Preventing Necrotising Enterocolitis

Necrotising enterocolitisNecrotising enterocolitis is a devastating disease. The treatments for NEC are limited and outcomes remain poor. As such, the imperative to prevent NEC is very strong. Unfortunately there are few effective options. There is undoubtedly a need for novel interventions that reduce the risk of infants developing NEC. NEC is primarily a disease of premature infants. As such, the most effective way to prevent NEC is to prevent premature birth. This has been a long term aim for obstetric care but despite extensive research and multiple potential interventions, the rates of premature birth are static or possibly rising. The routine use of antenatal steroids for lung maturation has the addition benefit of reducing the risk of NEC. Probiotics administration to infants remains controversial. There is some evidence of effectiveness but multiple studies have produced conflicting results. The most recent evidence suggests that the rate of feed advancement probably is not a factor in NEC but the choice of milk undoubtedly is. Maternal milk is the safest option with the lowest risk of NEC but donor milk is significantly better that cows’ milk-based formula feeds and arguably is not used enough in routine practice.