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Standardized feeding regimen for reducing necrotizing enterocolitis in preterm infants: an updated systematic review

B Jasani1, S Patole1,2

  • 1Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Perth, WA, Australia.

Journal of Perinatology : Official Journal of the California Perinatal Association
|March 31, 2017
PubMed

Insights

Standardized feeding regimens (SFR) significantly reduce necrotizing enterocolitis (NEC) in preterm infants. This review confirms SFR remains a vital tool for preventing NEC, highlighting its continued effectiveness.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Evidence-Based Practice

Background:

  • Necrotizing enterocolitis (NEC) poses a significant health burden in preterm infants.
  • Previous reviews indicated substantial NEC reduction with standardized feeding regimens (SFR).
  • Updated evidence is crucial given new studies and ongoing NEC challenges.

Purpose of the Study:

  • To systematically review and quantify the incidence of NEC in preterm infants before and after the implementation of SFR.
  • To assess the continued effectiveness of SFR in preventing NEC in contemporary preterm populations.

Main Methods:

  • A comprehensive literature search was conducted across major databases (PubMed, EMBASE, CINAHL) and conference proceedings up to May 2016.
  • Included were observational studies reporting NEC incidence pre- and post-SFR implementation.
  • Meta-analysis using random-effects models was performed on data from 15 studies (N=18,160).

Main Results:

  • Standardized feeding regimens (SFR) demonstrated a significant reduction in NEC incidence (Risk Ratio: 0.22; 95% CI: 0.13-0.36; P<0.00001).
  • The pooled analysis indicated a substantial decrease in NEC risk, with high statistical significance.
  • Results remained significant when analyzing studies across different time periods (1978-2003 vs. 2004-2016).

Conclusions:

  • Standardized feeding regimens (SFR) are a highly effective intervention for preventing necrotizing enterocolitis (NEC) in preterm infants.
  • The findings reinforce SFR as a critical component of neonatal care for reducing NEC.
  • Continued adherence to and refinement of SFR protocols are recommended for optimal outcomes.
Abstract

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