Breast milk and neonatal necrotising enterocolitis

Lucas, Alan; Cole, TJ

doi:10.1016/0140-6736(90)93304-8

Cited by 1,453 publications

(855 citation statements)

References 28 publications

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“…As previously described, breast milk appeared to reduce the severity of NEC. 2,6,26,27 Our multivariate analysis showed that in neonates who developed NEC, the reported use of breast milk decreased the likelihood that a neonate would require surgical treatment.…”

Section: Discussionmentioning

confidence: 79%

Necrotizing Enterocolitis Among Neonates in the United States

et al. 2003

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BACKGROUND:Prior studies have identified individual risk factors that are associated with necrotizing enterocolitis (NEC); however, the small sample sizes of these previous studies have not allowed the analysis of potential interaction between multiple variables and NEC. Our purpose was to describe the incidence and risk factors for NEC in premature neonates admitted for intensive care. METHODS:We identified neonates as having NEC if they met accepted diagnostic criterion for necrotizing enterocolitis. Using a national database, we assessed the association between NEC and a battery of risk factors previously reported in peer-reviewed literature. RESULTS:There were 15,072 neonates that met inclusion criteria; 14,682 did not have NEC, while 390 (2.6%) met criterion for NEC. Multivariate analysis showed that low birth weight was the most important risk factor for NEC. Other factors that were associated with an increased risk of NEC were exposure to antenatal glucocorticoids, vaginal delivery, need for mechanical ventilator support, exposure to both glucocorticoids and indomethacin during the first week of life, absence of an umbilical arterial catheter, and low Apgar score at 5 minutes. Length of hospital stay and mortality were higher in neonates with NEC than in neonates without NEC. CONCLUSIONS:NEC remains an important cause of morbidity and mortality in prematurely born neonates. In contrast to previous studies, we found that exposure to antenatal glucocorticoids was associated with an increased risk for NEC independent of birth weight.

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Section: Discussionmentioning

confidence: 79%

Necrotizing Enterocolitis Among Neonates in the United States

et al. 2003

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“…12 Human milk (HM) feeding has been associated with a lower incidence of NEC. [13][14][15][16] A meta-analysis of four randomized clinical trials of donor HM versus formula suggests that 100% HM feeding is protective against NEC. 16 Observational studies also have reported a lower incidence, among infants fed HM, of NEC 13 and NEC and sepsis combined.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16] A meta-analysis of four randomized clinical trials of donor HM versus formula suggests that 100% HM feeding is protective against NEC. 16 Observational studies also have reported a lower incidence, among infants fed HM, of NEC 13 and NEC and sepsis combined. 14,15 In many hospitals donor HM is not used, and because of insufficient maternal milk production, most infants who receive HM also receive varying amounts of formula.…”

Section: Introductionmentioning

confidence: 99%

Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants

et al. 2007

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Background: Necrotizing enterocolitis (NEC) is a frequent cause of mortality and morbidity in very low birth weight (VLBW) infants. Human milk (HM) feeding has been associated with lower risk of NEC. However, mothers of VLBW infants often experience insufficient milk production, resulting in mixed feedings of HM and formula. Moreover, medical complications often limit the volume of feeding they can be given.Objective: To determine if high proportions of (50% or greater) HM enteral feeding within the first 14 days of life are protective against NEC.Method: This was a prospective cohort study of VLBW infants who were grouped according to the HM proportion of enteral feeding in the first 14 days: <50% (low human milk, LHM, n ¼ 46) and X50% (high human milk, HHM, n ¼ 156). The outcome of interest was development of NEC (Bell stage 2 or 3). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) and to assess potential confounding due to perinatal risk factors.Result: Two hundred and two infants were studied. Confirmed NEC occurred in 5/46 (10.6%) of the LHM group, as compared with 5/156 (3.2%) of the HHM. Gestational age was the only perinatal factor associated with risk of NEC. After adjustment for gestational age, HHM was associated with a lower risk of NEC ((OR ¼ 0.17, 95% CI: 0.04 to 0.68), P ¼ 0.01). Conclusion:Enteral feeding containing at least 50% HM in the first 14 days of life was associated with a sixfold decrease in the odds of NEC.

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“…Lucas and Cole, 39 in a multicenter feeding trial involving almost 1000 preterm infants with birth weights less than 1850 g, demonstrated that the incidence of confirmed NEC was six times greater in formula-fed infants than in those receiving human milk. In addition, NEC was rare for infants greater than 30 weeks gestation who were fed human milk, but this was not the case for formula-fed babies.…”

Section: Initiation and Advancement Of Enteral Feedingsmentioning

confidence: 99%

Pragmatic Approach to In-Hospital Nutrition in High-Risk Neonates

Adamkin

2005

J Perinatol

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Breast milk and neonatal necrotising enterocolitis

Cited by 1,453 publications

References 28 publications

Necrotizing Enterocolitis Among Neonates in the United States

Necrotizing Enterocolitis Among Neonates in the United States

Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants

Pragmatic Approach to In-Hospital Nutrition in High-Risk Neonates

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