Tiny Fighters: Perusing Diet
Hi everyone! Welcome back to my blog!
Last week, I explored the potential connection between short bowel syndrome (SBS) and necrotizing enterocolitis (NEC) and how they may be interrelated. This connection allowed me to perceive NEC in a new light because it is not a standalone condition but can be influenced by other similar conditions arising in the small intestine. However, for this blog post, I would like to delve deeper into the feeding practices and misconceptions that occurred during research done earlier to prevent NEC.
Feeding practices are a critical aspect of NEC, and understanding the relationship between feeding practices and NEC is essential. Several factors can contribute to the development of NEC, including the type of feeding, the timing of feeding, and the amount of feeding. Research shows that premature infants who receive formula feeds are at a higher risk of developing NEC than those who are breastfed. Additionally, there are misconceptions about feeding practices that have contributed to the incidence of NEC. For example, the use of nasogastric tubes for feeding is a common practice in neonatal care but can contribute to the development of NEC if not used correctly. It is essential to understand the proper use of nasogastric tubes to prevent complications like NEC.
In the past, it was believed that delaying the introduction of enteral feeds (food that passes through the intestine) would help reduce the incidence of NEC in very preterm or very low birth weight infants. However, a Cochrane review conducted in 2013 found that starting enteral feeds early and continuing them for a week did not increase the incidence of NEC when compared to fasting and starting feeds at 7 or more days of life. The review concluded that initiating enteral feeds early appears to be safe for preterm and very low birth weight infants. Furthermore, starting feeds at a higher volume may also be beneficial. This group experienced fewer complications such as sepsis or feeding intolerance, and ultimately had shorter lengths of stay in the hospital and NICU.
Upon successful initiation and tolerance of feeds, the rate of feed advancement becomes a key factor in the care of infants. It has been observed that advancing feeds at a rapid pace does not increase the incidence of NEC when compared to a slower pace. This is encouraging news, as it suggests that advancing feeds more rapidly may have several benefits. Firstly, faster feed advancement can enable infants to reach full feeds sooner, which can result in better caloric intake and growth. This, in turn, can reduce the duration of parenteral nutrition, which is associated with a range of complications. Moreover, quicker feed advancement can also reduce the risk of infections and other complications that can arise from prolonged use of parenteral nutrition.
Understanding the relationship between feeding practices and NEC is crucial to preventing and managing this condition. By examining feeding practices more closely, we can develop better strategies to prevent the incidence of NEC and improve the outcomes of premature infants. Thank you for reading!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071274/