On July 24, 2026, the U.S. Court of Appeals for the Seventh Circuit handed Abbott Laboratories an appellate win in Mar v. Abbott Laboratories, No. 25-2587 — and by the end of the week the headlines were everywhere. If you are a parent whose premature baby developed necrotizing enterocolitis (NEC) after cow’s-milk-based formula, a headline that reads “court rules for Abbott” can land like a door closing. It is worth slowing down, because what the court actually held is narrower — and more specific to one family’s facts — than the headlines suggest.
This article explains, in plain English, what the Seventh Circuit decided, the single legal concept the case turned on (“warning causation”), the one fact that decided it, and why a fact-specific defense ruling in one case does not decide the outcome of the NEC litigation as a whole. Nothing here predicts what will happen in any other case — that depends entirely on that case’s own record.
The one-paragraph version. The Seventh Circuit affirmed summary judgment for Abbott in the first federal NEC bellwether. It did not rule that cow’s-milk formula cannot cause NEC. It ruled on warning causation: even assuming the warning should have been stronger, the plaintiff had not shown a better warning would have changed anything, because that particular NICU had no adequate supply of human milk to feed instead. The decision applied West Virginia law to one family’s specific facts. It does not bind state courts, it does not control cases with different facts, and other NEC cases — including a second federal trial — are moving forward.
What did the Seventh Circuit decide in Mar v. Abbott?
The Seventh Circuit affirmed a grant of summary judgment for Abbott in Mar v. Abbott, the first federal bellwether in the NEC baby formula multidistrict litigation (MDL 3026, before Judge Rebecca Pallmeyer in the Northern District of Illinois). In an opinion authored by Judge Michael Brennan, the court held that the plaintiff had not shown that a different, stronger warning would have changed what her baby’s doctors fed the infant — so, as a matter of law, the alleged failure to warn could not be treated as the cause of the child’s NEC.
Two things the ruling did not do are just as important as what it did. First, the court did not decide the scientific question at the heart of the litigation — whether cow’s-milk-based formula causes NEC in premature infants. Second, it did not rest on the “learned intermediary” doctrine. Because West Virginia law governed the claim, and West Virginia is among the small number of states whose highest court has declined to adopt the learned intermediary doctrine, the panel did not need to resolve that question. It decided the case on the narrower ground of causation. (We cover the learned-intermediary issue in a different case in our explainer on an NEC verdict reversed on appeal.)
What is “warning causation,” and why did it decide this case?
A failure-to-warn claim has more than one moving part. It is not enough to show that a warning was missing or too weak. A plaintiff also has to show causation — that the inadequate warning actually made a difference. Lawyers call this piece warning causation (or proximate cause), and it is where Mar was decided.
The logic runs in a chain. Break any link and the claim, in that case, fails on causation even if the warning truly was inadequate:
The warning was inadequate
The label should have said more about the NEC risk of cow’s-milk formula for premature infants. In Mar, the court assumed this rather than deciding it.
A better warning reaches the decision-maker
A stronger warning would have informed the physicians (and, in some states, the parents) who decided how to feed the baby.
The decision would have changed
Armed with that warning, the NICU team would have — and could have — fed the baby differently, avoiding the exposure. This is the link that broke in Mar.
The plaintiff’s proposed warning was, in essence, that human milk carries a lower risk of NEC than cow’s-milk-based formula. The Seventh Circuit’s problem was not with that message. It was that, on this record, telling the doctors that would not have changed what they did — because they did not have enough human milk to give.
The fact that decided Mar: the NICU had no other milk to give
According to the reporting on the decision, the baby’s mother could not produce enough breast milk, and the hospital had no donor-milk program at the time. The infant received roughly a 50/50 blend of the mother’s own milk and Abbott’s preterm formula. The treating physicians were aware of the NEC risk; they fed formula anyway because the alternative was not feeding a premature baby who needed nutrition. Testimony reportedly described how building a pasteurized donor human milk program at that hospital took roughly five years and required clearing hurdle after hurdle — containers, labeling, transport, storage, and staff training.
That is why the court concluded a stronger warning would have had, in effect, nowhere to go. As Judge Brennan put it, in the line every family reading this should sit with: “This is a tragic case by any measure. But Mar has not shown that her alternative warning would have made a difference.” The ruling is a statement about the options this NICU had in front of it — not a verdict on the science, and not a statement about what a different hospital, with donor milk on the shelf, would have done. The availability (or absence) of a human-milk alternative is exactly the kind of question we explore in our review of donor milk programs and the NEC-prevention evidence.
Does this ruling mean the NEC lawsuits are over?
No. It is one federal appellate decision, applying one state’s law, to one family’s facts, on one narrow issue. A defense win in a single bellwether is a data point, not a finish line. Several distinctions matter, and they are worth laying side by side.
| What Mar v. Abbott is | What Mar v. Abbott is not |
|---|---|
| A ruling on causation on one record | A ruling that cow’s-milk formula does not cause NEC |
| A federal decision applying West Virginia law | A rule that binds state courts or cases under other states’ law |
| Specific to a NICU with no human-milk alternative | A holding that applies where donor milk or the mother’s milk was available and adequate |
| One bellwether outcome used to gauge the litigation | A resolution of the roughly 810 cases still pending in MDL 3026 |
The larger litigation has not stopped. Roughly 810 NEC cases remain pending in MDL 3026 before Judge Pallmeyer. The first federal Enfamil trial, Inman v. Mead Johnson, began in early July 2026, and a second federal trial involving a Similac claim has been set for August 2026 — we previewed the federal picture in our Inman v. Mead Johnson trial preview and our MDL 3026 status update. And in state court, juries have returned verdicts for some families: in April 2026, for example, a Chicago jury returned a $70 million verdict against Abbott for four families whose premature babies developed NEC after Similac — a result we reported in Abbott ordered to pay $70 million in an NEC verdict. We report those outcomes as news; a past verdict is never a promise about any other case, and past results do not guarantee future outcomes.
Mar also sits alongside a separate line of federal rulings that dismissed early cases for a different reason — the exclusion of expert testimony under the Daubert standard — which we unpack in why some NEC cases never reach a jury. Different cases have risen or fallen on different issues. That is the nature of a mass tort working its way through the courts.
Why this makes the NICU feeding record even more important
If warning causation can turn on whether a particular NICU had a human-milk alternative, then the records that document those alternatives move to center stage. This is not abstract — it is the paper trail in the chart:
- The feeding and nutrition orders — what product was ordered, when, and in what proportion to the mother’s milk.
- Evidence of human-milk supply — whether the mother’s own milk was available and sufficient, whether pasteurized donor human milk was offered, and whether the hospital ran a donor-milk program at the time.
- The diagnosis and imaging — when NEC appeared and how severe it was, so the sequence lines up with the feeding record.
Two families with similar diagnoses can have meaningfully different cases depending on what the chart shows about the choices the NICU actually had. That is why our guide to the medical records an NEC case is built on stresses the linkage between documents rather than any single page — and why the honest first step is almost always to obtain the complete, unedited NICU chart and read it closely.
What a Board Certified trial lawyer takes from this ruling
“A defense ruling in a bellwether is not a headline that should scare a family away from asking questions — it’s a road map for how these cases are actually decided,” says Alex Alvarez, Managing Partner of The Alvarez Law Firm and a Board Certified Civil Trial Lawyer. “Mar lost on causation because of one hospital’s particular circumstances, not because the science was rejected and not because failure-to-warn cases can’t be won. When I look at a file, one of the first things I want to know is what feeding alternatives that NICU had. That answer is in the records, and it can look completely different from one hospital to the next.”
“What this decision really underscores is how fact-specific these cases are at the level of a single chart,” says Herb Borroto, M.D., J.D., the firm’s Medical-Legal Expert. “I read the feeding orders next to the notes about milk supply — was mom producing, was donor milk on the unit, what did the team actually have available the day they advanced feeds? A court in one case found no alternative existed. That is a finding about that NICU on those dates. It is not a medical conclusion about formula and NEC, and it says nothing about a different baby in a different unit. Each record tells its own story.”
This is general information, not legal or medical advice. This article summarizes a public court decision and what it means in general terms. It does not evaluate any product, diagnose any child, or predict the outcome of any case. Court decisions are fact-specific, the law varies by state, and rulings can be appealed or revisited. Past results do not guarantee future outcomes; every case is evaluated on its own facts.
How The Alvarez Law Firm approaches a NEC family’s case
When we review a potential NEC formula case, we start with the record, not the headlines. We request the complete NICU chart under the HIPAA right of access, line up the feeding orders against the diagnosis and imaging, and look closely at what the unit documented about the mother’s milk supply and any donor-milk availability — the very issues a ruling like Mar shows can matter. Our team, led by Board Certified Civil Trial Lawyer Alex Alvarez and supported by Medical-Legal Expert Herb Borroto, M.D., J.D., handles that work so families can stay focused on their child.
Free, confidential case review. No fees unless we recover compensation for you.
- Understand the records: the NICU documents an NEC case is built on.
- The human-milk question: donor milk programs and the NEC-prevention evidence.
- Where the litigation stands: the MDL 3026 update and the first federal trial.
- See if your family qualifies: Do I qualify for an NEC lawsuit?
Frequently asked questions
What did the Seventh Circuit decide in Mar v. Abbott?
On July 24, 2026, the U.S. Court of Appeals for the Seventh Circuit affirmed a grant of summary judgment for Abbott Laboratories in Mar v. Abbott, the first federal NEC baby formula bellwether case in MDL 3026. The court did not decide whether cow’s-milk-based formula can cause NEC. It ruled on a narrower point called warning causation: the plaintiff had not produced enough evidence that a stronger warning would have changed what the NICU physicians fed the baby, because the hospital did not have an adequate supply of human milk to use instead.
What is warning causation in a failure-to-warn case?
Warning causation is the requirement that an inadequate warning actually caused the harm. In a failure-to-warn claim it is not enough to show a warning was missing or too weak; the plaintiff must also show that a proper warning would have changed a decision and prevented the injury. In an NEC formula case that usually means showing the treating physicians would have fed the baby differently, and could have, if the label had said more.
Does the Mar v. Abbott ruling mean the NEC lawsuits are over?
No. Mar v. Abbott is one federal appellate decision applying West Virginia law to one family’s specific facts, and it turned on the particular hospital’s lack of a human-milk alternative. It does not decide whether formula can cause NEC, it does not bind state courts, and it does not control cases with different facts or under different states’ law. Other cases are proceeding, including a second federal trial and cases in state court where juries have returned verdicts for some families. Every case is evaluated on its own record.
Why does the Mar ruling make the NICU feeding record so important?
Because warning causation turns on what feeding options the NICU actually had, the records that show those options matter enormously: the feeding and nutrition orders, whether the mother’s own milk or pasteurized donor human milk was available and offered, and whether the hospital had a donor milk program. Two families with similar diagnoses can have very different cases depending on what the chart shows about the alternatives the NICU had at the time.
Sources
- Mar v. Abbott Laboratories, No. 25-2587 (7th Cir. July 24, 2026), opinion by Judge Michael Brennan (affirming summary judgment for Abbott on warning causation). Opinion via the U.S. Court of Appeals for the Seventh Circuit. media.ca7.uscourts.gov
- Justia — Mar v. Abbott Laboratories, No. 25-2587 (7th Cir. 2026) (case docket and opinion summary; West Virginia law governed; plaintiff did not show an alternative warning would have prevented the child’s death). law.justia.com
- Mealey’s / LexisNexis — “7th Circuit Affirms Judgment Dismissing 1st Bellwether Case In Baby Formula MDL” (July 29, 2026). mealeys.com
- Bloomberg Law — “Abbott Notches Appellate Win in Bellwether Infant Formula Case.” news.bloomberglaw.com
- U.S. Judicial Panel on Multidistrict Litigation — MDL No. 3026, In re: Abbott Laboratories, et al., Preterm Infant Nutrition Products Liability Litigation (N.D. Ill., Judge Rebecca Pallmeyer). jpml.uscourts.gov