Graduation Year
2026
Document Type
Senior Thesis
Degree
Bachelor of Science in Nursing
Primary Major
Nursing
Primary Minor
Leadership Studies
Thesis Advisor
Kendra Hoepper, DNP, APRN, PNP-C
Abstract
One of the leading causes of morbidity and death for preterm and very low birth weight (VLBW) newborns is still necrotizing enterocolitis (NEC). Existing literature consistently shows that the bioactive, anti-inflammatory, and microbiome-supporting components of human breast milk, including donor human milk, significantly lower the incidence of NEC. However, a lot of infants are forced to rely on formula and nutrient fortifiers because they cannot obtain maternal or donor milk. A critical gap persists regarding whether human milk derived fortifiers offer greater NEC protection than bovine derived fortifiers in infants who must receive formula. This thesis examines three interconnected themes; bioactive components of human milk, donor human milk as the preferred alternative when maternal milk is unavailable, and the importance of early standardized feeding protocols, and how they collectively reduce NEC incidence. A quasi-experimental, multi-site study is proposed to compare NEC outcomes in infants receiving formula fortified with either bovine derived fortifiers or human milk derived fortifiers in level 4 NICUs. Using the GutCheckNEC tool across four clinical time points, the study aims to determine whether human milk derived fortifiers provide additional protection against NEC even in formula fed infants. Findings have the potential to inform evidence based feeding guidelines, strengthen NEC prevention strategies, and support policy change for standardized human milk centered care in NICUs across the United States.
Included in
Congenital, Hereditary, and Neonatal Diseases and Abnormalities Commons, Critical Care Commons, Gastroenterology Commons, Maternal, Child Health and Neonatal Nursing Commons, Preventive Medicine Commons