Human milk oligosaccharides and necrotising enterocolitis
Human milk is known to reduce the risk of necrotising enterocolitis (NEC) in preterm infants, but mechanisms are poorly understood. Human milk oligosaccharides (HMOs) are complex sugars produced by the mammary gland and present in variable amounts in different breast milks. Animal models show HMOs impact on development of NEC and human
preterm infant studies show a specific HMO, called
disialyllacto-N-tetraose (DSLNT), is present in maternal milk in lower amounts in infants who go on to develop NEC. This article reviews the role of HMOs in NEC development and the clinical data in preterm infants, and considers the possible next steps for supplementation in preterm infants.
Kristina Chmelova1
Neonatal Research and Transport Fellow
k.chmelova@nhs.net
Andrea C Masi2
Clinical Researcher
Janet E Berrington1,2
Consultant Neonatologist
1Department of Neonatology, Newcastle upon Tyne Hospitals NHS Foundation Trust
2Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne

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- Although NEC is a major cause of mortality and morbidity in preterm infants, its pathogenesis remains unclear.
- HMOs are complex sugars in breast milk that cannot be digested by humans. Their composition varies widely from woman to woman.
- DSLNT is one HMO that may protect against NEC.
- Supplementation and synthesis of HMOs are subjects for future research.
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