Necrotizing Enterocolitis in Preterm Infants

Necrotizing enterocolitis or NEC is one of the diagnoses for which breast milk is regularly prescribed in the prevention and treatment of NEC (Updegrove 2004). Breast milk, regardless if it’s from mother’s own supply or donor, supplies significant protection against known risk factors of NEC. Furthermore, it offers therapeutic protection for the infant recovering from NEC. Without the breast milk, donor human milk potentially could save lives of fragile preterm infants, who are at highest risk of developing NEC.

The decision of breastfeeding or formula feeding can be a daunting task especially to mothers who have premature infants with NEC. These preterm infants requires longer hospital stays that feds them formula milk. When preterm infants are discharged, mothers may have to be particular and conscious on the nutritional intake of premature babies and if milk feedings are sufficient to meet the babies’ higher than average needs. The lack of informational and emotional support by those who counsels the breastfeeding mother may contribute to the reluctance of mothers who transition to breastfeeding.

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The reluctance of mother to feed the preterm infant may also be due to a maternal lack of confidence in having adequate supply of breast milk. Brief description of the proposed change Premature infants with necrotizing enterocolitis typically entails mothers of these preterm infants to continue to meet most of their infant’s nutritional needs through bottle feedings of expressed breast milk (EBM) due to the infant’s physiological immaturity and maternal concerns with an insufficient milk supply (Buckley and Charles 2006).

The challenge of motherhood includes the decision on whether to breastfeed or bottle feed their babies. Mothers are most often unaware of the huge differences and advantages of breastfeeding. Both babies and mothers can greatly benefit from breastfeeding. Preterm infants who obtained expressed breast milk rather than formula feeding have lesser infections and necrotizing enterocolitis, better cognitive, neurological and visual development (Howie, Forsyth, Ogston, Clark & Florey 1990).

Mothers can also benefit from breastfeeding her baby such as Anticipated benefits to the healthcare environment Premature babies have more health considerations such as feedings and optimal nutritional intake to meet higher needs than term babies. NEC among premature infants is marked with complications such as from introduction of enteral feedings, gastrointestinal bacterial colonization, gut motility, proinflammatory cytokines, impaired gut blood flow, and other complications in the pathogenesis of NEC.

In connection to NEC, human milk and probiotics has been found to contain natural anti-inflammatory agents that help alleviate the mentioned health complications (Grave et al 2007). Human milk in the form of breast milk can offer benefits to the healthcare environment namely decrease length of hospital stay, decrease long term complications like cost of long term care of the baby if the baby requires long term care (home care nurse), and decrease the amount of babies in the hospital longer than 30 days getting Medicaid.

The length of hospital stay can be shortened when premature babies are given optimum nutrition in breast milk compared to formula feedings. The anti-inflammatory agents in human milk has been found to contribute to an overall reduction health risks associated to NEC. References Buckley, K & Charles, G. (2006). Benefits and challenges of transitioning preterm infants to at-breast feedings. International Breastfeeding Journal. Grave, G. D. , Nelson, S. , Walker, W. A. , Moss, L. A. , Dvorak, B. , Hamilton, F. , Higgins, R. , & Raju, T. (2007).

New Therapies ad Preventive Approaches for Necrotizing Enterocolitis: Report of a Research Planning Workshop. Pediatric Research. Vol 62, 510-514. Howie, P. , Forsyth, J. S. , Ogston, S. A. , Clark, A. , & Florey, C. D. (1990). Protective effect of breast-feeding against infection. Ninewells Hospital and Medical School. 300: 11-16. Updegrove, Kim. (2004). Necrotizing Enterocolitis: the Evidence for Use of Human Milk in Prevention and Treatment. Journal of Human Lactation, Vol. 20, No. 3, 335-339.


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