Although necrotizing enterocolitis (NEC) is the most common gastrointestinal medical emergency occurring in premature babies, forty years of research has failed to decipher its origin or decrease its rates. Now, a new study by a Utah-based research team may shed some light on how to prevent NEC in the youngest at-risk patients, those in their first week of life.

Led by Dr. Gregg Stout, the team looked at data collected from premature infants admitted to a neonatal intensive care unit (NICU) between January 1, 2001 and December 31, 2006. Because NEC only rarely occurs during the first week, they hypothesized that it might be possible to identify predisposing factors and feeding practices in this group.

Study methods
They looked at X-rays, physician notes, nursing records, lab reports, and operative reports of any infants diagnosed with NEC during their first week of life. For those infants with confirmed cases, they recorded underlying conditions and every feeding given prior to diagnosis. Comparisons were made to infants of the same age who were in the NICU at the same time.

Study results
With regard to possible predisposing factors, here’s what Dr. Stout and his colleagues discovered. The 21 infants with early NEC were more likely to have had a meconium-positive test for illicit drug exposure. They were also more likely to have had early-onset sepsis and respiratory distress.

Their findings with regard to infant feeding are likewise thought-provoking. Infants who developed NEC within the first week were more likely to have been fed formula exclusively and less likely to have been fed human milk at all. None of those who were fed human milk exclusively developed early NEC. Most of the early NEC patients were fed (via tube or bottle) amounts that exceed what breastfed neonates receive.

What does it mean?
Although the study population was small, the researchers make several recommendations for preventing early NEC.

• Identify at-risk patients. Illicit drug exposure, early-onset sepsis and respiratory distress seemed to indicate increased risk.

• Feed them human milk. Being fed formula—at all and exclusive—seems to increase the risk of developing NEC. It should be avoided in favor of human milk (the mother’s own or donated milk from a human milk bank).

• Limit the amount of each feeding. Feedings should not exceed the amount that would be taken by healthy breastfed infants.

• Learn more about NEC. Several conditions may be misdiagnosed as NEC. Keep in mind that these may not be prevented by human milk feeding.
  

Delivering a pre-term infant must be a scary ordeal. It is reassuring to know that researchers are beginning to figure out how to prevent potentially-fatal infections from occurring.