Necrotizing enterocolitis in a preterm infant newborn and role of feeding: An update

Abstract

It is a clinical case presentation of a male premature baby new-born (+31 weeks) that was delivered in our hospital and transferred to NICU due to prematurity, VLBW and wish of respiratory support. Baby shortly underwent NEC on fifth day of life shortly after starting of expressed milk feeding. It had been early detected by the utilization of near infrared abdominal spectroscopy (NIRS). Baby was deteriorated clinically during a few hours and undergone intestinal perforation with peritonitis. So, abdominal exploration surgery with intestinal resection and end to finish anastomosis was done urgently. Baby improved gradually and early feedings was started and gradually increased up to full feedings with the utilization of human fortified milk (HMF), probiotics and prebiotics. The study stated the evidence-based feeding strategy guidelines for 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 that the single greatest risk factor for NEC and avoidance of premature birth is that the best thanks to prevent NEC; the role of feeding within the pathogenesis of NEC is uncertain, but it seems prudent to use breast milk and advance feedings slowly and cautiously; NEC is one among the leading causes of mortality, and therefore the commonest reason for emergent GI surgery in new-borns; NEC remains a serious unsolved medical challenge, that no specific therapy exists, and its pathogenesis remains controversial; a far 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, natural immunity , and micro biota during this disorder; and bioinformatics modeling may be a new emerging strategy aimed toward understanding the dynamics of varied inflammatory markers and their application in early diagnosis and treatment.