Lawsuits Threaten the Future of Neonatal Care and Neonatal Nutrition
Few patients in modern medicine are as fragile and more difficult to care for than a prematurely born infant. Premature infants are defined as those babies having a birth gestation less than 37 weeks, with normal gestation lasting between 38 and 42 weeks. With advances in neonatal care, babies as mature as 32-36 weeks’ gestation are relatively easy to care for successfully, with very high survival rates. At the lower end of the spectrum, however, are infants between 23 and 27 weeks’ gestation, whose care is far more complicated and challenging, though the majority of these infants survive as well.
In neonatal intensive care units (NICUs) across the country, one of the common problems healthcare professionals confront in very premature infants is a serious disease called necrotizing enterocolitis (NEC). NEC is a life-threatening inflammation of the intestine that primarily affects infants born at less than 28 weeks’ gestation. It can occur, however, in more mature babies, and rarely in full-term infants as well. Though a 2023 study found that fewer infants now die from NEC, it is still a very serious illness worthy of a cure and complicates the care of the premature infant in many ways.
Few issues in the management of the premature infant are as problematic as providing nutrition to these babies, and this challenge has perplexed neonatologists and neonatal nurses since the introduction of NICUs in the United States in the 1960’s. Yet increasing numbers of lawsuits that allege a link between NEC and infant formula products may ultimately cause substantial harm in NICUs, leading to even more death and disability among premature babies, since they will hamper the ability of neonatologists to provide adequate care and nutrition for these infants.
Premature babies and their families are already fighting against the odds as soon as they are born. There are many reasons why babies require approximately 40 weeks of gestation, since many organ systems take that long to mature. Thanks to the miracles of modern science, however, premature babies’ survival rates have improved dramatically during my nearly 40 years of neonatal practice, but serious issues like NEC still arise in the NICU.
Despite decades of research and studies, there is no clearly defined cause for NEC. It can occur in premature infants fed their own mother’s milk, donor milk, banked breast milk, and specialized preterm formula products. As a doctor, it is frustrating to not have a solution for every problem that arises in the NICU, and as a parent it can be devastating. As the grandparent of four children who required time in the NICU after birth, I am well aware of the stresses of having a child or grandchild in the NICU from both the physician and the parent/ grandparent perspective. And as a human being, I always want to know why something happens, as do most families. In the absence of a clear explanation, it is not uncommon to try to blame someone or something, even when the facts don’t merit it.