TO STUDY THE ROLE OF PROBIOTICS IN PREVENTING NECROTIZING ENTEROCOLITIS IN PRETERM AND LOW BIRTH WEIGHT NEONATES

Introduction: Necrotising Enterocolitis (NEC) is the most common gastrointestinal emergency in NICU, it is a life-threatening disease that occurs primarily in premature infants.1 Probiotics are the live microbial dietary supplements that when administered in adequate amount promotes health.2 In premature infants they are thought to improve the positive balance of colonizing bacteria that facilitate development of mucosal immunity and prevent the excessive in?ammation associated with NEC.3 The present study is a Prospective Observational study Methods and Materials: conducted in the NICU at Prathima Institute Of Medical Sciences, Karimnagar,Telangana. During the period of 2 years between December 2020 and November 2022. Neonates of <37 weeks of gestation and with birth weight <1500 gms admitted into NICU are included in the study. The selected neonates would be administered probiotic 2 million spores of Bacillus clausii ampules per day along with expressed mother's own milk daily till they reach full feeds (150ml/kg/day). These neonates were observed clinically, investigated and studied during their period of admission in NICU for the development of Necrotising Enterocolitis and also the morbidity and mortality of such neonates was studied. : In the present study, out of 50 Results neonates, 11 (22%) preterms developed NEC while 39 (78%) of them did not. This was found to be statistically signi?cant (p=0.01). Out of the 11 preterms, 1 (2%) belonged to ELBW while 10 (90%) belonged to VLBW. Out of the 11 preterms who developed developed NEC, 4 (8%) developed stage I NEC, 5 (10%) developed stage II NEC and 2 (4%) developed stage III NEC. This was statistically signi?cant (p= 0.001) In our present study, 4 (8%) of the preterms developed with sepsis while 46 (92%) did not develop sepsis. This was statistically signi?cant (p=0.001) Necrotizing Enterocolitis is a worldwide problem in Conclusion: Preterms Low Birth Weight neonates. The present study has found that Probiotic supplementation has reduced both the 4incidence and severity of NEC in such neonates. Probiotic supplementation has also reduced the incidence of culture proven 5sepsis in preterm and Low Birth Weight neonates

Risk factors for necrotizing enterocolitis in neonates:a prospective study

Background: Necrotizing enterocolitis (NEC) is mostly limited to preterm babies due to immaturity of gut. NEC is one of important cause of neonatal mortality and morbidity in the neonatal intensive care units all over the world.Aim of study is to find the antenatal and post-natal risk factors associated with necrotizing enterocolitis in neonates admitted to NICU.Methods: A prospective study was conducted on 45 neonates with necrotizing enterocolitis fulfilling the predetermined inclusion criteria. A detailed antenatal history including all maternal risk factors, birth history including the need for resuscitation and type of resuscitation was recorded. The gestational assessment was done by the New Ballard Score.Results: Pregnancy induced hypertension accounts as a risk factor to most of the cases of NEC 18 (40%), followed by setting for sepsis 12 (26.6%), least being gestational diabetes mellitus 1 (2.2%).Conclusions: Prematurity is found to be the most common risk factor followed by patent ductus arteriosus and sepsis. Most common antenatal risk factor was PIH (Pregnancy induced hypertension).

Benefits of early enteral nutrition in extremely low birth weight infants

<p><b>INTRODUCTION</b>Extremely low birth weight (ELBW) infants (i.e. preterm infants weighing < 1,000 g) often present with morphofunctional multiple organ immaturity. This study aimed to determine whether early enteral feeding improves digestive tolerance, and whether there is a difference in growth between ELBW infants who were fed with formula and those who were fed with breast milk.</p><p><b>METHODS</b>This study was conducted from 2012-2013 and involved 34 ELBW infants from the Preterm Neonatology Clinic of the 'Louis Turcanu' Clinical Children's Hospital Timisoara, Romania. Early enteral nutrition was introduced for all the infants - Group I was fed with formula, while Group II was fed with breast milk. Infants in each group were given their designated type of milk (formula/breast milk), using the same feeding method and the same volume rate advancement. They were monitored for any evidence of digestive intolerance (i.e. clinical signs of infection and necrotising enterocolitis [NEC]). Their growth curves and signs of infection were also monitored.</p><p><b>RESULTS</b>The average weight gained per week was greater among the infants in Group II than in Group I (120.83 g vs 97.27 g). The incidence of infection was 100% in Group I and 66.6% in Group II. Two of the infants in Group I developed NEC.</p><p><b>CONCLUSION</b>Early enteral feeding helped to improve the weight of ELBW infants. Breast milk was more effective than formula at improving the weight of these infants. Feeding with formula increased the incidence of NEC, invasive infection and morbidity among ELBW infants.</p>

Contaminated milk is a common cause of necrotising enterocolitis: A hypothesis

Necrotising enterocolitis (NEC) is the most commonly acquired gastrointestinal disease of neonates, particularly the very preterm (gestation 90%) of the NEC cases occurred in neonates on enteral feeding. Studies have shown that milk (whether EBM or formula) fed to neonates was not sterile and were further contaminated during collection, transport, storage and/or feeding. Other investigators have reported a reduction in the incidence of NEC when they improved infection control measures and hygienic procedures in handling milk. It is, therefore, hypothesised that the most common cause of NEC is due to the feeding of neonates, particularly the vulnerable very preterm small neonates, with milk heavily contaminated during collection at source, transport, storage and/or feeding. Because of the immaturity of the immune system of the neonates, excessive inflammatory response to the pathogen load in the gut leads to the pathogenesis of NEC.

Can Neonatal Pneumoperitoneum be Managed by Conservative Management Alone.

Common causes of pneumoperitoneum in neonates includes necrotising enterocolitis (NEC), specific infections, gastro intestinal obstruction, iatrogenic causes, idiopathic focal intestinal perforation, perforation secondary to intra thoracic pathology, mechanical ventilation etc. Primary peritoneal drainage and exploratory laparotomy remain the definitive management of pneumoperitoneum in neonates. Here we report a case of suspected spontaneous idiopathic intestinal perforation managed conservatively with monitoring of vital signs. The neonate had an uneventful recovery. This case highlights the need to identify infants with benign or non surgical causes of pneumoperitoneum thus avoiding unnecessary laparotomies and referrals in these vulnerable neonates.