Exclusive human milk-based diet reduces NEC risk in preterm infants, study finds

An Exclusive Human Milk Diet (EHMD) for very low birth weight infants may reduce cases of necrotizing enterocolitis (NEC) compared to infants fed cow milk-based products, according to a recent study.

While independent of Prolacta Bioscience, the company says the findings align with its mission as a leading provider of 100% human milk-based (HMB) nutritional products for critically ill and premature infants.

NEC is a serious and often fatal condition characterized by intestinal inflammation, which can lead to tissue death, severe infections, and, in some cases, the need for emergency surgery. In the smallest premature infants, NEC mortality rates can reach up to 50%, underscoring the importance of effective prevention strategies.

“The Harris research findings underscore what numerous studies have found,” says Melinda Elliott, MD, fellow of the American Academy of Pediatrics and chief medical officer at Prolacta. 

“Consistent implementation of an HMB feeding protocol not only improves outcomes for premature infants, but it’s also financially prudent for hospitals due to fewer complications in this vulnerable infant population.” 

Human milk-based nutrition

Published in Advances in Neonatal Care, the study’s results add to a growing body of clinical evidence supporting a 100% HMB feeding protocol as a key strategy in lowering the risk of NEC that primarily affects premature newborns.

The study’s authors emphasize the need for comprehensive education on EHMD protocols across the entire healthcare team. Additionally, the researchers state that as evidence continues to mount in favor of HMB nutrition, they support the shift away from cow milk-based feeding protocols in neonatal intensive care units (NICUs) and advocate for a safer and more effective approach to neonatal nutrition.

The researchers analyzed NEC incidence before and after a NICU transitioned from a cow milk-based feeding protocol to an EHMD.

The team reviewed medical records from 201 preterm infants born before 32 weeks gestation, all weighing less than 1,250 grams (2.75 pounds). Among these infants, 105 received an EHMD, while 96 were fed cow milk-based nutrition.

Compelling results

According to the research team, infants in the EHMD group had a mortality rate of just 1%, compared to 6% in the cow milk-based products group. The incidence of NEC was also significantly lower, with only 4.8% of EHMD-fed infants developing the disease, compared to 10.55% in the group fed cow milk-based nutrition. 

Additionally, the EHMD group experienced greater weight gain during hospitalization, a crucial factor in the health and development of premature infants.

The study also highlighted a financial advantage, estimating approximately US$868,000 in cost savings after the NICU adopted an EHMD protocol compared to the previous three years when cow milk-based products were used.

“Very low birth weight infants should only receive bovine-based formula if the mother’s expressed breast milk or pasteurized donor milk is not available,” the study reads. “Diets of bovine-based formula should be the last choice of feeding for very low birth weight neonates.”