New research has shed light on various factors that may contribute to the development of necrotizing enterocolitis in premature infants, a devastating gastrointestinal condition that often results in the need for emergency surgery and can lead to death. A meta-analysis published late last month in the journal BMC Pediatrics highlights more than a dozen of these risk factors, including infections, blood transfusions, pneumonia, congenital heart disease, and gestational diabetes. The study also emphasizes the protective role of breastfeeding and other measures in reducing the risk of NEC in premature infants. 

NEC and Its Devastating Consequences

Necrotizing enterocolitis (NEC) is a severe intestinal condition that poses a significant threat to the health and survival of premature infants. NEC primarily affects pre-term babies – in fact it is “one of the most common gastrointestinal diseases in neonates” – occurring when the delicate walls of their intestines become inflamed or necrotic due to bacterial invasion. This condition often necessitates emergency surgery while the newborn is still in the neonatal intensive care unit (NICU) and can lead to long-term complications or even death. The alarming rise in NEC cases has prompted researchers to investigate the factors that contribute to its development and identify preventive measures.

The Protective Effects of Breastfeeding

One of the most significant findings of the BMC Pediatrics study is the protective role of breastfeeding in reducing the risk of NEC. Breast milk or human milk offers unique nutritional and immunological benefits that support the development of a premature infant’s immune system and gastrointestinal tract. It contains essential substances like secretory IgA and lactoferrin, which enhance the body’s defense against infectious diseases in the gastrointestinal tract.

Breast milk or human milk also alleviates the osmotic load on the infant’s intestines, relieving intestinal pressure. Its lower osmolality compared to formula helps prevent the occurrence of infectious diseases of the gastrointestinal tract. The nutritional composition of breast milk aids in the maturation of the infant’s intestinal epithelial layer, strengthening its resistance to NEC.

Other Protective Measures Against NEC

In addition to breastfeeding, the study highlighted the importance of other protective measures in reducing the risk of NEC. Oral probiotics and prenatal use of glucocorticoids were found to decrease the likelihood of NEC by about a third. Probiotics promote a healthier balance of gut bacteria, while glucocorticoids have anti-inflammatory effects that can benefit premature infants.

The Impact of Formula Feeding on NEC Risk

While breastfeeding and other protective measures play a crucial role in reducing NEC risk, there is growing evidence that baby formula products, particularly cow’s milk-based infant formulas like Similac and Enfamil, increase the risk of NEC. Multiple studies have consistently demonstrated that premature infants fed these formulas face a higher risk of developing NEC compared to those exclusively fed breast milk or donor milk.

Infant Formula NEC Lawsuits

Mounting evidence linking cow’s milk-based infant formulas to an increased risk of NEC has prompted families whose infants suffered from NEC to pursue legal action against formula manufacturers. Lawsuits have been filed against Abbott Laboratories, the maker of Similac, and Mead Johnson, the maker of Enfamil. These lawsuits allege that the manufacturers failed to adequately warn about the associated risks and promoted their products for premature infants without sufficient evidence of safety.

The recent $60 million jury award in an Enfamil NEC lawsuit against Mead Johnson has further highlighted the potential liability faced by formula makers due to devastating necrotizing enterocolitis injuries. As more families become aware of the alleged link between formula feeding and NEC, the number of lawsuits is expected to increase, putting pressure on manufacturers to prioritize safety and provide clearer warnings.