Severe IUGR and Long Duration of Antibiotic Treatment may Overcome the Benefits of Appropriate Feeeding Strategies to Prevent Necrotising Enterocolitis

Abstract

Aim: To compare the characteristic features of premature neonates who developed necrotizing enterocolitis (NEC) or not and review the risks for NEC in our neonatal intensive care unit. Materials and Method: Ninety four premature neonates with gestational age ≤ 35 weeks and/or birth weight ≤1500 g were included into the study. Characteristic features of the study neonates were compared. Results: NEC occurred in 15.9% of the study population. Seventy nine neonates who did not develop NEC and 15 neonates who developed stage II and III NEC were compared. The rate of intrauterine growth restriction (IUGR), late onset sepsis and therefore broad-spectrum antibiotic usage were significantly higher in the group who developed NEC. At the time of diagnosis 93 % of NEC positive patients were on full feeds either with breast milk only or breast milk + fortifier, none of them were formula fed, 7 % of the cases were never fed. Surgery was performed in all stage III NEC patients and overall mortality rate was 33%. Conclusion: Our findings suggest that together with exclusive breast feeding regimen, other strategies to prevent NEC should be implemented in this high risk preterm neonates.