Preterm infant nutrition, gut bacteria, and necrotizing enterocolitis

Purpose of reviewProvide research that relates the developing intestinal microbiome, nutrition, and the subsequent host response to the development of necrotizing enterocolitis (NEC), one of the most common and deadliest diseases seen in newborn infants. After nearly 50 years of little to no progress in this area, we are finally beginning to obtain evidence that is likely to lead to better understanding of both pathophysiology and prevention of the disease.Recent findingsWe will discuss new discoveries related to the development of the microbiome from prenatal to postnatal life, as well as new findings of microbes and human milk oligosaccharides in human milk as they relate to pathogenesis of NEC. The effect of antibiotics and acid blocking agents, as they may increase the odds of development of NEC, will also be discussed.SummaryThe implications of these findings are that improved understanding of the developing microbiome, the factors that affect the microbiome including nutrition such as donor milk versus baby's own mother's milk, and certain drugs, will help clinicians to adjust their current feeding and drug utilization to potentially prevent this disease.