The fear of necrotizing enterocolitis versus achieving optimal growth in preterm infants - An opinion

Very-low-birthweight (VLBW) infants suffer marked growth delay despite well-intentioned efforts at combining enteral and parenteral nutrition. Fear of necrotizing enterocolitis (NEC) has traditionally influenced neonatologists toward delaying and progressing slowly with enteral feeding, while supporting the infant with parenteral nutrition. Current evidence suggests significant benefits of enteral feeding that is started early and advanced at rates of 20-35 ml/kg/d. Conclusion: We conclude that fear of inadequate growth should replace the fear of NEC in guiding nutritional strategies for these infants.