I found the following passages about intestinal bacteria and its relation to
NEC in the preterm infant.  It's a patent # 6132710 called,
"Preventing/treating neonatal NEC by administering lactobacillus salivarius
and lactobacillus plantarium or a combination thereof."  I thought it might
be of interest to some particular since it has references. What it says about
breastmilk is worth reading but of course this patent while based on what
breastmilk can do for the infant isn't promoting breastfeeding but rather the
use of their product for the preterm infant.  The assignee is a company
called ProBiotix, Inc.  And this company has received funding from the NIH.
Valerie W. McClain, IBCLC
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Human milk populates the intestine with Bifidobacteria and Lactobacilli,
generating a very different gut flora than that seen after formula feeding
(Keyworth N, Miller M R, Holland K T: Development of cutaneous microflora in
premature Neonates. Arch Dis Child 67:797, 1992; Yoshioka H, Iseki K, Fujita
K: Development and differences of intestinal flora in the neonatal period in
breast-fed and bottle-fed infants. Pediatrics 73:317-321, 1983.) It has long
been known that Bifidobacteria are the most common organisms found in newborn
fecal material. Yoshioka et al. used quantitative culture methods to study
differences in intestinal colonization patterns in breast- and bottle-fed
full term neonates. (Yoshioka H, Iseki K, Fujita K: Development and
differences of intestinal flora in the neonatal period in breast-fed and
bottle-fed infants. Pediatrics 73:317-321, 1983).

Both groups were first colonized with Enterobacteria. However, by day 6,
Bifidobacteria exceeded Enterobacteria by 1000:1 in breast-fed infants; in
bottle-fed infants, Enterobacteria outnumbered Bifidobacteria by 10:1. By one
month of age, Bifidobacteria was the predominant species in both groups, but
the absolute number of these organisms was 10 times fewer in bottle-fed
babies compared to the breast-fed group.

Of interest, a recent study demonstrated a higher incidence of aerobic flora
in preterm NICU infants fed frozen human milk, as well as an increased rate
of isolation of S. epidermidis. (El-Mohandes A, Keiser J F, Johnson L A,
Refat M, Jackson B J: Aerobes isolated in fecal microflora of infants in the
intensive care nursery: Relationship to human milk use and systemic sepsis.
Am J Infect Control 21:231-234, 1993.)

A number of investigators have found decreased numbers of Lactobacilli in
preterm infants; this reduction was correlated with previous antibiotic
therapy and time spent in an incubator (Hall M A, Cole C B, Smith S L, Fuller
R, Rolles C J: Factors influencing the presence of faecal lactobacilli in
early infancy. Arch Dis Child 65:185-188, 1990.)

Delayed transit time, seen in preterm infants could permit bacterial
overgrowth that could, in turn, initiate the cascade of events that lead to
NEC. This finding again underscores the potential for overgrowth by a small
number of potential pathogens in the low birth weight infant in the NICU.
(Vantrappen G, Janssens J, Choos Y: The interdigestive motor complex of
normal subjects and patients with bacterial overgrowth of the small
intestine. J Clin Invest 59:1158, 1977).

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