a Serious Feeding Question

[NeoMomRN]

Maybe it is just me, but in the past 3 1/2 years that I have been doing NICU, I have seen an increase in NEC and death to follow. The concern is that the increase has really only been in the past year or so. And alot of the NEC victims have passed away d/t perfs. Has anyone else seen an increase in perfs and NEC since the standard has said to start feeds early? And how many of ya'll are doing full feeds at 8 days old of full strength breast milk on a 24 weeker? Just wondering.... Any info and opinions are appreciated.....

[nurseiam]

In our unit we try to start feeds as soon as the Indocin is done. It seems that at first there was an increased amount of perfs but now it seems to have went back to normal. We have had a few 33-34 weekers that were advanced too soon and feeds then perf'd and died.

[iceNICUnurse]

Somehow we dont see many NEC here in Iceland, I think the last one that developed NEC was 3 years ago. (((knock on wood)))

We have about 400 admids a year.

I have no Idea what we are doing that keeps NEC away.

We usually start enteral feeding on the small ones on the second or third day(or as soon as mom has some milk) with really small amounts at first and then go slowly upto full feedings.

I think most of our little ones are on full feedings by 2-3 weeks of age.

Almost all our babies get their mothers milk. I think the last 2 NEC babies did not get breastmilk, maby that is a factor?

Otherwise I have no idea, maby the bacteria that couses NEC is just not in the flora here, but sometimes when we get NEC we have a few at the same time...interesting!

[dawngloves, BSN, RN]

I can't say I've seen I've seen any "true" NEC in quite some time. I think I've only had two cases this year.

Our trophic feeds usually start out at 1cc q6 and we advance like 1cc QOD. Not very aggresive.