…for their patients of course, or to be more accurate, to reduce the chances of small preterm infants becoming their patients. A review of ways to prevent necrotizing enterocolitis, and then to treat it if it occurs, was just published. The authors endorse probiotics, and note the value of breast milk in reducing NEC. They note that feeding preterm babies faster does not increase NEC. The review is quite complete regarding other important issues in the management of NEC, for all of them the response is unfortunately ‘dunno’.
Downard CD, Renaud E, St Peter SD, Abdullah F, Islam S, Saito JM, Blakely ML, Huang EY, Arca MJ, Cassidy L et al: Treatment of necrotizing enterocolitis: An american pediatric surgical association outcomes and clinical trials committee systematic review. J Pediatr Surg 2012, 47(11):2111-2122.
Here are their questions and the abbreviated version of their answers.
1. Does the use of prophylactic probiotics reduce the rate of NEC in newborn infants? YES
2. Does exclusive use of human breast milk rather than formula affect the rate of NEC in newborn infants? YES
3. Does the rate of feeding affect development of NEC in newborn infants? NO
4. Does peritoneal drainage versus laparotomy as treatment for perforated NEC affect mortality or long-term sequelae, such as neurodevelopmental outcomes and stricture rates? DUNNO
5. Does primary anastomosis at laparotomy versus enterostomy as treatment for NEC affect mortality or long-term sequelae, such as neurodevelopmental outcomes and stricture rates? DUNNO
6. Does length or type of antibiotic treatment affect recurrence rate of NEC? DUNNO
I’m being a bit facetious, but in fact the review is very complete, I think of high quality and well written. If you want a review of all the literature, this would be a very good place to start.