Previous studies reported that human milk oligosaccharides efficiently protected against NEC by restoring the proliferative ability of enterocytes in the ileum which increased the ratio of Ki67 expression by reducing the expression of TLR4 on intestinal epithelial cells.29 Weber et al. also reported that the proliferation marker Ki67 expression decreased in TLR4-deficient compared to TLR4-sufficient mice30 suggesting a proliferative state dependent on TLR4 signaling whose mechanism was similar to ours in this study. This evidence concerns the gene TLR4 and necrotizing enterocolitis.