ABSTRACT
Development of necrotizing enterocolitis (NEC) may be related to the interaction of an immature gut with colonizing intestinal bacteria. The innate and adaptive immune systems allow for appropriate interface with the intestinal microbiota, specifically colonization with commensal organisms and protection against pathogens. The immature intestinal barrier of a preterm infant may have increased contact with the intestinal microbiota secondary to delayed peristalsis, decreased gastric acid production, and immaturities of the intestinal epithelial barrier. An immature cellular response to intestinal microbiota increases the inflammatory response to both commensal and pathogenic organisms. Human milk and probiotics may contribute to protection against NEC by compensating for immune dysfunction found in the preterm gut.
