Infectious Diseases: Prevention and Control

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Necrotizing Enterocolitis in a Preterm Infant Newborn & Role of Feeding …. An Update! (A Clinical Case Report Presentation)

It’s a clinical case presentation of a male Preterm infant Newborn (+31 wks) who was delivered in our hospital & transferred to our NICU because of Prematurity, VLBW & need for respiratory support. Baby shortly undergo Necrotizing Enterocolitis (NEC) on the 5th day of life shortly after the start of expressed milk feeding …! Which was early detected by use of Near Infrared Abdominal spectroscopy (NIRS)? The baby was deteriorated clinically in a couple of hours & undergoes intestinal perforation with peritonitis, So, Abdominal exploration surgery with intestinal resection & end – to end anastomosis was done urgently. Baby improved gradually & early feedings were started & gradually increased up to full feedings with the use of Human Fortified Milk (HMF), probiotics &Prebiotics.

Findings: The Study stated the evidence-based Feeding Strategies guidelines for necrotizing enterocolitis (NEC) among very low birth weight infants & Role of trophic feedings, Probiotics, Prebiotics & micronutrients in Prophylaxis, Prevention & Management of NEC. 

Recommendations: 1) -Prematurity is the single greatest risk factor for NEC & avoidance of premature birth is the best way to prevent NEC. 2)-The role of feeding in the pathogenesis of NEC is uncertain, but it seems prudent to use breast milk (when available) and advance feedings slowly and cautiously. 3)-NEC is one of the leading causes of mortality, and the most common reason for emergent GI surgery in newborns. 4)-NEC remains a major unsolved medical challenge, for which no specific therapy exists, and its pathogenesis remains controversial. 5)-A better understanding of the pathophysiology will offer new and innovative therapeutic approaches, and future studies should be focused on the roles of the epithelial barrier, innate immunity, and microbiota in this disorder. 6)-Bioinformatics modeling is a newly emerging strategy aimed at understanding the dynamics of various inflammatory markers and their application in early diagnosis and treatment.

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