The article “Increased osmolality of breast milk with therapeutic additives” by Srinivasan et al¹ reports the osmolality of supplements, drugs, and fortifiers in breast milk for preterm infants based on the assumption that laboratory measured osmolality presents an increased risk of necrotising enterocolitis (NEC) for the preterm infant. When the association between hyperosmolar feeds and NEC is considered, there may be an important differentiation of osmolar substances into two groups: some …