In December 2025, a Connecticut court issued a decision that should reverberate through neonatal intensive care units across the country. In Hunte, the court found that NICU physicians had a legal duty to obtain informed consent before feeding a premature infant bovine-based products, including bovine-based fortifier and formula—and that the duty required a meaningful discussion of material risks, benefits, and alternatives. 

That isn't a “paperwork” ruling. It's a patient-rights ruling—one that recognizes a basic truth NICU families live every day: feeding choices are medical choices, and when the stakes include necrotizing enterocolitis (NEC) and death, parents must not be kept in the dark.

Connecticut Injury Firm's Austin Johns esq. and attorney Stephen Reck's ( of Levin, Rojas, Camassar & Reck LLC) were the trial team that obtained  victory against Yale and now helps establish a standard that prioritizes transparency, autonomy, and safety for the most vulnerable patients—premature infants who cannot speak for themselves.

Following the release of the Court's decision, Yale New Haven Health spokespersons alluded to their commitment to providing compassionate care and expressed their belief that they acted consistently with their standards in caring for the child. They also voiced disappointment in the verdict, acknowledged the family's loss, and stated they were evaluating their options. The one option we hope that they are evaluating is changing those hospital standards to conform with the Law of informed consent and not substitute its judgment for the rights of its patients to materially participate in medical decision making wherever possible. 

Feeding Isn't “Just Protocol”

The court credited expert testimony that, in 2018, NEC was a known and material risk associated with bovine-based feeding products for extremely premature infants—and therefore the NICU team was legally required to disclose their intention to use bovine-based products and obtain informed consent before doing so. The decision goes further: the duty included discussing that bovine-based fortifier and formula significantly increased the risk of NEC, including a risk of death, and explaining alternatives (including human-based fortifier and transfer options if needed). The court also found the “burden” was not on parents to decode terminology—especially where a product name suggests something it is not. In one of the decision's most important findings, the court rejected the idea that parents had to “glean” from the term “human milk fortifier” that it might contain anything other than human milk. That matters because it exposes a system problem: in high-pressure NICU environments, “protocol” can quietly replace consent—unless the law insists otherwise.

The “Human Milk Fortifier” Label Problem: Yale-Reviewed Research Shows Families Are Confused

One of the most striking aspects of this case is how closely the court's findings track what parents and clinicians have been saying in the medical literature.

A Yale IRB-reviewed survey study on “Human Milk Fortifier” (HMF) labeling found that only 21.9% of providersreported consistently describing the source of HMF to parents, and only 20.6% of parents whose child received HMF reported knowing the source. The study documents that families felt they were “not given information,” and that both parents and providers described the label as misleading. Even more powerfully, parents' qualitative comments describe exactly what informed consent is supposed to prevent—surprise after the fact:

• “I wish I would have been told that the fortifier was cow's-milk based.”

  HMF fortifier labeling perspect…

• “A label with ‘human milk' should only mean it's FROM humans.”

  HMF fortifier labeling perspect…

• “It's disappointing how uninformed parents are in the NICU during such a vulnerable time.” 

  HMF fortifier labeling perspect…

This is not a fringe concern. It is a documented communication failure in a setting where the consequences can be catastrophic.

Yale's Own Legislative Letter: Donor Milk Prevents NEC and Saves Lives

Long before the Hunte ruling, Yale neonatal leaders urged Connecticut lawmakers to support Medicaid coverage for donor milk, explaining that donor human milk is a substitute when a mother's milk is not available—and citing “studies” showing a 60% reduction in NEC when infants receive donor human milk instead of formula. The letter goes even further, estimating that if donor human milk reduced NEC rates by 60% statewide, 18 infants would avoid NEC each year and 6 deaths would be avoided. It also states the American Academy of Pediatrics recommends donor milk for very preterm infants and notes Yale started a donor milk program because they were “compelled by the evidence,” while describing a statewide “disparity” because donor milk was not available in all hospitals. Those statements matter because they show a deep institutional awareness—years before this verdict—of how profoundly feeding choices influence NEC risk.

Informed Consent Is Not Optional

Yale Law Journal scholarship has long recognized that the duty to disclose is fundamentally about protecting patient choice—an affirmative duty that can also be described as prohibitive: the clinician must not substitute their own values for the patient's. 

In a NICU, the “patient” includes the family's right—and responsibility—to participate in decisions with lifelong consequences. When the court found these parents would not have agreed to bovine-based products if properly advised, and would have asked for other options (including human-based fortifier or transfer), it underscored the heart of informed consent: choice must be real to be meaningful. 

Why Institutions Can't Be Allowed to “Set Their Own Standard” Behind Closed Doors

After the decision, Yale spokespersons reportedly emphasized compassion and confidence in their care standards and indicated they were evaluating options. Even when statements are carefully worded, they raise a larger issue the Hunte decision forces us to confront:

If a hospital can define its own internal “standard” without meaningful transparency, family participation, and accountability, then informed consent becomes whatever the institution says it is.

That is not how medicine should work—and it is not how the law works.

The Hunte decision rejects the idea that a NICU can rely on “protocol” while leaving parents uninformed until after harm occurs.It also rejects the idea that parents must be the ones to ask the “right” questions about ambiguous terms like “human milk fortifier.” Where the consequences include NEC totalis, organ failure, and death, “protocol” is not a shield. Connecticut Superior Court Judge, Hon. Karen A. Goodrow, got it right!

 Consent is the standard.

If NICUs want to protect babies and protect trust, the path forward is not complicated:

1. Feeding decisions must be treated as consent decisions when material risks include NEC and death.

   Hunte Memorandum of Decision

2. Terms like “HMF” must be explained plainly, including whether the product is cow-milk-derived or human-milk-derived.

   HMF fortifier labeling perspect…

3. Alternatives must be discussed, including donor milk and human-based fortifier options where available, or transfer pathways when they are not.

   Hunte Memorandum of Decision

4. Policies should be built around parent partnership, not just clinician convenience—because outcomes and grief are not borne by the hospital alone.

 Accountability Meets Patient Safety

This verdict represents a meaningful step toward protecting NICU families—not only in Connecticut, but everywhere neonatal care is delivered.

Connecticut Injury Firm is building a statewide and regional practice focused on life-altering injuries and medical negligence, including catastrophic  harm. We work with families and individuals in a variety of contexts including hospital and nursing home care, trucking accidents and catastrophic construction failures.  

If you have  questions about NICU feeding, informed consent, or any catastrophic failure of  professional or institutional safety failures we can help you obtain records, clarify what happened, and evaluate next steps.

(This article is for informational purposes only and is not legal advice. Every case is different. No attorney-client relationship is formed by reading this post.)