NEC and feeding routines...

Specialties NICU

Published

Our unit has had an UNUSUAL high instance of NEC over the past year that seems to go in cycles. We have instituted all sorts of infection control measures. Our docs are very aggressive with feedings (some are on full feeds with UAC's and still on high vent settings and unstable etc) but some of the nurses think that our NEC gets worse during the months that we use one formula (we rotate 6 months each for two major formula companies) but we also have a lot of our babies that are getting BM that are still perforating etc. Any suggestions? Anyone else finding NEC increases with a certain brand of formula or milk fortifier?

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Never noticed a higher occurance with any one formula. But i would think the other things had a lot to do with it!

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Specializes in Maternal - Child Health.

This question used to come up annually in our Level III unit where we rotated between 3 formulas, Similac, Enfamil and SMA. Many nurses and some docs believed that there was a higher incidence of NEC during the SMA rotation, which happened to be during the winter months. The theory was never supported by research, so we continued with all 3 formulas, probably because of the financial support offered by the formula companies. SMA is no longer commercially available in the US, and I personally doubt that the incidence of NEC has dropped since it was discontinued. More recently, I have worked in units where both Enfamil and Similac were available year round, and the physician made the choice of formula based on personal preference, parent's preference, WIC, etc.

What concerns me is your incidence of NEC with breastfed babies. In my experience, that has been a very rare occurence.

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Specializes in NICU, PICU, PACU.

It seems that NEC goes in spurts with us. We will go many months without any and then boom, we have 3 or more.

The formula really doesn't have anything to do with it. NEC is usually caused by some insult to the bowel (ie severe hypoxia before or after delivery), maternal drug use, indocin. It is up in the air over feeding with lines in. Some institutes use there their lines for a long time, other pull them after 7 days. The risk there is a clot that can plug a mesentaric vessel.

FYI..did you know that the formula that Walmart sells is really SMA? Our nutritionist just told us that.

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