Standardized Slow Enteral Feeding Protocol and the Incidence of Necrotizing Enterocolitis in Extremely Low Birth Weight Infants

Viswanathan, S.; McNelis, Kera; Super, Dennis M.; Einstadter, Douglas; Groh-Wargo, Sharon; Collin, Marc

doi:10.1177/0148607114552848

Cited by 51 publications

(35 citation statements)

References 41 publications

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“…This contrasts data by Viswanathan et al, who reported that a slow standardized enteral feeding protocol reduced the incidence of NEC in infants < 750 g . Infants began enteral feedings at roughly 14 days of life and were then slowly advanced to full enteral feedings by 44–52 days of life . Based on our data, study infants < 750 g achieved enteral feedings earlier than the collective group of epoch 1 infants (median of 22 days).…”

Section: Discussioncontrasting

confidence: 94%

Improving Nutrition Outcomes for Infants < 1500 Grams With a Progressive, Evidenced‐Based Enteral Feeding Protocol

2018

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Section: Discussioncontrasting

confidence: 94%

Improving Nutrition Outcomes for Infants < 1500 Grams With a Progressive, Evidenced‐Based Enteral Feeding Protocol

2018

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“…In the literature, the concept of slow advancements in enteral feeding volumes and consequently an increased number of parenteral nutrition days demonstrated no significant alterations in the overall incidence of NEC except in infants with a birth weight < 750 g [23]. In contrast to the number of parenteral feeding days, the velocity of enteral feeding volume expansion during the first postnatal week was not associated with the development of NEC.…”

Section: Discussionmentioning

confidence: 94%

Risk Factors for Necrotizing Enterocolitis: A Prospective Multicenter Case-Control Study

et al. 2018

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Background: The identification of independent clinical risk factors for necrotizing enterocolitis (NEC) may contribute to early selection of infants at risk, allowing for the development of targeted strategies aimed at the prevention of NEC. Objective: The objective of this study was to identify independent risk factors contributing to the development of NEC in a large multicenter cohort. Methods: This prospective cohort study was performed in 9 neonatal intensive care units. Infants born at a gestational age ≤30 weeks were included. Demographic and clinical data were collected daily until day 28 postnatally. Factors predictive of the development of NEC were identified using univariate and multivariable analyses in a 1: 5 matched case-control cohort. Results: In total, 843 infants (56 NEC cases) were included in this study. In the case-control cohort, univariate analysis identified sepsis prior to the onset of NEC and formula feeding to be associated with an increased risk of developing NEC, whereas the administration of antibiotics directly postpartum was inversely associated with NEC. In a multivariable logistic regression model, enteral feeding type and the number of days parenterally fed remained statistically significantly associated with NEC, whereas the administration of antibiotics directly after birth was associated with a lower risk of developing NEC. Conclusions: Formula feeding and prolonged (duration of) parenteral feeding were associated with an increased risk of NEC. Contrary to expectations, the initiation of treatment with antibiotics within 24 h after birth was inversely associated with NEC.

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“…Early feedings appear safe in these infants yet some feeding protocols involve the withholding of initial feedings for 7-14 d in ELBW infants (32). Slow feeding advances delay enteral provisions even if a mother's milk DHA concentration happens to be high.…”

Section: Articlesmentioning

confidence: 99%

Early docosahexaenoic and arachidonic acid supplementation in extremely-low-birth-weight infants

et al. 2016

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Background: Extremely-low-birth-weight (ELBW) infants accrue large deficits in docosahexaenoic acid (DHA) and arachidonic acid (ARA) and require improved supplementation strategies. We hypothesized that once daily DHA+ARA drops applied to buccal mucosa will increase blood levels. Methods: Thirty ELBW infants were randomized to receive DHA 20 mg/kg/d + ARA 40 or 60 mg/kg/d + ARA 120 mg/kg/d or placebo within 72 h of age for 8 wk duration. Red blood cell phospholipid levels of DHA (primary) and ARA (secondary) were measured at 2 and 8 wk of age. results: Twenty-eight survivors with a median birth weight of 806 g completed dosing and sampling. Red blood cell levels were similar between the three groups at 2 wk (DHA: 4.62 wt% (interquartile range (IQR) 4.1-5.5) for all, P = 0.29 between groups; ARA: 21.1 wt% ) for all, P = 0.41 between groups) and 8 wk (DHA: 6.0 wt% (IQR 5.1-7.1) for all, P = 0.57 between groups; ARA: 20.1 wt% .1) for all, P = 0.63 between groups). DHA in all infants showed a median increase of 31% from 2 to 8 wk (P < 0.04). ARA levels did not significantly change over time (P > 0.6). conclusion: Daily buccal DHA and ARA supplements did not affect fatty acid levels in ELBW infants.

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Standardized Slow Enteral Feeding Protocol and the Incidence of Necrotizing Enterocolitis in Extremely Low Birth Weight Infants

Cited by 51 publications

References 41 publications

Improving Nutrition Outcomes for Infants < 1500 Grams With a Progressive, Evidenced‐Based Enteral Feeding Protocol

Improving Nutrition Outcomes for Infants < 1500 Grams With a Progressive, Evidenced‐Based Enteral Feeding Protocol

Risk Factors for Necrotizing Enterocolitis: A Prospective Multicenter Case-Control Study

Early docosahexaenoic and arachidonic acid supplementation in extremely-low-birth-weight infants

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