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Association Between Immunonutrients and Necrotising Enterocolitis in Preterm Very Low Birth Weight Infants

Posted:  Tuesday, October 04, 2016

Efficacy of Immunonutrients in the Prevention of Necrotising Enterocolitis in Preterm Very Low Birth Weight Infants

A review focusing on the role of immunonutrients in the prevention of necrotising enterocolitis (NEC) in preterm very low birth weight (PVLBW) infants was published in the journal Nutrients.

Necrotising enterocolitis, which primarily occurs in PVLBW infants, is characterised by inflammation and necrosis in the gastrointestinal tract. Preterm infants are predisposed to NEC as many intestinal functions are affected by prematurity. Feeding strategies and several nutritional interventions are reported to play an important role in the prevention of NEC by modulating the intestinal functions.

Bovine colostrum (BC), which is the early milk from cows, contains trophic and immuno-regulatory factors that exert various physiological functions such as intestinal defence, intestinal growth and development, anti-infection, and immuno-regulation. Preclinical studies have suggested that BC when used as minimal enteral nutrition (MEN) immediately after preterm birth improves intestinal digestive and immune functions. These findings indicate that BC may be used as MEN for premature infants while waiting for the mother’s lactation to be established.

Clinical evidence indicates that oral probiotics are effective in reducing the incidences of NEC and death in infants. Randomised controlled trials and meta-analyses support the routine use of probiotics in preterm infants who are at high risk of NEC, if safe and clinically effective products are available. Human milk oligosaccharides and long chain polyunsaturated fatty acids can be supplemented to breast milk for infants with limited access to human milk. Parenteral nutrition supplemented with glutamine or arginine has been reported to be safe and could significantly reduce the incidence of NEC in PVLBW infants during the first few days or weeks of life.

More preclinical and clinical trials investigating biological functions are required to confirm the safety and efficacy of supplementation with immunonutrients in the prevention of NEC in PVLBW infants before recommending immunonutrients for routine use.

News source - Zhou P, Li Y, Ma LY, et al. The Role of Immunonutrients in the Prevention of Necrotizing Enterocolitis in Preterm Very Low Birth Weight Infants. Nutrients. 2015; 7(9):7256-70.