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Human Milk Use in the Preoperative Period Is Associated with a Lower Risk for Necrotizing Enterocolitis in Neonates with Complex Congenital Heart Disease
Journal article   Open access   Peer reviewed

Human Milk Use in the Preoperative Period Is Associated with a Lower Risk for Necrotizing Enterocolitis in Neonates with Complex Congenital Heart Disease

Acacia Cognata, Jasmeet Kataria-Hale, Pamela Griffiths, Shiraz Maskatia, Danielle Rios, Andrea O'Donnell, Dantin J. Roddy, Amy Mehollin-Ray, Joseph Hagan, Jennifer Placencia, …
The Journal of pediatrics, Vol.215, pp.11-16
12/01/2019
DOI: 10.1016/j.jpeds.2019.08.009
PMCID: PMC7294855
PMID: 31561958
url
https://www.ncbi.nlm.nih.gov/pmc/articles/7294855View
Open Access

Abstract

Objective To evaluate the hypothesis that feeding volumes exceeding 100 mL/kg/d and exposure to cow's milk formula preoperatively increase the risk for preoperative necrotizing enterocolitis (NEC) in infants with complex congenital heart disease. Study design All infants, of any gestational age, with an isolated cardiac lesion at high risk for NEC (ductal-dependent lesions, transposition of the great arteries, truncus arteriosus, and aorto-pulmonary window) admitted to Texas Children's Hospital from 2010 to 2016 were included. NEC was defined based on the modified Bell criteria. Feeding regimen information and relevant covariates were collected. Logistic regression was used to evaluate the association of feeding regimen and other potential risk factors with NEC. Results In this single-center, retrospective cohort of 546 infants, 3.3% developed Bell stage I-Ill NEC preoperatively. An exclusive unfortified human milk diet was associated with a significantly lower risk of preoperative NEC (OR 0.17, 95% CI 0.04-0.84, P = .03) in a multivariable regression model controlling for cardiac lesion, race, feeding volume, birth weight small for gestational age, inotrope use presurgery/pre-NEC, and prematurity. Feeding volumes exceeding 100 mL/kg/d were associated with a significantly greater risk of preoperative NEC (OR 3.05, 95% CI 1.19-7.90, P = .02). Conclusions The findings suggest that an unfortified exclusive human milk diet may reduce the risk of preoperative NEC in infants with complex congenital heart disease.
Life Sciences & Biomedicine Pediatrics Science & Technology

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