Necrotizing enterocolitis in a preterm infant newborn and role of feeding - an updateand#33;

Amr Ismael M Hawal

doi:10.21767/2471-805X-C4-015

Necrotizing enterocolitis in a preterm infant newborn and role of feeding - an update!

Joint Event on 25^th World Pediatrics Conference & 6^th International Conference on Pediatric Critical Care and Emergency Medicine
October 18- 20, 2018 Warsaw, Poland

Amr Ismael M Hawal

Prime Healthcare Group, UAE

Posters & Accepted Abstracts: J Pediatr Care

DOI: 10.21767/2471-805X-C4-015

Abstract

It is a clinical case presentation of a male preterm infant newborn (+31 weeks) that was delivered in our hospital and transferred to NICU because of prematurity, VLBW and need of respiratory support. Baby shortly underwent necrotizing enterocolitis (NEC) on fifth day of life shortly after starting of expressed milk feeding. It was early detected by the use of near infrared abdominal spectroscopy (NIRS). Baby was deteriorated clinically in a couple of hours and undergone intestinal perforation with peritonitis. So, 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 the use of human fortified milk (HMF), probiotics and prebiotics. 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; 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; and bioinformatics modeling is a new emerging strategy aimed at understanding the dynamics of various inflammatory markers and their application in early diagnosis and treatment.