Part 1. Current Controversies in the Understanding of Necrotizing Enterocolitis

Barbara Noerr, RNC, MSN, CRNP


Adv Neonatal Care. 2003;3(3) 

In This Article


NEC prevention strategies targeted at issues of GI maturation, enteral nutrition, mucosal immunity, inflammatory mediators, and infectious agents require further study. Bedside clinicians must be alert for signs and symptoms of NEC because preterm neonates and selected full-term neonates are at high risk. Important clinical guidelines include the following:

  • Encourage all mothers to initially provide breastmilk for their preterm neonates, even if the mother does not wish to continue breast-feeding.

  • Educate all staff about NEC clinical staging criteria to increase awareness of subtle disease signs.

  • When on rounds, discuss risk factors and time frames for NEC development.

  • Evaluate any untoward GI findings (eg, abdominal distension, feeding intolerance).

  • Keep abreast of evidence-based correlates for detection or prevention of NEC.

  • Establish unit-based feeding protocols based on current evidence.

True reductions in the incidence of NEC likely depend on limiting preterm births. Health care providers having close contact with infants at risk for NEC play a vital role in recognition and management of this potentially debilitating disease.


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