Early trophic feeding versus enteral fasting for very preterm or very low birth weight infants

Morgan, Jessie; Bombell, Sarah; McGuire, William

doi:10.1002/14651858.cd000504.pub4

Cited by 121 publications

(99 citation statements)

References 45 publications

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“…21 HM is started for 1-4 d when appropriate to stimulate gastrointestinal functioning and promote endocrine and metabolic maturity (50)(51)(52) (8,50,53). Most preterm infants cannot meet these high needs through enteral intake of breast milk or standard formula alone (53)(54)(55).…”

Section: $Dmentioning

confidence: 99%

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Shulhan¹,

Dicken²,

Hartling³

et al. 2017

Advances in Nutrition

105

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Preterm infants are extremely vulnerable to a range of morbidities and mortality. Underdeveloped cardiac, respiratory, gastrointestinal, and immune systems in the preterm period increase the risk of necrotizing enterocolitis (NEC), a serious disease of the gut. NEC affects 5-12% of very-low birthweight infants, leads to surgery in 20-40% of cases, and is fatal in 25-50% of cases. There are multiple factors that may contribute to NEC, but the exact cause is not yet fully understood. Severe cases can result in intestinal resection or death, and the health care costs average >$300,000/infant when surgical management is required. Different types of nutrition may affect the onset or progression of NEC. Several studies have indicated that bovine milk-based infant formulas lead to a higher incidence of NEC in preterm infants than does human milk (HM). However, it is not clear why HM is linked to a lower incidence of NEC or why some infants fed an exclusively HM diet still develop NEC. An area that has not been thoroughly explored is the use of semielemental or elemental formulas. These specialty formulas are easy to digest and absorb in the gut and may be an effective nutritional intervention for reducing the risk of NEC. This review summarizes what is known about the factors that contribute to the onset and progression of NEC, discusses its health care cost implications, and explores the impact that different formulas and HM have on this disease. Adv Nutr 2017;8:80-91.

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Section: $Dmentioning

confidence: 99%

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Shulhan¹,

Dicken²,

Hartling³

et al. 2017

Advances in Nutrition

105

View full text Add to dashboard Cite

show abstract

“…68 Because of the lack of harm and the likely physiological benefits mentioned previously, it is routine practice to commence enteral feeds in very low birth weight infants as early as possible, preferably with maternal breast milk. Once trophic feeds have been started, the timing of increasing enteral feeds is still unclear.…”

mentioning

confidence: 99%

Necrotizing enterocolitis: current perspectives

Yajamanyam

Rasiah²,

Ewer³

2014

RRN

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Necrotizing enterocolitis is the most common gastrointestinal emergency in neonates, particularly in those born very preterm. It is a leading cause of morbidity and mortality, especially in extremely low birth weight infants. Despite extensive research, the pathophysiology of necrotizing enterocolitis remains unclear and therapeutic options are limited. Multiple risk factors have been reported, but most are associated with prematurity and its complications. This makes management very challenging in vulnerable preterm infants. In this review, we focus on the risk factors and some of the current research in this area, particularly studies aimed at early detection and potential preventive measures for this potentially lethal condition.

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“…However, the minimal feeding group also had prolonged parenteral nutrition and central line placement, which carries other risks unrelated to NEC. In a 2013 Cochrane review, Morgan et al determined that there is insufficient evidence showing that early trophic feedings compared to enteral fasting or delayed enteral feeding improves feeding tolerance or prevents NEC (24). Other studies have demonstrated similar findings.…”

Section: Enteral Feeding Techniquesmentioning

confidence: 99%

Necrotizing Enterocolitis: A Narrative Review of Updated Therapeutic and Preventive Interventions

Reid¹,

Thompson-Branch²

2016

J Pediatr Rev

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Context: Necrotizing enterocolitis (NEC) remains one of the most common causes of morbidity and mortality for premature infants in the neonatal intensive care unit (NICU). Many theories concerning its pathophysiology and inciting factors have been suggested but progression in preventing the onset of NEC has been minimal. While this article highlights the pathophysiology, management, and outcomes of NEC, it mainly serves as a narrative review to discuss the emerging methods of treatment and prevention.Evidence Acquisition: A literature search was done using Medline/Pub Med, Cochrane Database of Systematic Reviews via Ovid, and CINAHL Complete with focus on articles published between 2000 and 2016. Searched terms included the following: necrotizing enterocolitis, pathogenesis, prevention, management, breast milk, formula, probiotics, prebiotics, and treatment. Results:Intestinal barrier dysfunction, hypoxic ischemic injury, receipt of packed red blood cells, immature intestinal immunity and alterations of the gut microbiome of the premature infant were reviewed factors that have been studied related to the pathophysiology of NEC. The presentation, staging and management remain relatively unchanged in the last few decades, though there have been a few studies evaluating different surgical options, various antibacterial regimen, and recently use of moderate hypothermia and amniotic fluid stem cells to treat NEC. Use of breast milk, use of pre-, pro-and postbiotics show promise in the prevention of NEC.Conclusions: NEC is a likely multifactorial illness of the gastrointestinal tract affecting mostly premature infants. Recent studies have focused on preventative strategies, with promise in pre-, pro-and postbiotics; however continued research is imperative.

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Early trophic feeding versus enteral fasting for very preterm or very low birth weight infants

Abstract: Early trophic feeding versus enteral fasting for very preterm or very low birth weight infants.

Cited by 121 publications

References 45 publications

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Necrotizing enterocolitis: current perspectives

Necrotizing Enterocolitis: A Narrative Review of Updated Therapeutic and Preventive Interventions

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