Necrotizing enterocolitis, a potentially fatal intestinal inflammatory disorder affecting primarily premature infants, is a significant cause of morbidity and mortality in neonates. While the etiology of the disease is, as yet, unknown, a number of risk factors for the development of necrotizing enterocolitis have been identified. One such risk factor, formula feeding, has been shown to contribute to both increased incidence and severity of the disease. The protective influences afforded by breastfeeding are likely attributable to the unique composition of human milk, an extremely potent, biologically active fluid. This review brings together knowledge on the pathogenesis of necrotizing enterocolitis and current thinking on the instrumental role of one of the more prominent classes of bioactive components in human breast milk, glycosaminoglycans.

We aim to describe the current programmatic structure and learning environment of US neonatal-perinatal medicine (NPM) fellowship programs. All U.S. NPM program directors (PDs) and associate program directors (APDs) were surveyed. Descriptive statistics for quantitative questions and thematic qualitative analysis of free-text responses were used to summarize findings. Out of 102 programs 99 (97%) responded. Out of 99 PDs 25 (25%) reported not receiving minimum ACGME full-time equivalent (FTE) for program administration. Fellows perform a median of 52 weeks (48–54) and 150 (120–165) night calls during training, with clinical time skewing more toward the 1st year. All programs report interaction with front-line clinicians (FLCs), and 81% (80/99) of fellowships reported conflict between fellows and FLCs. A minority of programs formally evaluated or instructed FLCs on teaching skills. PDs and APDs most commonly lead the planning of wellness activities, with only 37% of programs describing a fellow wellness leader. A minority of programs reported wellness committees at the university (40%), department (19%), or division (17%) level. About 25% of programs reported no wellness budget. Broadened institutional support toward program requirements and administration and further collaborative efforts with trainees and multidisciplinary providers are opportunities for growth in NPM fellowship programs.