Necrotizing Enterocolitis and Enteral Nutrition Products

Necrotizing Enterocolitis and Enteral Nutrition Products

Enteral feeding in premature infants typically refers to nutrition that is taken through a feeding tube, either nose to stomach, or mouth to stomach. Babies typically are not physically capable of coordinating sucking, swallowing, and breathing simultaneously until they are around 35 weeks old, so infants born before 35 weeks will likely need temporary tube, or enteral, feeding. 

But the kinds of enteral nutrition products infants are fed during those first few weeks can sometimes cause additional medical issues. Necrotizing Enterocolitis is a potentially deadly condition that has been linked to specific types of enteral nutrition products. Parents are often unaware of this serious condition, and what’s worse is that formula companies rarely publicize it.


Nutritional Needs of Premature Infants

Adequate nutritional support is necessary for the premature infant to gain weight at an appropriate rate, a rate which is almost twice that as a full term infant. Without adequate weight gain, a premature infant is at risk of postnatal grown failure, a potentially serious issue that can have significant neurological and health outcomes

Studies have shown that an exclusively human milk-based diet is associated with lower rates of necrotizing enterocolitis. Many preterm infants however, are not able to start enteral feeds immediately after birth. Parenteral nutrition, the delivery of nutrition intravenously, is often begun first. Doctors must carefully balance the intense nutritional needs of the infant with the maturity of its gastrointestinal system.  


What Is the Progression of Enteral Feeding?

Interestingly, Necrotizing Enterocolitis only occurs after infants have been fed enteral nutrition. 

Enteral feeding typically begins with gut priming for 1-4 days to stimulate gastrointestinal functioning. If the infant tolerates these feeds without issue, then feeding is increased slowly until the infant is meeting its feeding goals. 

But most premature infants cannot meet their high nutritional needs through enteral intake of breast milk or formula only, and will require fortification. 


Types of Fortification

Fortification can come in two types; human based and bovine based. In the event that the mothers own milk is not available, pasteurized donor human fortification can be used. Compared with bovine milk, this is much more easily digested and absorbed by the infant.  

Yet many infants are still provided a bovine milk–based preterm formula. While it provides a consistent amount of calories and nutrients, and is less expensive, it has also been linked in several studies to a higher risk of necrotizing enterocolitis. 


What Is Necrotizing Enterocolitis?

Necrotizing Enterocolitis or NEC is a serious gastrointestinal problem. When an infant suffers from NEC, their intestinal tissue becomes inflamed, causing it to eventually die. A hole may then form inside the baby’s intestine, allowing bacteria to leak into the abdomen or bloodstream. 

NEC usually develops somewhere between two to six weeks after birth, and is most commonly seen in premature infants. In some cases, NEC is mild, and requires little intervention. Other infants tragically experience severe or life-threatening symptoms. 


The Costs of Necrotizing Enterocolitis

The costs of caring for an infant with necrotizing enterocolitis are astonishingly high. Data from 2011 and 2012 show that the cost is typically between $180,000 to $198,000 per infant who is diagnosed. That cost nearly doubles when the infant receives surgical treatment associated with the condition. 

What’s more? The type of enteral nutrition product used can actually predict health care costs. Exclusive use of human milk from either the mother or a donor has been shown to result in savings of over $8000 in premature infants, along with almost 4 fewer days spent in the NICU. 


Formula Companies Know the Risk of Necrotizing Enterocolitis Associated With Their Products

The risks of giving a premature infant bovine based formula during enteral feeding has been known for over thirty years, and formula makers have been well aware of these issues. Yet they still have not stepped forward to adequately warn consumers or doctors of the risks associated with necrotizing enterocolitis and their products. 

A lawsuit is currently being pursued against Similac for failing to warn about the link between Similac’s formula and NEC, with Similac’s safety warnings only stating that very low-birth-weight babies were susceptible to “gastrointestinal complications” if fed formula. 

Formula companies need to be held responsible for failing to properly warn consumers about the potential dangers of their products. If your infant has suffered from NEC due to being fed a bovine based enteral nutrition product, we want to hear from you. Contact us today for a free consultation at 1-866-333-7715 or online via our form.