Prevention of Necrotizing Enterocolitis

NEC (Necrotizing Enterocolitis) is an increasing clinical burden to patients، families، and the neonatology health care team. Although the diagnosis is straightforward، the morbidity and mortality associated with the disease are not improving. Risk factors of prematurity، formula feeding، intestinal ischemia/hypoxia، and bacterial colonization accentuate the imbalance toward mucosal stress with impaired host defense، in some cases leading to uncontrolled intestinal inflammation and necrosis. The premature infant differs from term infants and older patients in multiple ways، including enteral feeding characteristics، bacterial colonization patterns، autoregulation of splanchnic blood flow host defense، and the regulation of the inflammatory cascade. Although several strategies to prevent NEC have been tested in humans and animals، most have had limited success. Recent results from studies using probiotic supplementation have been exciting، and following additional investigation، this novel approach may significantly impact the incidence، morbidity، and mortality associated with neonatal NEC.