Necrotising enterocolitis (NEC) continues to be a major cause of neonatal mortality and morbidity. It is less common in breastfed infants suggesting a protective role for breast milk. However NEC is now being seen in fully breast milk fed infants following introduction of fortifiers derived from bovine milk, which suggests a possible causative role for bovine products. This study investigates the relationship between the commencement of feed containing bovine milk products and the development of surgical NEC in preterm infants