[Necrotizing enterocolitis among preterm newborns with early feeding].
BACKGROUND
The development of necrotizing enterocolitis is a common and serious risk to newborns. It is caused by splanchnic bed vasoconstriction that can produce intestinal necrosis. The role of onset time, type and, speed enhancements of The factors of enteral feeding related with necrotizing enterocolitis genesis such as feeding onset, type and frequency are not well understood.


OBJECTIVE
The incidence of necrotizing enterocolitis and mortality among infants will be compared in infants whose enteral feeding was initiated 48 hours after birth to those whose feeding began on day 5 postpartum.


METHODS
A controlled clinical trial was conducted among 239 newborns weighing between 750-1,500 g and a gestation age of 27-32 weeks of gestational age. The infants were randomly assigned to two groups--135 to an early feeding regime and 104 to delayed feeding. Breast milk or formula milk was used. Feeding was begun with one ml every six hours, progressing to three hour intervals and 20 ml/kg daily. This was increased to 150 ml/kg-d if the infant condition remained stable and it manifested no oral intolerance.


RESULTS
In the early feeding group, 14 (10;4 %) necrotizing enterocolitis cases occurred, and in the late feeding group, 9 (8.7 %) occurred (RR= 1.22, 95 % CI 0.49-3.20, p= 0.65). Five children died in early feeding group (3.7 %, 95% CI 1.4-8.9) and eight in late feeding group (7.7 %, 95 % CI 3.6-15.0, RR=0.46, 95 % CI 0.12-1,60, p= 0.18).


CONCLUSIONS
Early enteral feeding in preterm newborns does not increase the risk of necrotizing enterocolitis or mortality among them; however it represents nutritional advantages for these infants.
Departamento de Pediatría, Facultad de Salud, Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia. lperezvera@hotmail.com
Luis Alfonso
LA
Pérez
Germán Lauro
GL
Pradilla
Gaby
G
Díaz
Sandra María
SM
Bayter
D000367:Age Factors; D001942:Breast Feeding; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D041943:Infant Formula; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008297:Male