Human Milk and the Small Premature Infant

Advances in recent years in knowledge and techniques of treatment of premature infants have resulted in lower neonatal mortality. The advances relate to management of respiratory failure, maintenance of energy, fluid, and electrolyte balance, and control of body temperature. As a result of improvement in these areas, attention has become focused on other causes of death, including infections and necrotizing enterocolitis. Much of the current interest in feeding human milk to small premature infants centers around the possibility that human milk may offer some protection against infections and/or necrotizing enterocolitis. Although the human infant, unlike the newborn of many species, absorbs little if any antibody from the maternal milk, it seems likely that human milk protects the human newborn against infection.1.2The antimicrobial properties of milk include antibodies, complement components, lysozyme, lactoperoxidase, lactoferrin, fatty acids, and cellular components.3.4The characteristic gut flora associated with feeding of human milk,