Dec 27, 2006

Special circumstances: trophic feeds, necrotizing enterocolitis and bronchopulmonary dysplasia

Seminars in Fetal & Neonatal Medicine
Regina M Reynolds, P J Thureen

Abstract

There are many unresolved issues regarding how to feed the extremely-low-birth-weight (ELBW) infant. Trophic feedings of small volumes of breast milk or formula do not appear to increase the incidence of necrotizing enterocolitis (NEC). For prevention of NEC, breast milk, antenatal steroids and fluid restriction each confers a benefit. Because the incidence of NEC is relatively low, to determine if a particular prevention strategy is effective, large numbers of infants would need to be enrolled in a prospective, randomized controlled trial, and such trials are rare. Candidate therapies for NEC prevention that warrant further study include oral immunoglobulins, probiotics, long-chain polyunsaturated fatty acids and arginine. Suboptimal nutrition in ELBW infants is common in the early postnatal period. This is also the most critical time for the development of bronchopulmonary dysplasia, when even brief periods of malnutrition have significant effects on lung development and growth.

Mentioned in this Paper

Metabolic Process, Cellular
Ischemia
Vitamin A
Epoetin Alfa
Lung
Antibiotic throat preparations
Erythropoietin Measurement
Uterus
Lung Growth
Energy Metabolism

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