ST. CLAIR COUNTY, Ill. — Jasmine Watson of Fairview Heights is the first mother whose premature baby died from an intestinal disease to take a formula company to trial for it.
She gave birth to twin boys, Chance and Chase Dean, in March 2020 at Barnes Jewish Hospital.
Chance was diagnosed with necrotizing enterocolitis, or NEC for short, after he began exclusive formula feedings at a Memorial Hospital in Shiloh, where donor breast milk was not available. He died when he was just 25 days old.
Now, Watson is one of hundreds of parents across the country suing formula maker Mead Johnson, alleging the company did not do enough to warn her about the increased risk of NEC that comes with feeding premature babies products made with cow’s milk. Formula giant Abbot is also a named defendant in many of the lawsuits.
Watson is Black, as are a majority of the parents of children who contract the deadly disease, according to Dr. Ravi Patel, who co-authored a study published in 2023 about the racial disparities of the disease.
“It's a quick killer, and it is one that most people haven't heard about,” said Patel, a professor of pediatrics at Emory University and Children’s Health Care in Atlanta. “Racial disparities are a big challenge.
“We know that preterm birth disproportionately affects Black mothers and Black infants, and NEC is the same. NEC has substantial racial disparity.”
Mead Johnson disputes its product, Enfamil Premature Infant Formula 24 Cal, caused Chance’s NEC. They noted all of the neonatologists who are scheduled to testify during the four-week-long trial in St. Clair County still use formula in their NICUs because babies who don’t grow have a lower chance of survival.
Watson’s attorneys pledged to present research showing preemies given human milk products only grow slower than their formula-fed counterparts but do not suffer any long-term effects in the end.
Mead Johnson sent a statement to the I-Team, which read: “Mead Johnson has over 120 years of expertise in infant nutrition and stands by our unwavering commitment to sound scientific innovations that provide safe, high-quality infant formula products to every parent and caregiver who puts their trust in us. We are very sympathetic to Ms. Watson, but allegations from the plaintiff’s lawyers are without merit and attempt to grossly oversimplify complex medical conditions with attacks not upheld by experts in the medical community. We look forward to vigorously defending these allegations in court.”
During opening statements, attorneys for Mead Johnson said formula doesn’t cause NEC, but breast milk better protects preemies from getting it. Patel agreed.
“We do know one of the best ways to prevent NEC is by providing breast milk and breastfeeding, or when that's not possible, to give donated human milk, which has been shown as a very effective way to prevent the disease,” Patel said.
The disease includes a sudden onset of inflammation of the intestines.
“One of the things that makes NEC tragic is it can happen suddenly and without warning,” Patel said.
Attorneys for Watson told jurors during opening statements to expect to see graphic pictures of the distended bellies of babies, including Chance battling the infection, at trial.
“About one baby dies of NEC every day in the United States, so it's really a very big concern,” Patel said. “About one in every 10 deaths in the NICU are because of NEC.”
The I-Team found multiple studies – including Patel’s – which conclude premature babies who are given cow’s milk-based formulas are more likely to get NEC than those who are given only human milk products.
The I-Team also learned insurance coverage for donor milk – whether through private insurance mandates, Medicaid or state budgets – is limited to 18 states, according to a study Patel also co-authored in the National Library of Medicine in 2022.
“The majority of high-risk infants who need access to donor human milk are not born in a state or district where that access is guaranteed; no state currently covers the cost of donor human milk whether inpatient, outpatient or for all infants who may benefit from its use,” the study said. “State and federal level advocacy is needed to ensure that donor human milk is available to all infants based on medical necessity, rather than privileging infants who happen to be born in a state or district where access is guaranteed.”
Chance Dean spent about half of his short life in the NICU at St. Louis Children’s Hospital, which Mead Johnson attorneys noted has a policy requiring premature infants to be fed their mother’s milk or donor human milk before administering any formula products. Then, about nine days before he died, he was transferred to Memorial Hospital in Shiloh, which does not provide donor human milk to NICU patients.
Attorneys for Watson argued formula is often provided for free to hospitals if they agree to use it for 90% of their feedings, which can be a financial incentive. Human donor milk is costly.
Treatment for the disease, if caught early, includes discontinuing all feeding and antibiotics. It can include surgeries to remove dead intestinal tissue.
Chance had three surgeries before he died, according to his attorneys.
“If they can survive the surgeries, and surgery usually involves removing some of their intestines that have been infected, they can have a lot of long-term challenges,” Patel said. “And those center around the disease affecting their neurodevelopment, so they can be at higher risk for things like cerebral palsy and developmental delays as they get older," and prematurity automatically puts babies at risk for the disease.
“NEC is a multifactorial disease, so there's not one single cause,” he said. “Breast milk is one of the most important ways to protect babies from NEC, but we do know that even babies who just get breast milk, are at risk. It's important to consider it a disease that has a lot of different risk factors, and not just any single risk factor."
Patel said there is some progress when it comes to closing the racial gap.
“Although that disparity has gotten narrower over time, that has still persisted, and some of that is related to differences in preterm birth, just more babies who are born pre-term that are Black,” he said.
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