Article Text

Download PDFPDF

Use of extensively hydrolysed formula for refeeding neonates postnecrotising enterocolitis: a nationwide survey-based, cross-sectional study
  1. Alexandre Lapillonne1,2,
  2. Maroun Matar3,
  3. Ariane Adleff4,
  4. Marwa Chbihi1,
  5. Elsa Kermorvant-Duchemin1,2,
  6. Florence Campeotto2,5
  1. 1Neonatal Department, APHP Necker-Enfants Malades Hospital, Paris, France
  2. 2Paris Descartes University, Paris, France
  3. 3Neonatology Division, University Medical Center of Rizk Hospital, Rizk, Lebanon
  4. 4Private Practice, Pertuis, France
  5. 5Pediatric Gastroenterology Department, APHP Necker-Enfants Malades Hospital, Paris, France
  1. Correspondence to Professor Alexandre Lapillonne; alexandre.lapillonne{at}


Objective To evaluate the prevalence of and reasons for using extensively hydrolysed formulas (EHFs) of cow's milk proteins in the French neonatal units as well as the modality of their prescription for refeeding infants recovering from necrotising enterocolitis (NEC).

Methods A multicentre nationwide cross-sectional study using a questionnaire to address the prevalence of use and the reasons for prescribing EHF in hospitalised neonates and to examine the protocols and the actual reasons for their use for refeeding infants in recovery from NEC. The questionnaire was sent to only 1 senior neonatologist in each neonatal unit included in the study.

Results More than half of the French neonatal units participated in the survey. 91% of the surveyed units used EHF. Of 1969 infants hospitalised on the day the survey was run, 12% were fed on an EHF. 11% of the EHF prescriptions were due to previous NEC. The main reasons for using an EHF to feed infants post-NEC were the absence of human milk (75%) and surgical management of NEC (17%). When given, EHF was mainly prescribed for a period varying between 15 days and 3 months. None of the involved units continued using the EHF after 6 months of age. More than half of the surveyed units acknowledged hospitalising infants for the initiation of weaning EHF but only 21% of them tested these infants for cow's milk allergy.

Conclusions The prevalence of EHF use in the French neonatal units is high. Refeeding infants post-NEC is one of the main reasons for such a high prevalence. The main incentive for using an EHF is the absence of human breast milk, either maternal or donor.

  • hydrolyzed formula
  • low birth weight infants
  • necrotizing enterocolitis

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.