The beneficial effect of human milk on reducing pathogenetic risk factors for necrotizing enterocolitis (NEC)

(A) Immaturity of the intestinal epithelial barrier and neonatal mucosal immune system predispose the preterm infant to bacterial invasion, which triggers the sequence of NEC. Stimulation of proinflammatory cytokines compromises intestinal defenses. Imbalance between epithelial cell injury and repair leads to a cycle of bacterial invasion, immune activation, uncontrolled inflammation, and gut barrier failure.
(B) Human milk provides oligosaccharides, acetylhydrolase, and mucosal immune components; alters bacterial flora; affects mucus coat; decreases epithelial permeability; increases peristalsis (motility); and lowers gastric pH, which enhances barrier function.