HM provided a clear protective effect against NEC , with an approximate 4 % reduction in incidence .
HM also provided a possible reduction in LOS , severe ROP and severe NEC .
Particularly for NEC , any volume of HM is better than EPTF , and the higher the dose the greater the protection .
Evidence regarding pasteurisation is inconclusive , but it appears to have no effect on some outcomes .
Improving the intake of mother ’s own milk ( MOM ) and /or donor HM results in small improvements in morbidity in this population
Enteral feeding regimens and necrotising enterocolitis in preterm infants: a multicentre case–control study
Background : Most preterm infants who develop necrotising enterocolitis ( NEC )  have received enteral feeds . Uncertainty exists about which aspects of the feeding regimen affect the risk of NEC . Aim : To examine associations between various enteral feeding practice s and the development of  NEC  in preterm infants . Methods : Multicentre case – control study . 53 preterm infants with NEC were enrolled together with a gestational age frequency-matched control without NEC from a r and omly selected neonatal unit . Clinical and feeding data were extracted and compared between the groups . Results : Significantly fewer cases than controls had received human breast milk ( 75 % vs 91 % ; OR 0.32 , 95 % CI 0.11 to 0.98 ) . The day on which enteral feeding was started did not differ significantly ( mean ( SD ) days after birth : cases 2.9 ( 2.8 ) and controls 2.8 ( 1.8 ) ) . The mean ( SD ) duration of trophic feeding ( < 1 ml/kg/h ) was significantly shorter in the cases ( 3.3 ( 3.1 ) days ) than controls ( 6.2 ( 6.7 ) days ) ( mean difference ( MD ) −2.9 , 95 % CI −4.9 to −0.9 ) days . Cases were fully fed significantly earlier than controls ( mean ( SD ) days after birth : cases 9.9 ( 4.2 ) and controls 14.3 ( 9.8 ) ; MD −4.4 , 95 % CI −7.3 to −1.5 ) . Conclusions : These data suggest that the duration of trophic feeding and rate of advancement of feed volumes may be modifiable risk factors for NEC in preterm infants . Further r and omised controlled trials are warranted to assess the effect of different rates of feed advancement on the incidence of NEC , as well as other outcomes
HM provided a clear protective effect against NEC , with an approximate 4 % reduction in incidence .
HM also provided a possible reduction in LOS , severe ROP and severe NEC .
Particularly for NEC , any volume of HM is better than EPTF , and the higher the dose the greater the protection .
Evidence regarding pasteurisation is inconclusive , but it appears to have no effect on some outcomes .
Improving the intake of mother ’s own milk ( MOM ) and /or donor HM results in small improvements in morbidity in this population