Feeding and necrotizing enterocolitis
H. I. Goldman
Twenty-six infants had necrotizing enterocolitis (NEC) in the neonatal unit
of the Long Island Jewish-Hillside Medical Center, New Hyde Park, NY,
between 1964 and 1976; 25 of these cases occurred between 1973 and 1976.
The relationship of feeding practices to this clustering of NEC cases was
investigated in two ways: (1) A 10% sample of all admissions, 1964 to 1976,
was studied. A striking correlation was found between the yearly incidence
of NEC and the percentage of infants in that year who had received large
increases in daily feeding volume. The highest mean daily feeding volume
occurred in 1974 and 1975, the two years of peak NEC incidence. (2) The
feeding records of the 26 NEC cases were studied. Thirteen NEC patients had
had large increases in feeding volume within two days of NEC onset. Seven
others received greater than 150 mL of formula per kilogram per day prior
to NEC onset. Rapid increase in feeding volume and the use of large volumes
are suggested as important etiologic factors of NEC.
