AI Article Synopsis
- - The study examined infants with necrotizing enterocolitis (NEC) to evaluate the effects of early (within 7 days) versus late (7 days or more) refeeding after nonoperative treatment, noting a lack of consensus on optimal fasting periods for these patients.
- - A review of 228 NEC patients revealed no significant differences in demographics between the early (40 patients) and late (98 patients) refeeding groups, although the late group had more patients with a more severe NEC stage (Stage IIB).
- - The findings indicated that early refeeding did not lead to higher rates of NEC recurrence, mortality, or strictures when controlled for NEC severity, highlighting the need for standardized guidelines in reintroducing
Article Abstract
Background: For infants with necrotizing enterocolitis (NEC) treated nonoperatively, no consensus exists on the optimal fasting period prior to reintroducing feeds after NEC. We report our experience with early (<7days) and late (≥7days) refeeding in this population.
Methods: A chart review of infants with NEC born between 2006 and 2016 was performed. Data elements include demographics, comorbidities, day of diagnosis, Bell's stage, recurrence, strictures, length of stay and mortality, and were grouped into early and late refeeding. T-tests were used for means and chi-squared tests for distribution of proportions. Linear and logistic regressions were used to further evaluate the association of length of stay, stricture, recurrence, and death with time to refeeding.
Results: Of 228 NEC patients, 149(65%) were treated nonoperatively (Bell Stages I, IIA, IIB, IIIA). Eleven patients were excluded owing to never restarting feeds, largely secondary to early death. The early (n=40) and late refeeding (n=98) groups were not significantly different with regard to mean gestational age at birth, race, birth weight, day of life at NEC diagnosis, or cardiac disease. NEC Stage was significantly different (p<0.001). The late group had significantly more Stage IIB patients (p=.02), and the early group had more stage I patients (p=<0.01). After adjusting for Bell's stage, the odds of NEC recurrence, death, and the composite outcome of recurrence or stricture or death were not significantly different between early and late groups.
Conclusions: No standardized guidelines exist for restarting enteral nutrition following medical NEC. In patients managed nonoperatively, early reintroduction of feeding was not significantly associated with increased NEC recurrence, mortality, or stricture.
Level Of Evidence: Treatment Study - Level III.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jpedsurg.2018.02.082 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical value of quantitative echocardiographic features in preterm infants with necrotizing enterocolitis.
Sci Rep
January 2025
Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China.
This study investigated the correlation between quantitative echocardiographic characteristics within 3 days of birth and necrotizing enterocolitis (NEC) and its severity in preterm infants. A retrospective study was conducted on 168 preterm infants with a gestational age of < 34 weeks. Patients were categorized into NEC and non-NEC groups.
View Article and Find Full Text PDFL-Citrulline in Neonates: From Bench to Bed Side.
Children (Basel)
December 2024
Division of Neonatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
L-citrulline (L-CIT), a precursor to L-arginine (L-ARG), is a key contributor to the nitric oxide (NO) signaling pathway. Endothelial dysfunction, characterized by deficient nitric oxide synthesis, is implicated in the pathogenesis of various neonatal conditions such as necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD) associated pulmonary hypertension (PH). This review summarizes the current evidence around the possible role of L-CIT supplementation in the treatment of these conditions.
View Article and Find Full Text PDFGenomic interrogation of commercial infant probiotic products for label accuracy.
Pediatr Res
January 2025
Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Objective: To evaluate the label accuracy of commercial infant probiotic products and identify potential microbial contamination.
Methods: DNA was extracted from seventeen infant probiotic products purchased from a large online vendor. Samples underwent 16S ribosomal RNA gene sequencing, QIIME analysis, and bacterial taxonomic classification.
The Relationship Between Hispanic Ethnicity and Outcomes for Infants Born Extremely Preterm.
J Pediatr
January 2025
Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Objective: To characterize the association between maternal ethnicity and infant survival to discharge without major morbidity.
Study Design: This is secondary analysis of a prospective cohort of infants born <27 weeks of gestation at NICHD Neonatal Research Network centers from 2006 through 2020. The primary outcome was survival to discharge without major morbidity (sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia grade 3, intracranial hemorrhage grade ≥3, periventricular leukomalacia, and advanced retinopathy of prematurity).
Addressing Health Inequities: Understanding the Relationship Between Social Determinants of Health and Necrotizing Enterocolitis.
J Pediatr Surg
January 2025
Division of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address:
Introduction: Necrotizing enterocolitis (NEC) is a severe illness with high mortality. Traditional risk factors are prematurity and neonatal stress. Maternal risk factors have also been postulated but are often overlooked.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!