title: Early onset necrotizing enterocolitis (NEC) in premature twins.
abstract: Twin infants born at 34 week gestation had frank blood in stools on day three of life on mixed feeds of formula and maternal breast milk. Sepsis work up was negative in these relatively well appearing infants with pneumatosis in the colon on abdominal x-ray. Blood in stools recurred on reintroduction of breast milk in Twin A. Both infants recovered from episodes of bloody stools on amino-acid based formula and were thriving at discharge. Early necrotizing enterocolitis in both twins is rare and has not been reported. Cow's milk protein sensitivity, possibly from in-utero sensitization, could explain non-infectious colitis in these twins, precipitated by formula or breast milk after birth.
authors.forename: B
authors.initials: B
authors.lastname: Afzal
authors.forename: V
authors.initials: V
authors.lastname: Elberson
authors.forename: C
authors.initials: C
authors.lastname: McLaughlin
authors.forename: V H S
authors.initials: VH
authors.lastname: Kumar
mesh_terms: D000328:Adult; D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001942:Breast Feeding; D003106:Colon / Q000000981:diagnostic imaging; D020345:Enterocolitis, Necrotizing / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D041943:Infant Formula; D007231:Infant, Newborn; D016269:Milk Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D010289:Parenteral Nutrition, Total; D011247:Pregnancy; D011859:Radiography; D014427:Twins
chemical_list: D000900:Anti-Bacterial Agents
keywords: Twins; allergic colitis; infant; necrotizing enterocolitis