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

Objectivewe 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 designwe 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.resultsthe 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.conclusionuse of standardized feedings with a hospital-based milk bank is associated with an incidence of nec lower than previously reported.