Exclusive human milk diet cuts NEC risk in babies with complex congenital heart diseases

A diet consisting exclusively of unfortified human milk may reduce the risk of preoperative necrotizing enterocolitis (NEC) in infants with complex congenital heart diseases, a recent study has shown.

Researchers conducted a single-centre retrospective analysis of 546 infants (58.4 percent male) with an isolated cardiac lesion and who were at high risk of NEC. Information about feeding regimen and relevant covariates, such as sociodemographic variables and medication, were collected.

Even before the first cardiac surgery, 3.3 percent of the patients developed NEC, at a median age of 8.5 days. The median age at surgery was 16 days. NEC occurred a median of 5 days after the initiation of feeding. Two infants who developed NEC were transfused with packed red blood cells.

Bivariate analysis found that a larger maximum volume of feeds given during the preoperative period correlated with a higher risk of NEC (median volume, 100 vs 20 mL/kg/d; p=0.04). An exclusive human milk diet also emerged as a significant protective factor.

Multivariable logistic regression analysis confirmed this. Exclusive feeding with an unfortified human milk diet cut the risk of NEC by more than 80 percent (odds ratio [OR], 0.17, 95 percent confidence interval [CI], 0.04–0.84; p=0.03).

On the other hand, having a biventricular lesion with ductal dependent pulmonary perfusion significantly increased NEC risk (OR, 3.27, 95 percent CI, 1.07–9.96; p=0.04).

Despite these findings, researchers pointed out that the present study was primarily hypothesis-gathering in nature and that future randomized studies are required to better characterize the benefits of an unfortified human milk diet in this population.