Breast milk can help protect preterm infants from harmful gut bacteria that cause necrotizing enterocolitis (NEC)
03/16/2020 // Michael Alexander // Views

New mothers may want to hold off on store-bought formula for now, as new research suggests breast milk may, in fact, provide preterm infants protection from a dangerous infection.

In a study published in the Nature Medicine journal, researchers found that babies are less likely to develop necrotizing enterocolitis (NEC) if they have breast milk’s immunoglobulin A (IgA) antibodies in their gut.

Timothy Hand, Ph.D., senior author and an assistant professor of pediatric infectious diseases at the R.K. Mellon Institute for Pediatric Research and Pitt’s School of Medicine, said he and his team evaluated fecal samples from 30 preterm infants with NEC and 39 infants of the same age who did not have NEC.

Hand noted that while bacterial invasion plays a part in the disease’s progress, something else occurs prior to its development that is still not understood. As such, Hand said, experts still are not sure what causes NEC.

During the study, the researchers found that babies who subsisted on breast milk had more IgA-bound gut bacteria than those who were on formula. Those who developed NEC were more likely to have been given formula.

Over time, the researchers said, children who had IgA antibodies not only had more diverse gut flora but also a healthier gut overall.

In addition to the fecal analysis they conducted, the researchers also bred mice that were incapable of producing IgA in their breast milk. According to the researchers, these mice, at birth, have an intestinal development comparable to a human baby born at 24 weeks.


The mice that were given IgA-free milk were just as susceptible to NEC as those on formula. Hand noted that this proved that breastfeeding alone isn’t enough to prevent NEC – the milk itself has to contain IgA.

According to the researchers, their findings may be particularly important for parents of infants who are born prematurely, as they are more likely to develop NEC.

Compounding this problem though is that preterm infants cannot breastfeed until they are developmentally ready at around 34 weeks, said Misty Good, assistant professor of pediatric pathology and immunology at the Washington University School of Medicine. Until then, Good noted, the infants are fed through a tube with either pumped breast milk or prepared infant formula. (Related: Breastmilk: Scientists are still trying to understand what’s in nature’s perfect food and why.)

Another issue, according to Hand, is that not every mother can produce milk.

“In cases where breastfeeding or providing pumped milk isn’t an option, donor milk is a possible solution for new parents,” Hand said, noting that while a woman should never feel pressured about her choice regarding her infant’s diet, mothers of preterm infants should know that feeding infants with prepared formula carries an increased risk of NEC.

Good agrees, citing donor milk as a possible solution for new parents.

“Breast milk is important for a premature baby, especially the early colostrum, so mothers should try to save every drop,” Good said, adding that while it may be hard for new mothers who delivered their babies preterm, they must remember that “...breast milk is like medicine to them and it’s the most important thing a mother can provide her infant that the NICU can’t.”

What's necrotizing enterocolitis?

NEC is a serious illness in newborns. This happens when the tissue in the large intestine or colon gets inflamed. As the inflammation worsens, this kills some tissue in the infant’s colon.

According to the Lucile Packard Children’s Hospital, any newborn can get NEC. However, the disease is most common in very sick or premature infants. The disease is also common in infants who weigh less than 3 pounds and 4 ounces. It often manifests within the first two weeks of an infant’s life.

Infants afflicted with the disease may exhibit abdominal swelling or distention, bloody stools, slow heart rate, difficulty with digestion, greenish bile in the stomach, apnea and sluggishness.

If left untreated, NEC can cause infants to develop holes in their intestines, intestinal scarring, sepsis and in extreme cases, death.

For similar stories on women's and children's health, visit WomensHealth.News.

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