Date of Completion

Spring 5-1-2016

Thesis Advisor(s)

Jacqueline McGrath

Honors Major



Maternal, Child Health and Neonatal Nursing


Purpose: To determine what degree of exposure to breast milk feeding is protective against Necrotizing Enterocolitis (NEC) in very low birthweight (VLBW) preterm infants.

Data Sources: This is a secondary data analysis of 56 VLBW preterm infants diagnosed with NEC and 56 age-matched VLBW infants who served as controls. All infants were born between 1997 and 2009 and cared for in the Newborn Intensive Care Unit (NICU). Infants were born at or before 29 weeks gestation and with a birth weight less than 1500 grams. Data included the volume fed daily and type of feeding along with demographic birth data.

Methods: The percentage of total volume of feeding that was breast milk versus infant formula was calculated over time frames of three weeks, two weeks, one week, six days, five days, four days, three days, two days and one day before the NEC diagnosis date in case infants. Odds ratios were used to determine the relationship between mean percent of breast milk feeding and the occurrence of NEC.

Results: In a preliminary odds ratio, breast milk feeding was protective against NEC at a threshold of 50%. When over 50% of the total feeding volume consisted of breast milk versus infant formula, infants were nearly half as likely to develop NEC. This finding was clinically significant and underscores the importance of breast milk in NEC protection. However, the sample size available to this study proved to be too small to be statistically significant.

Implications for Practice: Preterm infants in the NICU should receive the highest possible percentage of breast milk feedings. Strategies to increase the provision of breast milk need to be a priority.

Conclusions: Our findings demonstrate that if at risk infants receive at least 50% breast milk by volume, then the risk for NEC may be decreased by 50-66%. Further analysis involving a larger sample of preterm infants is needed to the support this finding.