NEC, or necrotizing enterocolitis, can cause serious complications for many infants. In about 25 percent of cases, infants die after facing a diagnosis of NEC. Since 2011, formula manufacturers and pediatricians have known that feeding cow’s milk-based formula to premature infants may increase the risk of developing NEC. Unfortunately, NICUs continue to use the formula, especially for premature infants who need to gain weight rapidly.
What baby formulas have a direct link to NEC? According to a study published in Breastfeed Med, infants fed cow’s milk-based formula and fortifiers have a higher overall risk of developing NEC. That includes popular formulas like Similac, made by Abbot Laboratories, and Enfamil, produced by Mead Johnson.
Does Infant Formula Cause NEC?
Cow’s milk-based infant formula does not cause NEC directly. However, consumption of cow’s milk-based formula, rather than human milk alone, can substantially increase the risk of a premature infant facing an NEC diagnosis. It also significantly increases the chance that they will develop the need for surgical treatment for NEC, or that the infant will die of NEC. Using cow’s milk-based infant formula poses an unnecessary risk to premature infants, who may prove extremely vulnerable to the bacteria that causes NEC.
Why is Baby Formula Linked to NEC?
According to the Surgeon General, in a warning issued in 2011, vulnerable premature infants have a higher risk of developing NEC any time they receive cow’s milk-based formula or formula supplementation instead of human milk alone. In fact, cow’s milk-based fortifier may increase the risk of developing NEC by 4.2 times, while it increases the risk of NEC that requires surgery, or that may end in death, by 5.1 times.
Human milk, including human donor milk, can substantially reduce those risks. It may also lead to better overall outcomes in infants already diagnosed with NEC than those given formula or fortifiers.
While scientists do not know why cow’s milk-based formula increases the risk of developing NEC, science offers several theories about why breast milk maintains infant health so well, particularly in premature infants.
Underdeveloped Digestive Systems
Infants, in general, do not have the same digestive system development as adults. Premature infants may have even more undeveloped digestive systems, making them more susceptible, in general, to the growth and development of harmful bacteria that can lead to NEC. Undeveloped digestive systems may not have the tools necessary to properly digest cow’s milk-based formula, which may increase the risk of other complications in addition to NEC.
Decreased Inflammation Protection
Human milk often serves to decrease inflammation in infant digestive systems. This may benefit premature infants since even minor inflammation can cause serious concern. Unfortunately, while it does not actively increase inflammation, cow’s milk formula may not offer the same protections as human milk.
Ultimately, human milk offers a higher degree of protection to premature infants. Premature infants should, whenever possible, receive human milk rather than formula for their dietary needs.
Formula Companies Know the Risks
The 2011 Surgeon General’s warning, echoed in 2012 by a warning by the American Academy of Pediatrics, makes it clear that feeding premature infants cow’s milk-based formulas and fortifiers can increase the risk of NEC development.
The American Academy of Pediatrics notes that “all preterm infants should receive human milk.” Furthermore, it notes that “If mother’s own milk is unavailable despite significant lactation support, pasteurized donor milk should be used.” Formula companies know about their products’ risks, yet they continue to market them to parents of vulnerable infants.
Unfortunately, many parents know little to nothing about those potential risks until their children receive a dangerous diagnosis that can impact them for the rest of their lives.
Formula for Preemies
Despite knowing the potential risks of formula feeding, major formula manufacturers, including Similac and Enfamil, continue to market their products heavily. In fact, both Similac and Enfamil, the two big names in formula manufacturing, have formula lines specifically designed and marketed for preemies.
These formulas note:
- Brain building or nourishing DHA
- Increased protein to aid in growth
- More calories per ounce than traditional formula
- Increased vitamins and minerals for immune health and support
The information provided on these packages may give parents the indication that these formulas can offer better overall support for their premature infants than human milk. Parents may feel that, without the extra calorie support of infant formula, their babies will fail to gain weight and grow as they might hope; or they might fear that their infants will ultimately stall in development.
However, during the vital first six to eight weeks of life, formula-fed infants and breastfed infants generally have no obvious differences in growth patterns. Furthermore, breastfed infants may have worse health outcomes than their formula-fed peers.
Dangerous Marketing Practices
Despite knowing about the increased risk of NEC associated with formula feeding, formula manufacturers continue to market their products, including marketing them to parents of premature infants.
Fear-Based Breastfeeding and Content
Both Similac and Enfamil claim to support breastfeeding and informed choice among parents. However, their website content focuses heavily on the downsides to breastfeeding and the potential challenges that may arise.
It offers a great deal of information like:
- Low supply issues, including how to supplement with formula instead of dealing with low supply
- Challenges the mother/baby may face in breastfeeding
- Marketing that suggests that formula feeding may ultimately prove superior to breastfeeding, including content that encourages mothers to resort to formula when needed
This fear-based breastfeeding content may create a sense of inadequacy in new and pregnant mothers even before they’re ready to start their breastfeeding journeys with their infants. As a result, mothers may not feel confident about their ability to breastfeed, even though most women can, given adequate support, successfully breastfeed their infants.
Ready Access to Formula Coupons and Samples
Formula companies like Similac and Enfamil heavily market their products to the medical community and directly to the consumer. They vie for new mothers’ attention early in the breastfeeding journey, providing coupons, free formula samples, and even formula in the doctor’s office that encourages women to trust the formula company.
Many companies also ensure that they have ready displays in the baby departments of most stores, which encourages women to think of formula as normal “baby gear” instead of considering the potential downsides to formula.
Ready access to formula may make mothers more likely to give up when they face any complications in their breastfeeding journey, from a fussy infant to low supply issues. In many cases, mothers who receive adequate support can continue to breastfeed successfully. Unfortunately, formula manufacturers make it easy to bypass that support and reach for a can or bottle of formula instead.
Once mothers reach for that formula, they may need to continue using it to supplement, ultimately allowing formula to push out the human milk that can help their infants. Breastfeeding operates on a supply and demand system. When the infant demands additional milk by spending more time at the breast, the mother's body compensates by providing additional milk.
On the other hand, as demand decreases when women supplement with formula, their bodies may respond by producing less breastmilk, which may interfere with the breastfeeding relationship and ultimately cause women to turn to formula altogether.
Helen Clark, the former Prime Minister of New Zealand, notes, “For decades, the formula milk industry has disregarded international recommendations when marketing their products, often to women who can ill afford it. Formula milk marketing knows no limits; it should be off limits.” Unfortunately, formula companies continue to market their products heavily, developing a false sense of security in many women.
Unnecessary Need
Formula manufacturers want parents to believe that their products offer better solutions for their infants than they can get through any other source. Baby formula packaging touts the many "benefits" it can supposedly offer, including enhanced vitamin and mineral content, increased brain health support, and ingredients designed to aid overall growth and development. In many cases, parents may perceive these as things they need to give their children to support their overall health.
Formula manufacturers may create a need where one does not exist. It convinces consumers that these products prove desirable for the "good life." Formula, manufacturers insist, can make life easier and offer better overall health for mom and baby. Then, formula companies provide parents with those free samples, getting them hooked on those solutions.
Inadequate Labeling
Strict requirements govern what labeling manufacturers must provide on infant products. Manufacturers must clearly warn parents about any potential risks associated with using a given product, and products that endanger infants usually end up recalled as soon as the risk becomes clear.
Cow's milk-based infant formula, on the other hand, remains on the shelves with no adequate warnings about the risk of NEC development.
Formula containers warn about scalding when microwaving infant formula due to “hot spots” that can develop in many microwaves. They do not, however, offer any warning about NEC. As a result, the parents of premature infants, who already find themselves under a great deal of stress, may not know that those formulas can pose a danger to their infants.
What Can You Do After Your Infant Suffers an NEC Diagnosis Due to Cow’s Milk-Based Formulas?
While the risks of cow’s milk-based formula prove obvious, unfortunately, many parents of preemies may have little to no knowledge about those potential risks.
If your child received a cow’s milk-based formula or breastmilk fortifier in the NICU and went on to develop NEC, you may have some options for pursuing compensation.
- Document your child’s diagnosis and any complications. Note your child’s specific diagnosis and keep track of any medical records associated with your child’s treatment. Keeping up with those records can prove essential to ensuring that you can prove your child’s diagnosis and the challenges faced by your family during an NEC battle.
- Keep up with medical bills related to your child’s diagnosis. Make sure you keep track of any medical bills associated with your child’s NEC diagnosis and treatment. Treatment costs for NEC can prove extremely high, ranging between $138,000 and $238,000 or more. Keep up with the medical bills related to that treatment, including any surgical procedures your child may have or an extended stay in the NICU due to your diagnosis. You may later need those medical bills to establish your family’s right to compensation, including how much you may deserve.
- Contact an NEC lawyer who can help guide you through a claim. Similac and Enfamil have already faced significant backlash over their marketing and the premature infant formula they continue to promote despite the many dangers associated with its use.
An experienced NEC lawyer can help you file a lawsuit that may help you gain compensation for some of the financial losses you have faced due to your child’s experience. While those funds may not restore your child’s lost health or make up for your family’s suffering, they can, in many cases, make it easier to pay the medical bills associated with that treatment. Contact a lawyer as soon as possible to learn more about your rights.
Contact an NEC Lawyer Today
Do you have questions about your family's right to compensation following the use of infant formula that led to NEC in your infant? Do not try to move forward with a claim on your own. Instead, call an NEC lawyer who can support you and your family as you navigate the difficult claim process.