Enteral Feeding Interventions in the Prevention of Necrotizing Enterocolitis: A Systematic Review of Experimental and Clinical Studies

Ilse H. de Lange, Charlotte van Gorp, Laurens D. Eeftinck Schattenkerk, Wim G. van Gemert, Joep P. M. Derikx, Tim G. A. M. Wolfs*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Necrotizing enterocolitis (NEC), which is characterized by severe intestinal inflammation and in advanced stages necrosis, is a gastrointestinal emergency in the neonate with high mortality and morbidity. Despite advancing medical care, effective prevention strategies remain sparse. Factors contributing to the complex pathogenesis of NEC include immaturity of the intestinal immune defense, barrier function, motility and local circulatory regulation and abnormal microbial colonization. Interestingly, enteral feeding is regarded as an important modifiable factor influencing NEC pathogenesis. Moreover, breast milk, which forms the currently most effective prevention strategy, contains many bioactive components that are known to support neonatal immune development and promote healthy gut colonization. This systematic review describes the effect of different enteral feeding interventions on the prevention of NEC incidence and severity and the effect on pathophysiological mechanisms of NEC, in both experimental NEC models and clinical NEC. Besides, pathophysiological mechanisms involved in human NEC development are briefly described to give context for the findings of altered pathophysiological mechanisms of NEC by enteral feeding interventions.

Original languageEnglish
Article number1726
Number of pages67
JournalNutrients
Volume13
Issue number5
DOIs
Publication statusPublished - May 2021

Keywords

  • BIRTH-WEIGHT INFANTS
  • ENDOPLASMIC-RETICULUM STRESS
  • EPIDERMAL-GROWTH-FACTOR
  • EXTREMELY PRETERM INFANTS
  • INTESTINAL BARRIER DYSFUNCTION
  • NEONATAL-RAT MODEL
  • NITRIC-OXIDE SYNTHASE
  • ORAL GLUTAMINE SUPPLEMENTATION
  • PLATELET-ACTIVATING-FACTOR
  • REUTERI DSM 17938
  • enteral nutrition
  • inflammation
  • intestinal barrier function
  • microbial colonization
  • necrotizing enterocolitis

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