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Researchers at the University of Oxford and the University of Southampton have the go ahead to begin a study to find out which milk feeds could help protect premature babies from a life-threatening bowel condition called necrotising enterocolitis (NEC).
The year-long study has been made possible with a grant of £26,262 from children’s charity Action Medical Research.
The research will involve analysing data on the feeding patterns and type of milk given to more than 400 premature babies.
More than 61,000 babies are born prematurely in the UK each year1-4 and, sadly, NEC is a significant cause of suffering and death in babies who are born too soon. Up to one in 20 babies in neonatal units develops this devastating condition.5
NEC happens when the lining of a baby’s intestines becomes inflamed and starts to die. This can lead to a hole developing, which allows the contents of the intestine to leak into the abdomen. This can cause a very dangerous infection. NEC can be difficult to diagnose but symptoms tend to include general signs of illness, problems feeding or vomiting, and a swollen and tender tummy.
Premature babies, those with a very low birth weight and babies who are already poorly are the most susceptible to developing NEC.
Babies with NEC need urgent treatment. This often involves emergency surgery to remove damaged parts of their bowel. In fact, NEC is the most common reason for emergency surgery in newborn babies6.
Tragically, many babies with NEC do lose their lives and some of those who survive suffer long-term complications, such as persistent bowel problems, poor growth and learning difficulties7.
Lead researcher Associate Professor Ed Juszczak of the University of Oxford says: “We are investigating how different milk feeds and food supplements affect babies’ chances of developing NEC, in the hope of better understanding why so many babies still develop this devastating condition.”
Babies who are at high risk of developing NEC tend to be given breast milk first, because evidence suggests breast milk is protective against the condition. Breast milk contains growth factors, antibodies and immune cells which may help prevent the problem. But it does not always provide all of the nutrients premature babies need to support growth and development – so it is often fortified or supplemented with formula. The team is investigating whether babies’ chances of developing NEC increase if breast milk is fortified or if they are given formula milk.
Researchers will analyse data from a previous study known as the ADEPT trial. This study, which was also funded by Action Medical Research, captured detailed ‘feeding logs’ of 404 premature babies in their first few days of life.
Associate Professor Nigel Hall, who is overseeing the research along with colleagues at the University of Southampton, explains: “We hope that the data from ADEPT will enable us to find out whether the type of milk babies are fed affects their chances of getting NEC – whether babies are more likely to develop NEC if they’re given breast milk, fortified breast milk or cow’s milk formula. We are also studying the relationship between the timing of any changes in the type of milk babies were given and the onset of NEC.”
Associate Professor Hall adds: “If certain types of milk feeds in these babies seem to protect against NEC, or put babies at increased risk of developing NEC, we plan to set up a clinical trial to investigate this further.”
Director of Research at Action Medical Research Dr Tracy Swinfield says: “We are so pleased to be able to support this important new project. The earlier ADEPT study, also funded by Action Medical Research, was the largest of its kind and produced a large amount of high quality data. Now, by analysing these results in more detail, the researchers will, we hope, find out more about how to protect tiny, vulnerable babies from necrotising enterocolitis.”
** Ends **
Notes to Editors
About the ADEPT trial:
- A previous study funded by Action Medical Research, known as the ADEPT trial, aimed to establish whether it is better to feed premature babies their first milk feeds within two days of birth, or feed them intravenously and delay milk feeding for up to six days.
- The ADEPT trial was the largest study ever conducted on the introduction of milk feeds in premature babies. A lot of information was gathered on the feeding patterns of 404 premature babies and what type of milk they were given as time went by.
- The study showed that babies who received early milk feeding achieved full milk feeds faster and the incidence of necrotising enterocolitis did not appear to increase, whereas the late feeding group needed a longer course of intravenous feeding and a longer stay in intensive care.
- This meant there was no longer any need to delay milk feeding – something that had been common practice in the past but had been based on weak evidence.
- https://www.npeu.ox.ac.uk/research/adept-64
References
1. National Institute for Health and Care Excellence (NICE). Preterm labour and birth final scope April 2013. http://www.nice.org.uk/guidance/gid-cgwave0660/resources/preterm-labour-and-birth-final-scope2 Website accessed 15 August 2016
2. Office for National Statistics. Statistical bulletin: Birth Summary Tables, England and Wales: 2015. Live births, stillbirths, and the intensity of childbearing measured by the total fertility rate. http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsummarytablesenglandandwales/2015Website accessed 15 August 2016.
3. ISD Scotland Data Tables (2015 data). Maternity and Births. Table 5 - Live births (all, singleton and multiple) by birthweight and gestation. http://www.isdscotland.org/Health-Topics/Maternity-and-Births/Publications/data-tables.asp?id=1543#1543 Website accessed 15 August 2016.
4. Northern Ireland Statistics and Research Agency. Births. Live births 1887-2014. http://www.nisra.gov.uk/demography/default.asp8.htm Website accessed 15 August 2016.
5. Rees CM et al. Trends in infant mortality from necrotising enterocolitis in England and Wales and the USA. Arch Dis Child Fetal Neonatal Ed 2008;93:F395-F396.
6. Great Ormond Street Hospital for Children. Necrotising enterocolitis. http://www.gosh.nhs.uk/medical-information-0/search-medical-conditions/necrotising-enterocolitis Website accessed 16 November 2016.
7. MedlinePlus. Necrotizing enterocolitis. https://medlineplus.gov/ency/article/001148.htm Website accessed 3 August 2016.
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