We examined the effect of two strategies to prevent necrotizing enterocolitis (NEC) in extremely low birth weight (ELBW) infants—adherence to a standardized feeding protocol and use of a hospital-based milk bank to provide exclusive preterm human milk feedings.
We conducted a single-center observational study from 2010 to 2015. Infants received preterm human milk, initially trophic feeds from days 7 to 14 after birth, followed by advancement of 15 mL/kg/day to reach a goal of 180 mL/kg/day. Fortification was used selectively for weight gain < 15 g/kg/day. We determined the incidence of NEC, other morbidities, and growth.
The cohort included 398 ELBW infants who survived to day 14 without congenital anomalies. Mean gestational age was 26.2 ± 1.9 weeks. Maternal milk was used as the sole feeding in 62% of infants; preterm donor milk was used solely or as supplement in 29%. Full feeds were reached at a median of 27 (IQR 23, 33) days. Four infants (1%) developed NEC.
Use of standardized feedings with a hospital-based milk bank is associated with an incidence of NEC lower than previously reported.
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We thank Nancy Dock, PhD for her thoughtful review of this manuscript and Charlene Insalaco, RN for her contribution to our human milk bank.
Conflict of interest
The authors declare that they have no conflict of interest.
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Murthy, S., Parker, P.R. & Gross, S.J. Low rate of necrotizing enterocolitis in extremely low birth weight infants using a hospital-based preterm milk bank. J Perinatol 39, 108–114 (2019). https://doi.org/10.1038/s41372-018-0235-3