Cow’s Milk-Based Formulas, Including Enfamil and Similac, Linked to Necrotizing Enterocolitis (NEC) in Premature Babies

Cow’s Milk-Based Formulas, Including Enfamil and Similac, Linked to Necrotizing Enterocolitis (NEC) in Premature BabiesDo you have a premature baby?

Was your baby fed Enfamil, Similac or other cow’s milk-based formula while in the neonatal intensive care unit (NICU)?

Did your baby develop necrotizing enterocolitis (NEC), a bowel disease?

The risk of developing NEC in premature infants is substantially heightened with cow’s milk-based formulas, such as Enfamil and Similac.

Unfortunately, NEC may be fatal to premature babies in some cases. In other cases, NEC may necessitate surgery and cause a range of health problems, including sepsis (a blood infection).

Premature babies and nutrition

Infants who are born premature often require specific nutrition plans. The safest feeding plan for premature infants is typically mother’s milk, donor milk (milk donated by another lactating mother), or non-cow’s milk based supplemental formula. Human milk is easier to digest. Human milk also contains substances that help fight infection and help intestinal cells mature.

In some cases, neonatologists or pediatricians may recommend supplementing breast milk with cow’s milk formula or fortifier. Common brands of cow’s milk-based formula include Enfamil and Similac.

Studies have shown that premature babies who are fed cow’s milk–based formulas (often referred to as “bovine” based formulas in the medical community) are more likely to develop necrotizing enterocolitis (NEC) than those who receive only human breast milk. In 2011, multiple hospitals found that “Extremely premature babies fed human donor milk are less likely to develop the dangerous intestinal condition necrotizing enterocolitis than babies fed a standard premature infant formula derived from cow’s milk.” Over the past decade, countless studies have confirmed these findings.

Unfortunately, many parents are never informed of the risk of NEC in premature infants associated with these cow’s milk-based formulas. If your premature baby was fed Enfamil or Similac, were you told of the risks to your baby’s survival and bowel health?

What is necrotizing enterocolitis?

NEC is the inflammation of the intestines, caused by a bacterial infection. Persistent infection and inflammation destroy the walls of the infant’s bowel causing stool to leak into the baby’s abdomen. According to the Children’s Hospital of Los Angeles (CHLA), NEC is “the most common cause of gastrointestinal-related morbidity and mortality in the neonatal intensive care unit (NICU).”

How dangerous is NEC?

NEC can be a deadly condition. According to research published in Advances in Nutrition, “NEC affects 5–12% of very–low birth-weight infants, leads to surgery in 20–40% of cases, and is fatal in 25–50% of cases… Severe cases can result in intestinal resection or death.”

Which formulas use cow’s milk as a base?

About 80% of baby formulas are cow’s milk-based, and almost every major brand (and store brand equivalent) offers a bovine-based formula, including:

·       Enfamil

·       Similac

·       Earth’s Best

·       Happy Baby

·       Go & Grow

·       Gerber

·       Parent’s Choice

·       Baby’s Only

·       Loulouka

·       Holle

·       Kendamil

·       Bobbie

·       Lebenswert



Note: Whether a formula is organic or not plays no role in the development of NEC.

What are the signs of NEC?

Most signs of NEC occur within days to weeks. The most obvious sign is bloating or swelling of the abdomen (abdominal distension) though other signs may include:

  • Vomiting, particularly green vomit containing bile
  • Diarrhea
  • Bloody or dark stools
  • Delayed gastric emptying and constipation
  • Trouble feeding
  • Tender, red, or painful abdomen
  • Decreased bowel sounds (ileus)
  • Apnea (pauses in breathing)
  • Lethargy
  • Slowed heart rate (bradycardia)
  • Low blood pressure (hypotension)
  • A low or unstable body temperature
  • Decreased peripheral perfusion
  • Abdominal wall erythema (advanced stages)
  • Shock (in advanced stages)
  • Cardiovascular collapse (advanced stages)

(Necrotizing Enterocolitis Overview, Medscape)

NEC may require medication, but severe cases will necessitate surgery – and even the surgery may pose serious risks of permanent injury to premature babies. As CHLA explains:

In some cases, scarring and narrowing of the bowel may develop and can lead to future intestinal obstruction or blockage. Another residual problem may be malabsorption (the inability of the bowel to absorb nutrients normally). This is more common in children who require surgery for NEC and lose a large segment of intestine. Still, there are some infants who lose so much intestine from the infection that they do not have enough intestine left to survive. These infants may end up requiring a bowel transplant to survive.

Who is liable if my child develops NEC from drinking cow milk-based formulas?

Despite knowing for at least a decade that their products pose a life-threatening risk to preemies, many manufacturers do not list that potential risk on their products – and doctors may not explain those risks, either. If your preterm infant developed necrotizing enterocolitis from cow’s milk-based formula, you may be able to file a lawsuit to recoup damages:

  1. A product liability lawsuit against the maker of the formula. You could have a claim against companies who manufacture and sell the products your premature infant was fed.
  2. A medical malpractice lawsuit against the doctor(s) and/or hospitals. You could have a claim against medical professionals who give these products to preemies instead of mother’s breast milk, donor human milk or other available non-cow’s milk-based formulas.

The product liability and medical negligence attorneys of Phelan Petty fight for families and infants who have been injured by cow’s milk-based formula. If your preemie developed a serious, potentially deadly disease linked to cow’s milk-based formula, we want to help. To learn more about our services, please call us in Richmond at 804-980-7100 or fill out our contact form. The initial consultation is free. We serve clients throughout Virginia.