Ask any NICU clinician about necrotizing enterocolitis (NEC) and their response is immediate: It must be prevented. Pre-term and medically fragile infants who develop NEC are at high risk of long-term complications and mortality.
NEC most often occurs in premature infants, and usually within 3 – 12 days after birth.1 The rate of NEC increases in the premature population with low birth weight and younger gestational age, and declines after 32 weeks postmentrual age.2 Its prevention and treatment is a high priority in neonatal care due its devastating consequences.
NEC may impact the intestinal lining or the entire thickness, which must be addressed immediately before the intestinal disorder progresses. Unfortunately, its progression can lead to intestinal tissue damage and subsequent infection caused by bacteria leaking out to the abdomen. That constitutes a serious medical emergency.
The impact of necrotizing enterocolitis is tragically high:3
· A 10 – 50% mortality rate
· Annual costs to care for NICU infants in the US with NEC are $500 million to $1 billion
· Patient outcomes are often poor once surgery is required
How human milk can help NEC prevention
There is a reason the American Academy of Pediatrics (AAP) recommends human milk feeding for premature infants ahead of artificial milk (formula). The AAP cites the advantages of human milk include a reduction in occurrence of necrotizing enterocolitis, sepsis, and mortality, along with improved tolerance of feeding and earlier attainment of full enteral feeding – and still more, including long-term growth and neurodevelopment.
How can human milk reduce the occurrence of NEC? It reduces inflammation and bacterial invasion of the gastrointestinal tract. In addition, epidermal growth factor, nucleotides, and glutamine components stimulate intestinal maturity.4 There’s a reason human milk is called “medicine”!
A human milk diet can constitute mother’s own milk (MOM) and/or donor human milk (DHM). Those two options, even when combined, are considered exclusive human milk feeding. While enough MOM may not always be available, there are multiple resources to access quality donor human milk for your patients to prevent issues such as NEC.
View an infographic below to learn more about NICU NEC statistics, and the incredible impact of human milk.
Learn more about Medolac Benefit Human Milk products, which help NICU clinicians provide exclusive human milk feedings to their patients.
References:
1. Cleveland Clinic, Diseases and Conditions (2014). Necrotizing Enterocolitis. Cleveland Clinic website. Accessed online June 17, 2020. https://my.clevelandclinic.org/health/diseases/10026-necrotizing-enterocolitis
2. Hermann et al (2014). An exclusively human milk diet reduces necrotizing enterocolitis. Breastfeeding Medicine, Volume 9, Number 4, 2014.
3. Bode, Lars (2018). Human Milk Oligosaccharides in the Prevention of Necrotizing Enterocolitis: A Journey From in vitro and in vivo Models to Mother-Infant Cohort Studies. Frontiers in Pediatrics. Accessed online June 17, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288465/
4. Schanler, Richard J. (2015). In time: human milk is the feeding strategy to prevent necrotizing enterocolitis. Scielo. Accessed online June 17, 2020. https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822015000200131