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Related Experiment Video

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Estimating Neonatal Necrotizing Enterocolitis Based on Feeding Practices.

Miguel Baños-Peláez1, Valeria Avila-Sosa1, Luis Alberto Fernández-Carrocera2

  • 1Department of Physiology and Cellular Development, National Institute of Perinatology "Isidro Espinosa de los Reyes", Mexico City 11000, Mexico.

Children (Basel, Switzerland)
|April 3, 2021
PubMed
Summary

Exclusive mother's own milk (MM) and fortified human milk (FHM) feeding strategies significantly reduce the risk of necrotizing enterocolitis (NEC) in premature infants compared to fasting. Promoting MM in Neonatal Intensive Care Units (NICUs) may improve NEC outcomes.

Keywords:
enterocolitishuman milkneonatology

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Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Nutritional Science

Background:

  • Necrotizing enterocolitis (NEC) is a significant concern in premature neonates.
  • The precise relationship between enteral nutrition and NEC remains incompletely understood.
  • Current feeding strategies require further investigation to optimize NEC prevention.

Purpose of the Study:

  • To assess the association between various feeding strategies and the incidence of NEC in premature infants.
  • To compare feeding practices in neonates with NEC versus those without the condition.
  • To identify specific feeding-related factors that may mitigate NEC risk.

Main Methods:

  • Retrospective case-control study involving premature infants (<35 weeks' gestation).
  • Analysis of feeding practices and clinical data at multiple time points during hospitalization (birth, days 3, 7, 14).
  • Longitudinal and cross-sectional analyses using generalized linear, mixed, and binary logistic regression models.

Main Results:

  • Exclusive mother's own milk (MM) and fortified human milk (FHM) were significantly associated with a lower likelihood of NEC (p < 0.001).
  • Enteral fasting on days 7 and 14 was positively correlated with an increased risk of NEC (p < 0.05).
  • MM demonstrated a reduced risk for NEC (OR 0.148), with factors like birth weight, antenatal steroids, and FHM use on day 14 further decreasing NEC odds (p < 0.001).

Conclusions:

  • Mother's own milk (MM) and fortified human milk (FHM) are linked to reduced NEC incidence compared to periods of enteral fasting.
  • Feeding practices in Neonatal Intensive Care Units (NICUs) should prioritize exclusive MM during the critical first two weeks.
  • Promoting specific milk feeding strategies may serve as a guideline to improve NEC outcomes in premature infants.