We all know that breast is best. Our doctors, relatives, friends, and assorted movie stars tout the benefits of breastfeeding and the risks associated with formula feeding our infants. We have heard about breast milk’s antibodies, growth factors, hormones, and other awesome molecules that provide immune support and nutrition. But did you know that breast milk is so important for premature babies (think life or death) that we use pasteurized donor human milk when mother’s milk is unavailable?
Premature infants have fragile, immature gastrointestinal (GI) tracts that are susceptible to infection and inflammation. Formula is artificial milk that is made in a factory. It is heavier and denser than breast milk, which can stress out the premature infant’s GI system. The digestion of formula can also kill cells. A recent experiment conducted by Penn et al. (2012) exposed several types of human cells (GI membrane, blood vessel wall, white blood cell) to both formula and breast milk. Enzymes were added to simulate digestion. Their results are shocking: the byproducts of formula digestion caused significant cell death compared to human milk digestion. The researchers theorized that this may contribute to the neonatal intensive care unit’s deadliest GI disorder: necrotizing enterocolitis (NEC).
NEC is a problem in every neonatal intensive care unit (NICU). This devastating disorder is marked by intestinal inflammation which ultimately leads to dead areas, or necrotic sections, of bowel. NEC can be treated medically with IV fluids, antibiotics, and gut rest (no feedings); or surgically by removing the dead sections of bowel. Unfortunately, 20-40% of cases require surgery and mortality rates associated with NEC can reach 50% (Yee et al., 2012). Not surprisingly, using pasteurized donor human milk (PDHM) instead of formula protects against this deadly disease. An analysis that reviewed several previous research studies found a 79% reduction in the risk of NEC when PDHM is used instead of formula (Boyd, Quigley & Brockelhurst, 2007). A recent randomized clinical trial assigned extremely low birth weight infants (weighing less than 1,500 grams or 2.75 pounds at birth) to a formula or PDHM group. Only 1 infant in the PDHM group (out of 29 infants) acquired NEC which was treated medically, while 5 infants in the formula group (out of 24 infants) acquired NEC and 4 of these cases required surgery (Cristafolo et al., 2012).
Pasteurized donor human milk protects against NEC and saves lives. It also boosts the infant’s healthy balance of good gut bacteria or probiotics. Pasteurized donor human milk is full of small sugar molecules, called human milk oligosaccharides. These sugar molecules are the perfect food source for the good bacteria in the infant’s stomach. Colonization by good bacteria, as opposed to bad bacteria, is crucial for healthy growth and development and may even protect against NEC in the preterm population (Caicedo, Schanler & Neu, 2005). So next time you hear about the benefits of breast milk, please think about pasteurized donor human milk and the amazing milk donors that make this all possible.
Written by Summer Kelly, RN, BSN, IBCLC, Breastmilk extraordinaire and Clinical Chair of the Board of Directors. When she is not helping new mothers breastfeed or educating local hospitals about implementing human milk procedures, she is completing a masters degree in Molecular Biology from Northeastern University. We are honored to have her resounding expertise on our team.