Necrotizing enterocolitis (NEC) is an acquired severe disease of the digestive system affecting
mostly premature babies, possibly fatal and frequently associated to systemic complications.
Because of the severity of this condition and the possible long-term consequences on the child’s
development, many studies have aimed at preventing the occurrence of the primary events at the
level of the bowel wall (ischemia and necrosis followed by sepsis) by modifying or manipulating
the diet (breast milk versus formula) and/or the feeding pattern (time for initiation after birth, continuous
versus bolus feeding, modulation of intake according clinical events).
Feeding have been investigated so far in order to prevent NEC. However, currently well-established
and shared clinical nutritional practices are not available in preventing NEC. Nutritional and surgical
treatments of NEC are instead well defined. In selected cases surgery is a therapeutic option of
NEC, requiring sometimes partial intestinal resection responsible for short bowel syndrome. In this
paper we will investigate the available options for treating NEC according to the Walsh and Kliegman
classification, focusing on feeding practices in managing short bowel syndrome that can complicate
NEC. We will also analyze the proposed ways of preventing NEC.
Keywords: necrotizing enterocolitis, preterm infants, enteral nutrition, parenteral nutrition, surgical treatment, laparotomy, primary peritoneal drenage, prevention.
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