Study Links Breastfeeding, Other Protective Measures to Prevention of NEC in Preterm Infants

In addition to breastfeeding, researchers found that oral probiotics and prenatal use of glucocorticoids decreased a prematurely born infant's risk of NEC.

The findings of new study highlight a number of factors that may contribute to the risk that a newborn will develop necrotizing enterocolitis (NEC), a devastating intestinal condition that often results in emergency surgery and can be fatal. However, the research also supports the findings of other recent studies, revealing that breastfeeding can help keep the deadly condition at bay.

Chinese researchers report that infections, blood transfusions, congenital heart disease, antibiotics and a list of other health issues appear to increase the risk of NEC significantly, while the risks are reduced by breastfeeding, and other protective measures. Their findings were published late last month in BMC Pediatrics.

Necrotizing enterocolitis (NEC) primarily impacts premature babies, occurring when harmful bacteria breaches the walls of the intestines, causing portions of the tissue to become inflamed or die. The condition often results in the need for emergency surgery while the baby is still in the NICU, and many infants do not survive.

Amid growing evidence that cow’s milk-based infant formula products dramatically increase the risk of NEC for preemies, several hundred families nationwide are now pursuing Similac lawsuits and Enfamil lawsuits against Abbott Laboratories and Mead Johnson, alleging that the manufacturers placed their desire for profits before consumers safety, by failing to warn families and the medical communities about the increased risks compared to use of human milk, and specifically promoting versions of their formula for premature babies.

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Premature infants fed Similac or Enfamil cow's milk formula faced increased risk of necrotizing enterocolitis (NEC) or wrongful death.


In this latest study, researchers used a number of databases to conduct a systemic review and meta-analysis, involving 8,616 NEC cases, including 2,456 cases in an intervention group, and 6160 cases in a control group.

The researchers determined there were 16 risk factors and three protective factors linked to NEC in premature infants. The highest risks were linked to respiratory failure, which increased the risk of NEC by a factor of seven, as well as pneumonia and infections, which increase the risks six-fold.

Other risks included septicemia, blood transfusions, neonatal asphyxia, congenital heart disease, intrahepatic cholestasis of pregnancy, the need for mechanical ventilation, gestational diabetes, respiratory distress syndrome, hypoalbuminemia, severe anemia, patent ductus arteriosus, a history of antibiotic use and meconium-stained amniotic fluid.

The protective measures included breast feeding, oral probiotics and prenatal use of glucocorticoids, which all decreased the risk of NEC by about a third.

“Breast milk, with its lower osmolality compared to formula, alleviates the osmotic load of food, relieving intestinal pressure,” the researchers determined. “In addition, breast milk is rich in secretory IgA, lactoferrin and other antimicrobial active substances, which enhance the body’s immune defense and effectively prevent the occurrence of infectious diseases of the gastrointestinal tract.”

Breastfeeding Benefits Over Infant Formula

This is one of numerous studies published over the past several decades have extolled the virtues of breastfeeding or human milk products, which have been found to deliver the necessary nutrients a newborn needs to thrive, provides some key immunities already developed by the mother, and helps the infant’s digestive tract develop.

Research has consistently shown cow’s milk-based baby formula products do not confer the same benefits as breastfeeding and may increase the risk that premature infants develop NEC, which frequently results in severe, life-long injuries or death.

A January 2022 study found that that nutrients in breast milk help the intestinal epithelial layer mature in preterm infants, strengthening their resistance to NEC. However, these nutrients are not present in cow’s milk-based infant formula marketed for premature babies, such as the popular Similac and Enfamil product lines.

In July 2022, the American Academy of Pediatrics (AAP) issued a policy statement calling for hospitals and the government to promote breastfeeding as the primary form of nutrition for newborns.

The statement called for medical providers to support and encourage breast feeding with strong policies designed to assist mothers who wish to breastfeed their children, in stark contrast to decades of hospitals allowing infant formula manufacturers to promote their products directly to new patients with free samples and gift baskets.


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