Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Reply to Dr Bell

Journal of Perinatology volume 28, pages 383–384 (2008)Cite this article

It is with deep respect that we write this response to Dr Bell1 who has inspired generations of physicians to do research on acquired neonatal intestinal diseases, most notably NEC. We are also pleased to read his agreement that spontaneous intestinal perforation (SIP) and necrotizing enterocolitis (NEC) are distinct and separate disease entities. We hope that this editorial exchange will encourage others to consider how best to approach these disparate diseases and the populations they affect.

We do endorse a large, multicenter, randomized trial of probiotics that encompasses ELBW infants. Such a trial could examine the possibility that probiotic bacteria may be present in peritoneal or blood cultures taken from infants who develop SIP. It remains to be seen how this promising potential therapy would affect our most vulnerable charges. A system allowing investigators to delineate the type of acquired neonatal intestinal disease in each patient would help us understand each of these pathologies. Our guidelines5 may not prove to be the final version of that system, but we hope that they might be seen as a starting point.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Bell MJ . Letter to the editor. J Perinatol 2008 (in press).

  2. Deshpande G, Rao S, Patole S . Probiotics for prevention of necrotising enterocolitis in preterm neonates with very low birthweight: a systematic review of randomised controlled trials. Lancet 2007; 369: 1578–1580.

    Article  Google Scholar 

  3. Moss RL, Dimmitt RA, Barnhart DC, Sylvester KG, Brown RL, Powell DM et al. Laparotomy versus peritoneal drainage for necrotizing enterocolitis and perforation. N Engl J Med 2006; 354: 2225–2234.

    Article  CAS  Google Scholar 

  4. Hintz SR, Kendrick DE, Stoll BJ, Vohr BR, Fanaroff AA, Donovan EF et al. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis. Pediatrics 2005; 115: 696–703.

    Article  Google Scholar 

  5. Gordon PV, Swanson JR, Attridge JT, Clark R . Emerging trends in acquired neonatal intestinal disease: is it time to abandon Bell's criteria? J Perinatol 2007; 27: 661–671.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ochsner Health Sytem, New Orleans, LA, USA

    P V Gordon

  2. Department of Pediatrics, University of Virginia, Charlottesville, VA, USA

    J R Swanson

  3. Department of Pediatrics, University of Virginia, Charlotttesville, VA, USA

    J T Attridge

  4. Pediatrix Inc., Greenville, SC, USA

    R Clark

Authors
  1. P V Gordon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J R Swanson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J T Attridge
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P V Gordon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gordon, P., Swanson, J., Attridge, J. et al. Reply to Dr Bell. J Perinatol 28, 383–384 (2008). https://doi.org/10.1038/jp.2008.26

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2008.26

Search

Advanced search

Quick links