Enteral feeding for very low birth weight infants: reducing the risk of necrotising enterocolitis

The principal modifiable risk factors for necrotising enterocolitis (NEC) in very low birth weight infants relate to enteral feeding practices. Evidence exists that feeding with formula milk increases the risk of NEC. Currently, only limited data are available on the effect of the timing of feed introduction and advancement on the risk of developing NEC. Large, multicentre randomised controlled trials of these strategies are needed. Other promising interventions that merit further evaluation include the use of prebiotics and probiotics, and the avoidance of exposure to H-2-receptor antagonists.