As the mother of a premature baby, I learned during our time in the NICU about some of the complications that can occur with infants born before 36 weeks. Those complications are amplified for babies that are born very prematurely.
According to the March of Dimes, babies born prematurely have an increased chance of health problems at birth and later in life than those born in and around their due date. Preterm infants can have long-term intellectual and developmental disabilities and problems with their brain, eyes, lungs and other organs.
One of the complications that preterm infants can be prone to during their time in the NICU is necrotizing enterocolitis (NEC), a serious disease of the gut. The U.S. National Library of Medicine (UNLM) explains that underdeveloped cardiac, respiratory, gastrointestinal and immune systems can increase the risk of NEC, which affects five to 12 per cent of very-low birth-weight infants. It will lead to surgery in 20 to 40 per cent of cases and is fatal in 25 to 50 per cent of cases.
Many factors can contribute to NEC, the UNLM states, but the exact cause is not fully understood. We are learning more about necrotizing enterocolitis, and it is very concerning. For example, I recently discovered studies that show baby formula containing bovine milk may lead to a higher incidence of NEC in preterm infants than human milk.
Something baby needs to live could be deadly
Think about that. Something the baby needs to live could have lifelong or even fatal consequences. What is especially troubling is that even though there are studies out there, the word may not be getting out on a widespread basis. Even those in neonatal intensive care units who work so hard to preserve the health and lives of these babies may not be aware of the possible link between baby formula and necrotizing enterocolitis.
Necrotizing enterocolitis is a devastating bacterial disease that invades the intestines. The intestine can no longer hold waste, so bacteria can travel into the bloodstream and cause a life-threatening infection. Waste that can pass into the baby's stomach can make it very ill.
KidsHealth reports that in most cases, a specific cause for NEC isn't found, but experts believe the following may play a role:
- an underdeveloped intestine
- not enough oxygen or blood flow to the intestine at birth or later
- an injury to the intestinal lining
- heavy growth of bacteria in the intestine that erodes the intestinal wall
- viral or bacterial infection of the intestine
- formula feeding
Symptoms develop within two to four weeks of birth
According to KidsHealth, most cases of necrotizing enterocolitis occur in babies born before 32 weeks of gestation, and they generally develop it within two to four weeks of their birth. The symptoms can include trouble feeding, low body temperature, apnea, a swollen, red or tender belly, low blood pressure, a slowed heart rate, diarrhea, constipation or vomit containing bile.
Of course, as soon as NEC is diagnosed, treatment begins immediately. That could include temporarily stopping all feedings, antibiotics, removing fluid and air from the stomach and intestine and, in severe cases, surgery.
Most babies who develop necrotizing enterocolitis recover fully with no further feeding problems. However, the intestine is scarred, narrowed, or blocked in some instances, and more surgery may be needed.
KidsHealth states that if the baby responds to the treatment, they can return to regular feedings after a week or two. However, breast milk is recommended because "it is easily digested, supports the growth of healthy bacteria in the intestinal tract, and boosts a baby's immunity."
May be given pasteurized human breast milk
If a mother cannot breastfeed or cannot produce enough breast milk, the baby may be given pasteurized human breast milk from a milk bank. Indeed, ScienceDaily reported that researchers at Johns Hopkins Medical Institutions found that extremely premature babies fed donor milk are less likely to develop necrotizing enterocolitis than babies fed a standard premature infant formula derived from cow's milk. It was also noted that sadly up to 40 per cent of babies who develop NEC will die.
The study noted that while the health advantages of mother's milk are well known, "some concerns about donor milk have lingered, including how it compares to mother's milk and whether it is, indeed, superior to cow milk formula," according to ScienceDaily. Researchers said their findings should resolve any doubts about the risks and clarify the benefits of human donor milk.
"The stark differences in the risk of NEC, its complications and the need for surgery between babies who receive human donor milk and those who get formula signal the need for a change in feeding practices across neonatal intensive care units," lead investigator Dr. Elizabeth Cristofalo told ScienceDaily. In exclusively formula-fed babies, the confirmed disease was six to 10 times more common than those fed breast milk alone and three times more common than those who received formula plus breast milk.
About 1,500 low birth weight babies born in Ontario each year
Milk banking is a common practice around the world, states Sinai Health; adding donated breast milk can help save a preterm baby's life "by dramatically reducing the rate of a life-threatening medical complication." About 1,500 low birth weight babies are born in Ontario each year, and 70 per cent don't have access to a full supply of mother's milk, which has vital nutrients and protective properties. They estimate more than 1,000 fragile babies in Ontario hospitals could reduce their risk of health complications by receiving donated milk each year.
"While mother's own milk is the gold standard, many mothers of extremely vulnerable hospitalized babies are unable to provide the necessary volume of milk for their babies," according to the Sinai Health website. "When mother's own milk is not available or is limited, pasteurized donor milk is recommended as an alternative to formula by the Canadian Paediatric Society for sick hospitalized infants."
When parents go through the heartbreaking ordeal of watching their newborn suffering from something as traumatic as NEC, there are many questions. However, how likely would they be to draw a connection to baby formula containing bovine milk and necrotizing enterocolitis?
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