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Do feeding practices during transfusion influence the risk of developing necrotising enterocolitis in preterm

Cathie Hilditch1,2, Amy Keir1,2,3

  • 1Healthy Mothers, Babies and Children Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.

Journal of Paediatrics and Child Health
|May 15, 2018
PubMed

Insights

Withholding feeding during blood transfusions for preterm infants with anemia may reduce necrotizing enterocolitis risk. Clinical equipoise suggests local decisions on feeding practices are reasonable until more evidence is available.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Hematology

Background:

  • Anemia of prematurity is common in preterm infants.
  • Blood transfusions are frequently required but carry risks.
  • Transfusion-associated necrotizing enterocolitis (TANEC) is a serious complication.

Purpose of the Study:

  • To evaluate the impact of feeding practices during blood transfusions on TANEC risk in preterm infants.
  • To synthesize current evidence on the clinical question: 'In a preterm infant with anemia of prematurity, do feeding practices during blood transfusion reduce the risk of developing TANEC?'

Main Methods:

  • Evidence-based review of existing literature.
  • Analysis of clinical trial data (where available).

Main Results:

  • Limited evidence suggests withholding enteral feeds during red blood cell transfusion may decrease TANEC risk.
  • Clinical equipoise exists regarding the optimal feeding strategy.

Conclusions:

  • Individual clinical units may consider withholding enteral feeds during transfusions based on current limited evidence.
  • The UK-based Withholding Enteral Feeds Around Transfusion (WHEAT) trial is expected to provide definitive evidence.
  • Further research using innovative study designs in neonatal care is warranted.

Keywords:
enteral feedingenterocolitis, necrotisinginfant, newborntransfusion, red blood cell

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