Necrotizing Enterocolitis In A Preterm Infant Newborn And Role Of Feeding: An Update | 102774
Neonatal and Pediatric Medicine
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Statement of the Problem: It is a clinical case presentation of a male preterm
infant newborn (+31 weeks), who was delivered in our hospital and transferred to
our NICU because of prematurity, VLBW and need to respiratory support. Baby
shortly underwent necrotizing enterocolitis (NEC) on 5th day of life shortly after
start of expressed milk feeding. This was early detected by use of Near Infrared
Abdominal Spectroscopy (NIRS). Baby was deteriorated clinically in a couple of
hours and underwent intestinal perforation with peritonitis.
Methodology: Abdominal exploration surgery with intestinal resection and
end to end anastomosis was done urgently. Baby improved gradually and early
feedings was started and gradually increased up to full feedings with use of human
fortified milk (HMF) and probiotics, prebiotics.
Findings: The study stated the evidence-based feeding strategy guidelines for
necrotizing enterocolitis (NEC) among very low birth weight infants and role
of trophic feedings, probiotics, prebiotics and micronutrients in prophylaxis, prevention and management of NEC. Prematurity is the single greatest risk factor for NEC and avoidance of premature birth
is the best way to prevent NEC. The role of feeding in the pathogenesis of NEC is uncertain but it seems prudent to use breast
milk (when available) and advance feedings slowly and cautiously. NEC is one of the leading causes of mortality and the most
common reason for emergent GI surgery in newborns. NEC remains a major unsolved medical challenge for which no specific
therapy exists and its pathogenesis remains controversial.
Conclusion: A better understanding of the pathophysiology will offer new and innovative therapeutic approaches and future
studies should be focused on the roles of the epithelial barrier, innate immunity and microbiota in this disorder. Bioinformatics
modeling is a new emerging strategy aimed at understanding the dynamics of various inflammatory markers and their
application in early diagnosis and treatment.
Amr Ismael M Hawal is a Pediatrician and Neonatologist whose experience in the field spans 20 years, backed by a higher education degree from Ain Shams University in Egypt. He is pioneering an open and contextual evaluation model based on constructive responses, which has led in the creation of new methods to improve Pediatric Healthcare, Neonatology and Pediatric Nutrition. He has established this model following his years of experiences in medical practice, research and evaluation, teaching and administration in hospitals and medical universities in the region including Egypt, Saudi Arabia and the UAE. He has published several studies in reputable international journals in Neonatology and Pediatric Nutrition. He has also presented his findings in prestigious international conferences and symposia.