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As survival rates for preterm infants improve, attention is focused on improving the quality of survival through nutritional management. Necrotising enterocolitis (NEC) remains one of the most critical complications. Although no individual randomised controlled trial (RCT) has been sufficiently powered to examine the true effect of breast milk on the incidence of NEC in preterm babies, 1 a series of observational studies and a meta-analysis suggest a reduced incidence in those fed breast milk. 2–5 There is also evidence that human milk is better tolerated than formula, leading to a faster attainment of enteral feeding. 6

Mothers of preterm infants experience physiological and emotional challenges, which may adversely affect breast feeding outcome following delivery. Therefore, it is not surprising that these mothers start and sustain breast feeding at lower rates than mothers of term babies. 7 This is further compounded …