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How to feed a baby recovering from necrotising enterocolitis when maternal milk is not available
  1. Nicholas D Embleton,
  2. Stefan P Zalewski
  1. Newcastle Neonatal Service, Newcastle Hospitals NHS Foundation Trust & Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Nicholas D Embleton, Ward 35 Neonatal Unit, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK; Nicholas.embleton{at}ncl.ac.uk

Abstract

Necrotising enterocolitis (NEC) is a devastating disease with significant mortality and serious adverse outcomes in at least 50% including short gut and poor neurodevelopment. Research and management are complicated by a lack of robust clinical markers, and without histological confirmation, there is a risk of both underdiagnosis and overdiagnosis. Interunit variations in the thresholds for surgical referral, laparotomy and postmortem rates mean the actual incidence is difficult to determine, especially because the histological term ‘NEC’ is used in practice to describe a heterogeneous clinical syndrome. In this article, we discuss issues relating to choice of milk feed type following a clinical diagnosis of ‘NEC’ where mother’s own milk is not available. We review common clinical concerns relating to feeding following NEC and the rationale for modifications of the macronutrient composition and quality of formula milk.

  • necrotising enterocolitis
  • infant, premature
  • formula milk
  • nutrition
  • short gut

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Footnotes

  • Contributors NDE developed the structure and wrote the first draft. SPZ developed the systematic search and retrieved the key articles for further review. Both authors wrote and approved the final version.

  • Competing interests NDE declares that he has received research funding or lecture honoraria from the following manufacturers of infant formula or other nutritional products: Nestle Nutrition UK; Danone Early Life Nutrition; Prolacta Bioscience US.

  • Provenance and peer review Commissioned; externally peer reviewed.

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