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Influence of Enteral Nutrition on Occurrences of Necrotizing Enterocolitis in Very-Low-Birth-Weight Infants
Karine S Kimak1, Margarida M de Castro Antunes, Taciana D Braga
1*Post-Graduate Program in Child and Adolescent Health †Department of Maternal and Child Health, Federal University of Pernambuco ‡Neonatal Intensive Care Unit, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.
Objective:
The aim of the present study was to investigate the influence of enteral feeding management on occurrences of necrotizing enterocolitis (NEC) in very-low-birth-weight (VLBW) infants.
Methods:
This was a case-control study conducted in a sample of 1028 VLBW infants (750 to 1499 g) admitted to a neonatal intensive care unit between January 2003 and May 2008. "Cases" were infants born with VLBW and diagnosed with NEC within the first 30 days of life, and "controls" were VLBW infants who did not develop NEC during this period. Occurrences of NEC were defined using the modified Bell criteria (stage ≥2).
Results:
Among the 1028 VLBW infants, 55 (5.4%) developed NEC within the first month of life. Logistic regression analysis showed that breast milk given exclusively for <7 days (odds ratio [OR] = 4.02), never achieving full enteral feeding during the first month (OR = 3.50), and parenteral nutrition (OR = 2.70) were factors that increased the chances of NEC occurrence. The use of vasoactive drugs was associated with a lower risk of NEC (OR = 0.15).
Conclusions:
Breast milk should be recommended as a priority for the enteral nutrition of VLBW infants for no <7 days. Enteral nutrition should start early and progress quickly to achieve full enteral feeding; these procedures may help reduce the occurrence of NEC.
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