The Journal of Pediatrics
Volume 156, Issue 4 , Pages 562-567.e1 , April 2010

An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products

  • Sandra Sullivan, MD

      Affiliations

    • Department of Pediatrics, University of Florida, Gainesville, FL
    • ,
  • Richard J. Schanler, MD

      Affiliations

    • Department of Pediatrics, Schneider Children's Hospital at North Shore, Manhasset, NY
    • Albert Einstein College of Medicine, Bronx, NY
    • Corresponding Author InformationReprint requests: Richard J. Schanler, MD, Division of Neonatal-Perinatal Medicine, North Shore University Hospital, 300 Community Dr, Manhasset, New York 11030.
    • ,
  • Jae H. Kim, MD, PhD

      Affiliations

    • Department of Pediatrics, University of California, San Diego Medical Center, San Diego, CA
    • ,
  • Aloka L. Patel, MD

      Affiliations

    • Department of Pediatrics, Rush University Medical Center, Chicago, IL
    • ,
  • Rudolf Trawöger, MD

      Affiliations

    • Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Ursula Kiechl-Kohlendorfer, MD

      Affiliations

    • Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Gary M. Chan, MD

      Affiliations

    • Department of Pediatrics, University of Utah Medical Center, Salt Lake City, UT
    • ,
  • Cynthia L. Blanco, MD

      Affiliations

    • Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX
    • ,
  • Steven Abrams, MD

      Affiliations

    • Department of Pediatrics, Baylor College of Medicine, Houston, TX
    • ,
  • C. Michael Cotten, MD, MHS

      Affiliations

    • Department of Pediatrics, Duke University Medical Center, Durham, NC
    • ,
  • Nirupama Laroia, MD

      Affiliations

    • Department of Pediatrics, University of Rochester, Golisano Children's Hospital at Strong, Rochester, NY
    • ,
  • Richard A. Ehrenkranz, MD

      Affiliations

    • Pediatrics, Yale University School of Medicine, New Haven, CT
    • ,
  • Golde Dudell, MD

      Affiliations

    • Children's Hospital and Research Center, Oakland, CA
    • ,
  • Elizabeth A. Cristofalo, MD, MPH

      Affiliations

    • Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
    • ,
  • Paula Meier, PhD

      Affiliations

    • Department of Pediatrics, University of Utah Medical Center, Salt Lake City, UT
    • ,
  • Martin L. Lee, PhD

      Affiliations

    • Prolacta Bioscience, Monrovia, CA
    • ,
  • David J. Rechtman, MD

      Affiliations

    • Prolacta Bioscience, Monrovia, CA
    • ,
  • Alan Lucas, MD

      Affiliations

    • MRC Child Nutrition Research Center, Institute of Child Health, London, United Kingdom

Received 8 April 2009 ,Revised 16 September 2009 ,Accepted 29 October 2009.

References 

  1. American Academy of Pediatrics. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496–506
  2. Schanler RJ, Shulman RJ, Lau C. Feeding strategies for premature infants: Beneficial outcomes of feeding fortified human milk vs preterm formula. Pediatrics. 1999;103:1150–1157
  3. Schanler RJ, Lau C, Hurst NM, Smith EO. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics. 2005;116:400–406
  4. Arnold LDW. The cost-effectiveness of using banked donor milk in the neonatal intensive care unit: Prevention of necrotizing enterocolitis. J Hum Lact. 2002;18:172–177
  5. Boyd CA, Quigley MA, Brocklehurst P. Donor breast milk versus infant formula for preterm infants: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2007;92:F169–F175
  6. Wojcik KY, Rechtman DJ, Lee ML, Montoya A, Medo ET. Macronutrient analysis of a nationwide sample of donor breast milk. J Am Diet Assoc. 2009;109:137–140
  7. Alexander GR, Himes JH, Kaufman RB. A United States national reference for fetal growth. Obstet Gynecol. 1996;87:163–168
  8. Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986;33:179–201
  9. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481
  10. Guthrie SO, Gordon PV, Thomas V, Throp JA, Peabody J, Clark RH. Necrotizing enterocolitis among neonates in the United States. J Perinatology. 2003;23:278–285
  11. Uauy RD, Fanaroff AA, Korones SB, Phillips EA, Phillips JB, Wright LL. Necrotizing enterocolitis in very low birth weight infants: Biodemographic and clinical correlates. J Pediatr. 1991;119:630–638
  12. Furman L, Taylor G, Minich N, Hack M. The effect of maternal milk on neonatal morbidity of very low-birth-weight infants. Arch Pediatr Adolesc Med. 2003;157:66–71
  13. Meinzen-Derr J, Poindexter B, Wrage L, Morrow AL, Stoll B, Donovan EF. Role of human milk in extremely low birth weight infants' risk of necrotizing enterocolitis or death. J Perinatol. 2009;29:57–62
  14. Bell EF. Preventing necrotizing enterocolitis: what works and how safe?. Pediatrics. 2005;115:173–174
  15. Bisquera JA, Cooper TR, Berseth CL. Impact of necrotizing enterocolitis on length of stay and hospital charges in very low birth weight infants. Pediatrics. 2002;109:423–428
  16. Lucas A, Cole TJ. Breast milk and neonatal necrotizing enterocolitis. Lancet. 1990;336:1519–1523
  17. Lucas A, Fewtrell MS, Morley R, Lucas PJ, Baker BA, Lister G, et al. Randomized outcome trial of human milk fortification and developmental outcome in preterm infants. Am J Clin Nutr. 1996;64:142–151
  18. McGuire W, Anthony MY. Donor human milk versus formula for preventing necrotising enterocolitis in preterm infants: systematic review. Arch Dis Child Fetal Neonatal Ed. 2003;88:F11–F14
  19. Quigley MA, Henderson G, Anthony MY, McGuire W. Formula milk versus donor breast milk for feeding preterm or low birth weight infants (review). Cochrane Database of Systematic Reviews. 2007;1–41
  20. Narayanan I, Prakash K, Murthy NS, Gujral VV. Randomised controlled trial of effect of raw and holder pasteurised human milk and of formula supplements on incidence of neonatal infection. Lancet. 1984;ii:1111–1113
  21. Narayanan I, Gupta J. Human milk and neonatal infections. Acta Paediatr Scand Suppl. 1989;351:126–130
  22. Koivusalo A, Kauppinen H, Anttila A, Rautelin H, Jusufovic J, Lindahl H, et al. Intraluminal casein model of necrotizing enterocolitis for assessment of mucosal destruction, bacterial translocation, and the effects of allopurinol and N-acetycysteine. Pediatr Surg Int. 2002;18:712–717

 S.S., R.J.S., J.H.K., A.L.P., R.T., U.K.-K., G.M.C., C.L.B., S.A., C.M.C., N.L., R.A.E., G.D., and E.A.C. received financial support from Prolacta Bioscience. The authors were responsible for the conduct of the study and collection of the data. M.L.L. and D.J.R. are employees of Prolacta Bioscience. A.L. is a paid Consultant of Prolacta Bioscience. P.M. received no support or payment. S.A., C.L.B., E.A.C., R.A.E., M.L.L., A.L., P.M., D.J.R., and R.J.S. were responsible for the design of the study. M.L.L. was responsible for the data analyses. R.J.S. wrote the draft of this manuscript. All of the authors were responsible for review and interpretation of the data and review of the manuscript.

 Clinicaltrials.gov reg. # NCT00506584

PII: S0022-3476(09)01085-3

doi: 10.1016/j.jpeds.2009.10.040

The Journal of Pediatrics
Volume 156, Issue 4 , Pages 562-567.e1 , April 2010

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