Abstract
Feeding has been implicated in the etiology of NEC. To determine the relationship between milk selection, enteric(PO) feeding rate and total fluid volume, the alimentation records of 19 cases of NEC were compared to 2 controls(CON) for each NEC, matched by birthweight and time of admisslon(CON=38). Birth-weight (1.4±0.4 v 1.4±0.4kg) (X+SD), gestational age(31.6±2.8 v 31.4±2.6wks), Apgars, sex, weight for age, incidence of intubation and umbilical arterial catheters(UAC) were similar. Initiation of feeds after removal of UAC was equivalent: NEC 30.8±19.2 and CON 51.3±46hr. Furthermore, the use of PO medications, formula/milk selection, aspirates as % of feed, 1st day of PO feeds (3.9±2.6 v 7.3±8.7d) and volume fed 1st day(22±20 v 16±13) were not different. Onset of NEC was 9.9±6.3d of life. The day of maximum PO volume among NEC patients was 5.0±4.1 and was matched to that specific, corresponding day in the 2 respective case controls(table). The daily increment of PO volume was greatest in NEC patients after 3±2d of feeds. This increment was higher in NEC(57±19 v 22±30, p<0.001) when matched for the increment on the corresponding day in CON. We conclude that rapid feeding progression or excessive acute volume increments may predispose the neonate to endemic NEC.
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Anderson, D., Rome, E. & Kliegman, R. 1324 RELATIONSHIP OF ENDEMIC NECROTIZING ENTEROCOLITIS (NEC) TO ALIMENTATION. Pediatr Res 19, 331 (1985). https://doi.org/10.1203/00006450-198504000-01348
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DOI: https://doi.org/10.1203/00006450-198504000-01348