Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants

Abstract

Background: Necrotizing enterocolitis (NEC) is a frequent cause of mortality and morbidity in very low birth weight (VLBW) infants. Human milk (HM) feeding has been associated with lower risk of NEC. However, mothers of VLBW infants often experience insufficient milk production, resulting in mixed feedings of HM and formula. Moreover, medical complications often limit the volume of feeding they can be given.Objective: To determine if high proportions of (50% or greater) HM enteral feeding within the first 14 days of life are protective against NEC.Method: This was a prospective cohort study of VLBW infants who were grouped according to the HM proportion of enteral feeding in the first 14 days: <50% (low human milk, LHM, n ¼ 46) and X50% (high human milk, HHM, n ¼ 156). The outcome of interest was development of NEC (Bell stage 2 or 3). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) and to assess potential confounding due to perinatal risk factors.Result: Two hundred and two infants were studied. Confirmed NEC occurred in 5/46 (10.6%) of the LHM group, as compared with 5/156 (3.2%) of the HHM. Gestational age was the only perinatal factor associated with risk of NEC. After adjustment for gestational age, HHM was associated with a lower risk of NEC ((OR ¼ 0.17, 95% CI: 0.04 to 0.68), P ¼ 0.01). Conclusion:Enteral feeding containing at least 50% HM in the first 14 days of life was associated with a sixfold decrease in the odds of NEC.

Does early enteral feeding of very low birth weight infants increase the risk of necrotizing enterocolitis?

“…Contrarily, the incidence of NEC did not increase in the EEF group in our study. This result is also supported by the study by Sisk et al (2007), who fed 72% of 202 VLBW babies in the first three days of life and 97% in the first week. An enteral feeding of 50 ml per kg per day has been achieved on an average of 11.2 days and 100 ml per kg per day on 16.3 days.…”

Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study

“…Breast milk has been shown to significantly decrease morbidity associated with prematurity, including feeding intolerance, late onset sepsis and necrotizing enterocolitis. [3][4][5] Other suggested benefits include decreased length of hospital stay and improved neurodevelopmental outcomes. 6,7 Providing breast milk to the VLBW infant is a challenging experience for many mothers, as it is fraught with numerous obstacles.…”

Preterm infants fed fortified human milk receive less protein than they need

“…Human milk provides to preterm infants important protection against infection [1][2][3] and necrotizing enterocolitis [4][5][6][7] and leads to better neurocognitive development. [8][9][10][11][12] Therefore, it is the preferred feeding for preterm infants.…”