Pasteurized donor human milk for VLBW infants: The effect on necrotizing enterocolitis and related factors

Objective: Necrotizing enterocolitis (NEC) causes significant morbidity and mortality in very low birth weight (VLBW) infants. Our objective was to assess the influence of pasteurized donor human milk (PDHM) on the incidence of NEC. Methods: This is a retrospective chart review of 179 VLBW (< 1500 g) infants born in the pre-PDHM era (January 2001-March 2003) vs 152 born in the post-PDHM era (April 2003-December 2004). Results: The cohorts had similar demographic characteristics. The overall incidence of NEC was 12% in the pre-PDHM era vs 10% in the post-PDHM. Although not statistically significant, surgical NEC decreased from 7% to 3% respectively. Sepsis decreased from 10% to 6% between the pre and post-PDHM eras (p=0.04). Erythropoietin administration for anemia of prematurity was associated with a protective effect for NEC, even after adjusting for gestational age, indomethacin and mother's own milk intake (OR 0.37, 95% CI 0.16-0.85, p=0.02). The introduction of PDHM did not decrease the amount of mother's own milk use. Conclusions: The overall incidence of NEC remained unchanged after the introduction of PDHM in a single neonatal intensive care unit, but the cases of surgical NEC had a trend to decrease. Randomized controlled clinical studies evaluating the effect of PDHM on the severity of NEC are warranted.