71 Can a Change in Feeding Practices in VLBW Infants Influence the Incidence of Necrotizing Enterocolitis?

To show whether a change in feeding practices in Very Low Birth Weight (VLBW) infants by implementing a feeding protocol can decrease the incidence of Necrotizing Enterocolitis (NEC) in these infants.

Retrospective chart review of all premature infants <1500 g admitted to a level III NICU in the period between Jan 1994-Dec 2003. The incidence of NEC 4 years prior and 5 years after implementing the feeding protocol is reported. Early mortality (1st week of life), NEC requiring surgery, and death due to NEC are also reported.

A total of 1710 infants < 1500 g were admitted to the NICU. In the period before and after implementing the Feeding Protocol, the mortality rate was 14.8% & 12.5% and the incidence of NEC was 8.0% & 6.5% respectively.

Surgery for NEC was 43.8% & 36% between the two time periods. Death due to NEC was 31.6% before and 34% after Protocol implementation.

There was an improvement, not significant, in mortality rate and NEC incidence after protocol implementation. There was a noted decrease in NEC requiring surgery, which could be partially due to more conservative surgical approach i.e. abdominal drain insertion.

NEC is a multi-factorial disease that affects primarily the immature gut. Other risk factors besides entral feeding need to be investigated.