Breast milk: A modulator of the immature immune system in the management of necrotising enterocolitis in preterm neonates

Necrotising enterocolitis remains (NEC) a major source of morbidity and mortality among preterm infants. The use of breast milk is a major protective factor against NEC, with its anti-infective nutritional and immunological properties. Breast milk, expressed either from the mother’s own milk, or in the form of pasteurised donor milk, is the preferred nutritional source of enteral feeding for very low and extremely birth weight infants. Although there is a lack of definite data, breast milk is superior to preterm commercial formulas. However, breast milk seems not only to protect the immature bowel of preterm neonates but also treat the immature host defense system of the gut. The present review presents the currently available data in the literature on the diverse aspects of the role of breast milk not only as a useful feeding strategy to prevent NEC, but also as a means to treat the immature gut of preterm infants.