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Questions and Answers
What is the recommendation for advancing enteral nutrition in infants ≥1000g at high risk for NEC?
What is the recommendation for infants at risk for NEC regarding the use of mother's milk?
What is the current evidence regarding the use of probiotics in infants at risk for NEC?
What is the recommendation regarding glutamine supplementation in infants at risk for NEC?
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What is the current evidence regarding the role of arginine and long chain polyunsaturated fatty acid supplementation in infants at risk for NEC?
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When should feeds be reintroduced to infants with NEC?
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What is the primary goal of nutrition support in infants at risk for NEC?
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What is the grading system used to evaluate the evidence in the development of the clinical guideline recommendations?
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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.
