Breast Milk Protection Against Enterocolitis

Abstract

A neonatal rat model of necrotizing enterocolitis was produced by feeding pregnant mothers a 2.5% protein diet and by stressing her newborns with 3 days of hypoxia (FIO2<5%) and hypothermia (4°C). The resultant malnourished pups (birth weight 5.7 gm vs 7.8 gm, daily weight gain 1.5% vs 12.5%, total protein 2.9 gm% vs 3.9gm%, albumin 1.5 gm% vs 1.9 gm%, p <.05) following stress developed histologically confirmed enterocolitis (24 of 95 pups, 26%), despite feeding from their own mother. When these animals were foster nursed by a normally nourished mother, there was a dramatic diminution in the incidence of enterocolitis (4 of 44, 9.0%). Breast milk was analyzed from malnourished and normal mothers and found to be significantly deficient in protein (7.27 gm% vs 8.72 gm%, p <.05) and total mononuclear cells (1.4 × 10⁶ cells/cc vs 3.2 × 10⁶ cells/cc, p < .05). Subsequently, foster nursing was done between AgB incompatible Lewis and Brown Norway strains, and in both pup-maternal strain combinations, foster nursing to normally nourished mothers afforded protection against enterocolitis. Furthermore, subsequent breast milk donor strain skin grafts onto recipient pups failed to demonstrate either tolerance or sensitization to donor strain antigen (median survival time 9.0 days). These data suggest that although maternal nutritional status may play a significant role in protecting the malnourished rat pup from developing enterocolitis, it is unlikely that the cellular component of this milk is immunologically active.

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