The fear of necrotizing enterocolitis versus achieving optimal growth in preterm infants—an opinion
Orna Flidel-Rimon,
David Branski,
Eric S. Shinwell,
Orna Flidel-Rimon
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Search for more papers by this authorDavid Branski
Department of Pediatrics, Hadassah Hospital. Jerusalem, Israel, Hebrew University, Jerusalem, Israel
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Search for more papers by this authorCorresponding Author
Eric S. Shinwell
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Eric S. Shinwell, Department of Neonatology, Kaplan Medical Center, PO Box 1, Rehovot 76100, Israel. Tel: +972-89441218. Fax: +972-89441768. E-mail: [email protected]Search for more papers by this authorOrna Flidel-Rimon,
David Branski,
Eric S. Shinwell,
Orna Flidel-Rimon
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Search for more papers by this authorDavid Branski
Department of Pediatrics, Hadassah Hospital. Jerusalem, Israel, Hebrew University, Jerusalem, Israel
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Search for more papers by this authorCorresponding Author
Eric S. Shinwell
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel, Hebrew University, Jerusalem, Israel
Eric S. Shinwell, Department of Neonatology, Kaplan Medical Center, PO Box 1, Rehovot 76100, Israel. Tel: +972-89441218. Fax: +972-89441768. E-mail: [email protected]Search for more papers by this authorAbstract
Very-low-birthweight (VLBW) infants suffer marked growth delay despite well-intentioned efforts at combining enteral and parenteral nutrition. Fear of necrotizing enterocolitis (NEC) has traditionally influenced neonatologists toward delaying and progressing slowly with enteral feeding, while supporting the infant with parenteral nutrition. Current evidence suggests significant benefits of enteral feeding that is started early and advanced at rates of 20–35 ml/kg/d.
Conclusion: We conclude that fear of inadequate growth should replace the fear of NEC in guiding nutritional strategies for these infants.
References
- [1] American Academy of Pediatrics, Committee on Nutrition. Nutritional needs of low-birth-weight infants. Pediatrics 1985; 75: 976–86.
- [2] Ehrenkranz RA, Younes N, Lemons JA, Fanaroff AA, Donovan EF, Wright LL, et al. Longitudinal growth of hospitalized very low birth weight infants. Pediatrics 1999; 104: 280–9.
- [3] Dusick AM, Poindexter BB, Ehrenkrantz RA, Lemons JA. Growth failure in the preterm infant: can we catch up Semin Perinatol 2003; 27: 302–10.
- [4] Embelton NE, Pang N, Cooke RJ. Postnatal malnutrition and growth retardation: an inevitable consequence of current recommendations in preterm infants Pediatrics 2001; 107: 270–3.
- [5] Cooke RJ. Are there critical periods for brain growth in children born preterm Arch Dis Child Fetal Neonat Ed 2006; 91: F17–F22.
- [6] Wright K, Dawson J, Vogt E, Lorch V. New postnatal growth grids for very low birth weight infants. Pediatrics 1993; 91: 922–6.
- [7] Hack M. Young adult outcomes of very low birth weight children. Semin Fetal Neonat Med 2006; 11: 127–37.
- [8] McClure RJ, Newell SJ. Randomized controlled study of clinical outcome following tropic feeding. Arch Dis Child Fetal Neonat 2000; 82: F29–33.
- [9] Cooke RJ, Embleton ND. Feeding issues in preterm infants. Arch Dis Child Fetal Neonat 2000; 83: F215–8.
- [10] Schmidt H, Martindale R. The gastrointestinal tract in critical illness. Curr Opin Clin Nutr Metab Care 2001; 4: 547–51.
- [11] Burrin DG, Stoll B. Key nutrients and growth factors for the neonatal gastrointestinal tract. Clin Perinatol 2002; 29: 65–96.
- [12] Burrin DG, Davis TA, Fiorotto ML, Reeds PJ. Stage of development and fasting affect protein synthesis activity in the gastrointestinal tissues of suckling pigs. J Nutr 1991; 121: 1099–108.
- [13] Lucas A, Bloom SR, Aynsley-Green A. Gut hormones and minimal enteral feeding. Acta Paediatr Scand 1986; 75: 719–23.
- [14] Burrin DG, Stoll B, Jiang R, Chang X, Hartmann B, Holst JJ, et al. Minimal enteral nutrient requirements for intestinal growth in neonatal piglets: how much is enough Am J Clin Nutr 2000; 71: 1603–10.
- [15] Berseth CL. Effect of early feeding on maturation of the preterm infants’ small intestine. J Pediatr 1992; 120: 947–53.
- [16] Shulman RJ, Schanler RJ, Lau C, Heitkemper M, Ou CN, Smith EO. Early feeding, feeding tolerance, and lactase activity in preterm infants. J Pediatr 1998; 133: 645–9.
- [17] Hammerman C, Bin-Nun A, Kaplan M. Germ warfare: probiotics in defense of the premature gut. Clin Perinatol 2004; 31: 489–500.
- [18] Van Elburg RM, Fetter WP, Bunkers CM, Heymans HS. Intestinal permeability in relation to birth weight and gestational age. Arch Dis Child Fetal Neonat Ed 2003; 88: F52–5.
- [19] Nakayama M, Yajima M, Hatano S, Yajima T, Kuwata T. Intestinal adherent bacteria and bacterial translocation in breast-fed and formula-fed rats in relation to susceptibility to infection. Pediatr Res 2003; 54: 364–71.
- [20] Maxson RT, Jackson RJ, Smith SD. The protective role of enteral IgA supplement ementation in neonatal gut origin sepsis. J Pediatr Surg 1995; 30: 231–3.
- [21] Okuyama H, Urao M, Lee D, Drongowski RA, Coran AG. The effect of epidermal growth factor on bacterial translocation in newborn rabbits. J Pediatr Surg 1998; 33: 225–8.
- [22] Dunn L, Hulman S, Weiner J, Kliegman R. Beneficial effects of early hypocaloric enteral feeding on neonatal gastrointestinal function: preliminary report of a randomized trial. J Pediatr 1988; 112: 622–9.
- [23] Weinberger B, Watorek K, Strauss R, Witz G, Hiatt M, Hegyi T. Association of lipid peroxidation with hepatocellular injury in preterm infants. Crit Care 2002; 6: 521–5.
- [24] McClure RJ. Trophic feeding of the preterm infant. Acta Paediatr Supplement 2001; 90: 19–21.
- [25] Tyson JE, Kennedy KA. Trophic feedings for parenterally fed infants. Cochrane Database of Systemic Reviews 1997; 4: CD000504.
- [26] Troche B, Harvey-Wilkes K, Eagle WD, Nielsen HC, Frantz ID, Mitchell ML. Early minimal feedings promote growth in critically ill premature infants. Biol Neonate 1995; 67: 172–81.
- [27] Flidel-Rimon O, Friedman Even-Tov S, Juster-Reicher A, Amitay M, Shinwell ES. Early enteral feeding and nosocomial sepsis in very low birth weight infant. Arch Dis Child Fetal Neo Ed 2004; 89: 289–92.
- [28] Martin CM, Doig GS, Heyland DK, Morrison T, Sibbald WJ. for the Southwestern Ontario Critical Care Research Network. Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy. CMAJ 2004; 170: 197–204.
- [29] Weissman C. Nutrition in the intensive care unit. Crit Care 1999; 3: R67–75.
- [30] Lemons JA, Bauer CR, Oh W, Korones SB, Papile LA, Stoll BJ, et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. Pediatrics 2001; 107: E1.
- [31] Hintz SR, Kendrick DE, Stoll BJ, Vohr BR, Fanaroff AA, Donovan FF, et al. Neurodevelopmental and growth outcomes of extremely low birth infants after necrotizing enterocolitis. Pediatrics 2005; 115: 696–703.
- [32] Stoll JB, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low birth weight infants with neonatal infection. JAMA 2004; 292: 2357–65.
- [33] Ostertag SG, LaGamma EF, Reisen CE, Ferrentino FL. Early feeding does not affect the incidence of necrotizing enterocolitis. Pediatrics 1986; 77: 275–80.
- [34] Davey AM, Wagner CL, Cox C, Kedig JW. Feeding premature infants while low umbilical artery catheters are in place: a prospective, randomized trial. J Pediatr 1994; 124: 795–9.
- [35] Tyson JE, Kennedy K. Minimal enteral nutrition in parenterally fed neonates. Cochrane Database of Systemic Reviews 2005; 3: CD000504.
- [36] Tyson JE, Kennedy K. Early versus delayed initiation of progressive enteral feedings for parentally fed low birth weight preterm infants. Cochrane Database of Systemic Reviews 2000; 1: CD001970.
- [37] Rayyis SF, Ambalavanan N, Wright L, Carlo WA. Randomized trial of ‘‘slow’’ versus ‘‘fast’’ feed advancements on the incidence of necrotizing enterocolitis in very low birth weight infants. J Pediatr 1999; 134: 293–7.
- [38] La Gamma EF, Browne LE. Feeding practices for infants weighting less than 1500g at birth and the pathogenesis of necrotizing enterocolitis. Clin Perinatol 1994; 21: 271–306.
- [39] Caple J, Armentrout D, Huseby V, Halbardier B, Garcia J, Sparks JW. Randomized, controlled trial of slow versus rapid feeding volume advancement in preterm infants. Pediatrics 2004; 114: 1597–600.
- [40] Kennedy K, Tyson JE, Chmnanvanakij S. Rapid versus slow rate of advancement of feedings for promoting growth and preventing necrotizing enterocolitis in parenterally fed low birth weight infants. Cochrane Database of Systemic Reviews 2000; 2: CD001241.
- [41] Berseth CL, Bisquera JA, Paje VU. Prolonging small feeding volumes early in life decreases the incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics 2003; 111: 529–34.
- [42] Patole SK, de Klerk N. Impact of standardized feeding regimens on incidence of neonatal necrotizing enterocolitis: a systemic review and meta-analysis of observational studies. Arch Dis Child Fetal Neonatal Ed 2005; 90: F147–51.
- [43] Dsilna A, Christensen K, Alfredsson L, Lagerkrantz H, Blennow M. Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants. J Pediatr 2005; 147: 43–9.
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