Low rate of necrotizing enterocolitis in extremely low birth weight infants using a hospital-based preterm milk bank

Objective We examined the effect of two strategies to prevent necrotizing enterocolitis (NEC) in extremely low birth weight (ELBW) infants-adherence to a standardized feeding protocol and use of a hospital-based milk bank to provide exclusive preterm human milk feedings. Study design We conducted a single-center observational study from 2010 to 2015. Infants received preterm human milk, initially trophic feeds from days 7 to 14 after birth, followed by advancement of 15 mL/kg/day to reach a goal of 180 mL/kg/day. Fortification was used selectively for weight gain < 15 g/kg/day. We determined the incidence of NEC, other morbidities, and growth. Results The cohort included 398 ELBW infants who survived to day 14 without congenital anomalies. Mean gestational age was 26.2 +/- 1.9 weeks. Maternal milk was used as the sole feeding in 62% of infants; preterm donor milk was used solely or as supplement in 29%. Full feeds were reached at a median of 27 (IQR 23, 33) days. Four infants (1%) developed NEC. Conclusion Use of standardized feedings with a hospital-based milk bank is associated with an incidence of NEC lower than previously reported.