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Necrotizing Enterocolitis in Neonates: Nutrition Support

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Necrotizing Enterocolitis in Neonates: Nutrition Support

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Questions and Answers

What is the recommendation for advancing enteral nutrition in infants ≥1000g at high risk for NEC?

Advance by 45 mL/kg/d

Advance by 15 mL/kg/d

Advance by 30 mL/kg/d (correct)

Advance by 60 mL/kg/d

What is the recommendation for infants at risk for NEC regarding the use of mother's milk?

Use formula in addition to mother's milk

Do not use mother's milk at all

Use mother's milk exclusively (correct)

Use bovine-based products instead of mother's milk

What is the current evidence regarding the use of probiotics in infants at risk for NEC?

There is insufficient data to recommend the use of probiotics (correct)

Probiotics increase the risk of NEC

Probiotics significantly reduce the risk of NEC

Probiotics have no effect on the risk of NEC

What is the recommendation regarding glutamine supplementation in infants at risk for NEC?

Do not recommend glutamine supplementation Signup and view all the answers

What is the current evidence regarding the role of arginine and long chain polyunsaturated fatty acid supplementation in infants at risk for NEC?

There is insufficient evidence to recommend supplementation Signup and view all the answers

When should feeds be reintroduced to infants with NEC?

There is insufficient data to make a recommendation Signup and view all the answers

What is the primary goal of nutrition support in infants at risk for NEC?

To reduce the risk of NEC Signup and view all the answers

What is the grading system used to evaluate the evidence in the development of the clinical guideline recommendations?

Grading of Recommendations, Assessment, Development and Evaluation Signup and view all the answers

Study Notes

Necrotizing Enterocolitis (NEC) in Neonates

NEC is a devastating disease in the neonatal population, with extremely low birth weight (ELBW) and extremely preterm infants at greatest risk.
Mean prevalence of NEC is 7% in infants weighing <1000g in the US and Canada.

Nutrition Support for NEC Prevention

Initiate minimal enteral nutrition within the first 2 days of life and advance by 30 mL/kg/d in infants ≥1000g. (Weak recommendation)
Exclusive use of mother's milk is suggested instead of bovine-based products or formula in infants at risk for NEC. (Weak recommendation)
Probiotics: insufficient data to recommend their use in infants at risk for NEC. (Further research needed)

Nutrients and NEC Prevention

Glutamine supplementation is not recommended for infants at risk for NEC. (Strong recommendation)
Arginine and/or long chain polyunsaturated fatty acid supplementation: insufficient evidence to make a recommendation. (Further research needed)

Feeding After NEC

Insufficient data to recommend when to reintroduce feedings to infants after NEC. (Further research needed)

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Description

A systematic review of evidence on nutrition support for neonates at risk of necrotizing enterocolitis, a devastating disease affecting extremely low birth weight and preterm infants.