Human Milk Fortifier Can Raise NEC Risks for Preterm Babies

Preterm infants are at higher risk for developing a life-threatening condition called necrotizing enterocolitis (NEC). The threat is even greater for premature babies that weigh less than three pounds, four ounces at birth. Often, these infants – known as very low birth weight (VLBW) preemies – require extra nutrition to grow and thrive. And while breastfeeding is best, in some cases, mother’s milk alone cannot supply VLBW babies with everything they need. If you have a VLBW baby, your doctor or hospital’s neonatal medical team may recommend adding human milk fortifier. What you may not know is that most human milk fortifier products sold today also contain cow’s milk-based proteins. Unfortunately, studies show those same cow’s milk-derived proteins used in baby formula can also increase NEC risks for preterm babies.

Meta-Analysis: 3.3-Fold Increased NEC Risk for Babies Fed Fortifiers That Contain Cow’s Milk

A May 2020 meta-analysis reviewed three recent studies on exclusively breastfed preterm babies given supplemental nutrition using human milk fortifier. The studies included 453 total test subjects, all of whom were exclusively fed a human milk-based diet. (This milk came either directly from the baby’s mother, or from donor milk.) However, as is common practice in many hospital Neonatal Intensive Care Units (NICU), the babies also received human milk fortifier. NICUs participating in these studies fed some VLBW babies a fortifier made from cow’s milk (CMDF). Others fed the babies using a fortifier that did not contain cow’s milk-derived proteins (HMDF). Researchers found that this cow’s milk-based product, CMDF, made VLBW babies 3.3-fold more likely to develop NEC.

According to this meta-analysis, no NICU staffers fed any baby formula to the preterm infants participating in these studies. The only exposure to cow’s milk-based proteins for these babies came from mixing mother’s milk with human milk fortifier.

But higher NEC risks alone weren’t the only adverse outcomes for VLBW babies given cow’s milk-based fortifiers. The meta-analysis found babies in the cow’s milk-derived fortifier group also had:

  • 40% higher risk for any other serious adverse effects, such as bronchopulmonary dysplasia (BPD), late-onset sepsis, or patent ductus arteriosus (PDA)
  • 2.4-fold higher risk for developing a serious eye disorder known as retinopathy of prematurity, which can lead to blindness
  • More than double the risk for death

One HMF Alternative Made Exclusively With Human Donor Milk

Currently, Prolacta is the only manufacturer that makes human milk fortifier products without using any cow’s milk-derived proteins. Prolacta’s 100% human milk-based nutritional products use concentrated proteins exclusively derived from donor breast milk. Instead of using cow’s milk to give preterm babies additional proteins and sugars, Prolacta products exclusively use human milk oligosaccharides (HMOs).

If you would like to request a consultation, please contact Levin, Rojas, Camassar, and Reck, LLC today.

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