Does the Opening of a Milk Bank in NICU Cancel the Incidence of NEC?

Several studies suggest that donor milk (DM) is effective in preventing necrotizing enterocolitis (NEC) in preterm infants and DM is widely used for this purpose when the mother's milk (OMM) is unavailable, and the presence of a DMB (Donor Milk Bank) in NICU has indeed increased breast milk feeding. The underlying cause of NEC is poorly understood but seems multifactorial and is strongly associated with prematurity. The protective effect is likely a result of effects from countless bioactive components and cells that function synergistically to provide multiple levels of protection. In our experience the availability of DMB in NICU has improved and standardized the use of breast milk and DM for premature babies, using internal protocols and a breastfeeding support practice that has been consolidated over the years. The present study consists of the assessment of the impact of DMB on the incidence of NEC, intestinal perforation with recourse to surgery, and mortality from NEC in our NICU. We compared the data related to two distinct periods, pre and post activation of the DMB: the years 2006 to 2011 versus the years 2012 to 2016. The population includes 372 very low birth weight infants (VLBW). We observed a reduction of 53% in the incidence of NEC, 86% of the recourse to surgery and 58% of mortality in the second rather than the first period in question, with total reset of all three entries in the years 2015-2016, where no case of NEC was observed in the VLBW. The comparison between the numbers of transferred infants for surgery in the two periods indeed has a statistical significance. Our experience is further evidence of the protective role of human milk on NEC and supports the recommendations that encourage its wide use in NICU. It also confirms that the existence of the internal guide grafting favors the use of breast milk and DM in NICU.