on NEC rates.
Experts strongly agree that feeding premature newborns human milk exclusively is the best way to reduce the risk of NEC. In this study, researchers considered the following factors:
- Human milk versus formula
- Human donor milk-derived fortifier versus cow’s milk-derived fortifier
- Colostrum for oral care
- Strategies to promote human milk feeding in neonatal intensive care units (NICUs)
The evidence in this study are clear – prioritizing human milk in NICUs is the best way to prevent NEC. Researchers found that the American Academy of Pediatrics (AAP), the National Association of Neonatal Nurses (NANN) and the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) all agree that human milk is,
“Scientifically superior feeding for preterm infants. Specific health benefits for the preterm infant population including lower rates of sepsis, NEC, improved feeding tolerance, improved neurodevelopmental outcomes, lower mortality rates, more responsive immune function, lower rates of Retinopathy of Prematurity and fewer hospitalizations in the first year post-NICU discharge compared to formula feeding.”
In situations where the mother’s own milk (MOM) is not available, meta-analyses show that pasteurized donor milk is superior to formula for nutrition and prevention of NEC. Again, prioritizing human milk to reduce NEC is the only way to stop preventable infant deaths.
Experts Recommend Prioritizing Fortifiers as well as Formulas
Research also shows that human milk-based fortifiers are superior, and have more nutritional value, than cow’s milk-based fortifiers. As with primary feeding, the AAP recommends using human milk-based fortifiers. Research shows,
“…Lower risks of death, NEC, NEC requiring surgery, and sepsis in infants less than 1250 g was shown with risks rising incrementally as the percentage of cow’s milk in an infant’s diet increases.”
There are no studies showing adverse effects when using a strictly human milk-based diet, including fortifiers.
Importance of Protecting Preemies from NEC
Protecting premature infants, or preemies, from the known risks of NEC should be a priority for healthcare providers and hospitals. With so much evidence proving that cow’s milk-based formulas increase the risk of this deadly disease, these formulas should not be a staple in NICUs and pediatrician offices.
Medical malpractice attorney, Charles Brown, says,
“The science is clear. Cow’s milk formulas cause, or at least increase the risk of, NEC. It is imperative that we continue research, that we continue to educate parents on the risks of NEC, and that we continue to demand product manufacturers properly disclose risks.”
NEC is a costly disease. Not only do newborns suffer the physical manifestations of the disease, but their families are also affected. On average, NEC that requires surgery can cost families up to $250,000. That is not accounting for long-term or lifetime costs if the child survives and suffers neurodevelopmental or gastrointestinal issues. Prioritizing human milk to reduce NEC rates will help reduce healthcare costs that stifle families.
Research shows that 20-40% of infants with NEC will require surgery. Tragically, around 50% of infants with NEC do not survive. By preventing NEC, we prevent the enormous costs, pain and suffering and potential deaths.