Semester of Graduation
Spring 2026
Degree Name
Masters of Science in Nursing
Department
Wellstar School of Nursing
Committee Chair/First Advisor
Dr. Nancy Ballard
Abstract
Introduction/Question: NEC is a serious condition characterized by the death of intestinal tissue, primarily affecting premature infants or those with low birth weight. The incidence of NEC poses a significant concern in neonatal healthcare due to its substantial mortality risk, particularly among vulnerable populations. This condition can lead to various complications, including sepsis, nutritional deficiencies, delays in growth and development, and, in severe cases, death. NEC not only impacts the health of the infant but also affects the emotional well-being and bonding experiences of parents. Despite advancements in neonatal care, the rate of NEC has increased, highlighting the need to assess the associated risk factors and potential interventions. The objective of this integrative review is to investigate how different types of feeding, specifically breast milk compared to formula, affect the development of NEC in infants in the United States.
Findings: Research revealed the protective role of breast milk composition against NEC. Specific substances, such as bioactive lipid dioleoyl phosphatidylcholine (DOPE), Immunoglobulin A (IgA), and Human Milk Oligosaccharides (HMOs), make breast milk unique and beneficial for newborns. Studies have also found that Exclusive Human Milk Diet (EHMD) and fortified maternal milk decrease the risk of NEC compared to bovine-based fortifiers. In contrast, endotoxins and lipopolysaccharides, which are found in formulas, are known to contribute to mortality from NEC in premature infants.
Conclusion: This review highlights the advantages of breast milk over formula feeding in preventing NEC in premature infants. Key findings suggest that human milk’s protective properties, including oligosaccharides and IgA, contribute to its superiority. The use of EHMD with fortifiers improves growth and lowers NEC incidence. Further research is needed on educational programs for healthcare professionals to standardize feeding practices and understand the effects of combining breast milk and formula. Education for caregivers about the benefits of breast milk is essential for the health of premature infants.