An abstract on similar surgery:
Gail S. Hertz, MD, IBCLC
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: J Pediatr Surg 1998 May;33(5):705-7


Necrotizing enterocolitis after gastroschisis repair: a preventable
complication?

Jayanthi S, Seymour P, Puntis JW, Stringer MD.

Department of Paediatric Surgery and Neonatology, Leeds General Infirmary,
England.

BACKGROUND: Necrotizing enterocolitis (NEC) has been documented in up to 20%
of infants after repair of gastroschisis and is responsible for significant
morbidity. NEC is reported to occur up to 10 times more in preterm infants
receiving standard formula compared with those who have been fed exclusively
with breast milk. Does breast milk confer a similar protection against NEC
in infants who have undergone surgery for gastroschisis? METHODS: All
newborns with gastroschisis delivered between 1990 and 1996 and treated in a
single neonatal unit were analyzed retrospectively. Clinical data, details
of feeding regimens, and episodes of definite NEC were recorded. RESULTS: Of
60 infants with gastroschisis, 6 (10%) died but none had evidence of NEC. Of
the remaining 54 infants, clinical and radiological signs of NEC developed
in 8 (15%). All recovered with medical treatment including the three
patients with recurrent episodes. NEC developed in none of the 12 babies
exclusively fed with expressed breast milk (EBM) in contrast to 1 (5%) of
the 19 who received both EBM and formula, and 7 (30%) of the 23 who were fed
solely on formula. There was no significant difference in gestation,
incidence of primary versus silo closure, or incidence of intestinal
atresia/stenosis in those with NEC (n=8) compared with those without (n=46),
but birth weight in the NEC group was lower. NEC was less likely to develop
in infants who received EBM than those who were exclusively formula fed (P <
.02). CONCLUSION: After gastroschisis repair, feeding with maternal
expressed breast milk may help to protect the infant from developing NEC.

PMID: 9607472 [PubMed - indexed for MEDLINE]

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