Human Milk Growth Factors and Their Role in NEC Prevention: A Narrative Review

Abstract

Growing evidence demonstrates human milk's protective effect against necrotizing enterocolitis (NEC). Human milk derives these properties from biologically active compounds that influence intestinal growth, barrier function, microvascular development, and immunological maturation. Among these protective compounds are growth factors that are secreted into milk with relatively high concentrations during the early postnatal period, when newborns are most susceptible to NEC. This paper reviews the current knowledge on human milk growth factors and their mechanisms of action relevant to NEC prevention. It will also discuss the stability of these growth factors with human milk pasteurization and their potential for use as supplements to infant formulas with the goal of preventing NEC.

Keywords: Epidermal Growth Factor (EGF); Erythropoetin (EPO); Granulocyte Colony Stimulating Factor (G-CSF); Heparin-Binding EGF-like Growth Factor (HB-EGF); Holder pasteurization; Insulin-like Growth Factor 1 (IGF-1) Insulin-like Growth Factor 2 (IGF-2); Vascular Endothelial Growth Factor (VEGF); growth factors; human milk; necrotizing enterocolitis.

Figure 1

Graphical representation of mechanisms by which growth factors present in breast milk may protect the neonatal intestine against NEC.