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Necrotising enterocolitis (NEC) is a devastating inflammatory condition of the gut that primarily affects preterm infants. Whilst the aetiology varies from case to case, recent data show that the onset of NEC is closely associated with the pattern of gut microbiota, especially in the few days prior to NEC onset. Recent studies suggest Human Milk Oligosaccharides (HMOs) may be a key component of breast milk associated with reductions in NEC.