Failure of delayed oral feedings to prevent necrotizing enterocolitis. Results of study in very-low-birth-weight neonates.

To test the hypothesis that delayed oral feedings would lower the incidence of necrotizing enterocolitis (NEC) in neonates weighing less than 1,500 g at birth, we compared the incidence of NEC in two matched groups of newborns. High-risk neonates were selected from 160 consecutive admissions, based on a cumulative risk scoring of their illness during the first three days of life. One group (N = 20) was given no oral feedings for two weeks, receiving nutrition parenterally, while the other (N = 18) was given incremental enteric feedings of dilute infant formula or breast milk during the first two weeks of life. The overall incidence of NEC in the parenterally fed group was 60% (12/20) compared with 22% (4/18) in the early-oral-feeding group. These data show that withholding oral feedings for two weeks postnatally does not lower the incidence of NEC and in fact may promote its occurrence.