Probiotics and other preventative strategies for necrotising enterocolitis

Necrotising enterocolitis (NEC) remains one of the commonest causes of death and significant morbidity in preterm infants after the first few postnatal days. NEC affects approximately 5-10% of infants born at <= 28 weeks; about a third will die. Although there do not appear to be any 'simple fixes', it is clear that there are many clinical strategies that affect NEC. There is controlled trial evidence for breast milk, fluid regimes, enteral antibiotics, immuno-nutrients and probiotic supplements. This paper will review the evidence relevant to current populations of preterm infants and determine which, if any, can be safety and effectively introduced into current clinical practice. (C) 2007 Elsevier Ltd. All rights reserved.