Early feeding after necrotizing enterocolitis in preterm infants.
OBJECTIVE
To report our experience with an early initiation of enteral feedings after necrotizing enterocolitis (NEC).


METHODS
Over a 4-year period, all inborn infants with NEC Bell stage II or greater received enteral feedings, increased by 20 mL/kg/d, once no portal vein gas had been detected on ultrasound for 3 consecutive days (group 1). Infants were compared with a historic comparison group (group 2).


RESULTS
Necrotizing enterocolitis rates were 5% (26/523) in the early feeding group and 4% (18/436) in the comparison group. One early feeding infant and two comparison group infants died of NEC, whereas two and one, respectively, had recurrent NEC. Enteral feedings were restarted at a median of 4 days (range, 3-14) versus 10 days (range, 8-22) after onset of NEC. Early feeding was associated with shorter time to reach full enteral feedings (10 days [range, 7-31] vs 19 days [range, 9-76], P<.001), a reduced duration of central venous access (13.5 days [range, 8-24] vs 26.0 days [range, 8-39], P<.01), less catheter-related septicemia (18% vs 29%, P<.01), and a shorter duration of hospital stay (63 days [range, 28-133] vs 69 days [range, 36-150], P<.05).


CONCLUSIONS
Early enteral feeding after NEC was associated with significant benefits and no apparent adverse effects. This study was underpowered, however, to exclude a higher NEC recurrence risk potentially associated with this change in practice.
Bohnhorst
Bettina
B
Department of Neonatology and Pediatric Pulmonology, Hannover Medical School, Hannover, Germany.
Müller
Sylvia
S
Dördelmann
Michael
M
Peter
Corinna S
CS
Petersen
Claus
C
Poets
Christian F
CF
D004750:Enteral Nutrition; D020345:Enterocolitis, Necrotizing / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D013997:Time Factors; D016896:Treatment Outcome