Review ArticleTreatment of necrotizing enterocolitis: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review
Section snippets
Questions
In an effort to summarize and categorize current therapies for infants with NEC, the American Pediatric Surgical Association (APSA) Outcomes and Clinical Trials Committee posed several questions which are pertinent to the daily care of infants with NEC. These questions were chosen based on common clinical scenarios.
- 1.
Does the use of prophylactic probiotics reduce the rate of NEC in newborn infants?
- 2.
Does exclusive use of human breast milk rather than formula affect the rate of NEC in newborn
Results
The Cochrane Collaborative addressed the first three of these questions with recent systematic reviews that are summarized in this report. The last three questions were evaluated with the methods described.
Summary of findings
In conclusion, definitive studies to aid the pediatric surgeon with care of infants with NEC are lacking (Appendix). Several studies do support probiotics as being effective in preventing NEC, and the Cochrane Collaboration recommends routine use in practice, though the precise formulation and timing is not determined. Human milk generally should be fed to preterm infants when available, as there is an increased risk of NEC when formula is used. Feeds can be initiated early in life, which is
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2022, Seminars in Pediatric SurgeryCitation Excerpt :There is also evidence that probiotic supplementation in the first week of life can help prevent severe forms of NEC. However, while it is widely accepted that NEC is associated with the initiation of enteral feeds, there is no strong evidence to support delaying the initiation of feeds or slowing the advancement of enteral feeds in the prevention of NEC.107 Once NEC is diagnosed, treatment is larely based on the severity.
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