title: Feeding during Blood Transfusions and the Association with Necrotizing Enterocolitis.
abstract: Objective The aim of this study was to determine whether very low-birth-weight (VLBW) infants who had feedings withheld during all blood transfusions had a lower incidence of necrotizing enterocolitis (NEC) compared with infants who were fed during transfusions. Study Design A retrospective chart review over a 3-year period in a level-3 neonatal intensive care unit was conducted. A total of 108 inborn VLBW infants (weight range: 500-1,500 g) who had received a transfusion before 36 weeks were reviewed. Diagnosis of NEC (≥ Bell stage II), demographics, feeds, transfusions, outcomes, and variables associated with NEC were collected. Results The percentage of NEC cases was lower in infants who had feeds withheld during transfusions: 5/64 (7.8%) compared with 16/116 (13.8%) infants who were fed during transfusions. While potentially clinically important (6% absolute difference), this difference was not statistically significant (p = 0.33 by two-tailed Fisher exact test). Conclusions No significant decrease in the incidence of NEC was found when feeds were withheld during blood transfusions. Holding feeds during transfusions is not without consequences such as the need for intravenous access, additional fluids, and the disruption of optimum nutrition. Further studies are needed to establish the relationship between blood transfusions, feeds, and NEC.
authors.affiliation: Division of Neonatology, University of California, San Diego, California.
authors.forename: Megan
authors.initials: M
authors.lastname: Doty
authors.affiliation: Division of Neonatology, Banner - University Medical Center Phoenix, Arizona.
authors.forename: Christine
authors.initials: C
authors.lastname: Wade
authors.affiliation: Division of Neonatology, Banner - University Medical Center Phoenix, Arizona.
authors.forename: Julie
authors.initials: J
authors.lastname: Farr
authors.affiliation: Division of Neonatology, Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Vanessa Celleri
authors.initials: VC
authors.lastname: Gomezcoello
authors.affiliation: Division of Neonatology, Banner - University Medical Center Phoenix and Cardons Childrens Medical Center, Phoenix, Arizona.
authors.forename: Gregory
authors.initials: G
authors.lastname: Martin
authors.affiliation: Division of Neonatology, Phoenix Perinatal Associates Pediatrix, Phoenix, Arizona.
authors.forename: Tala
authors.initials: T
authors.lastname: Nasr
mesh_terms: D001130:Arizona; D020345:Enterocolitis, Necrotizing / Q000401:mortality*; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies