Susan Hepworth and Mitchell Goldstein, MD

Researchers may have pinpointed the “secret ingredients” that allow human milk to protect newborns against a life threatening condition called necrotizing enterocolitis. They are HMOs – human milk oligosaccharides. (1)

Up to 200 different types of HMOs exist, and consuming a diversity of HMOs has been linked with enhanced immune system development, growth, and possibly brain development. The list of benefits grows with the results of a new study. Researchers revealed that extremely low birth weight babies who received human milk with a broader array of HMOs had a lower risk of developing necrotizing enterocolitis, or NEC.(2)

Human milk has long been recommended to reduce the risk of NEC in premature babies, yet some babies fed human milk exclusively still develop the condition. This new information clarifies which components of human milk, specifically which HMOs, provide the protective effect.

Known as prebiotics, HMOs feed good bacteria, called probiot-

ics – essential to building a healthy intestinal gut that can fight

viruses. Prebiotics can also limit the growth of harmful, infection-

causing bacteria. HMOs are the third most abundant component

of human milk, after fats and carbohydrates.

The health benefits of human milk are well documented. It pro-

vides antibodies to ward off GI and ear infections; it lowers babies’

risk of asthma, allergies, and respiratory illness, among other ben-

efits. A broader understanding of HMOs’ function now bolsters

that list.

However, it also underscores a painful disparity. Not every baby

has access to human milk. Not all mothers produce milk or enough

milk, and some babies are adopted or in foster care. Where avail-

able, human milk banks that provide donor milk can help to meet

that need. Nevertheless, access and cost remain barriers. There

are not enough banks or donated milk.

Moreover, cost is an issue. Processing and safely delivering hu-

man milk is expensive. Not all insurance companies provide cov-

erage for the cost of human milk or human milk-based fortifiers,

despite their demonstrated health benefits for fragile infants.

Broader coverage policies could increase access to many, ben-

efitting babies’ health and shielding insurance companies from the

expense of dangerous and avoidable conditions like NEC.