Sir.—I read with interest the article "Epidemic Occurrence of Neonatal Necrotizing Enterocolitis," by Guinan et al (Journal 133:594-597, 1979). The observation that almost all infants (38 of 39) were fed prior to the onset of necrotizing enterocolitis (NEC) is in agreement with other studies.1-5 In one retrospective, case-control study similar in design to that of Guinan et al, 54 of 54 infants were fed prior to NEC onset, whereas only 63% of 98 matched controls (P <.001) were fed at a comparable time.2 These findings strongly suggest an etiologic relationship between feeding and NEC. Guinan et al do not tell us how many of their controls were fed, and this would be a statistic of some interest.
In an unpublished survey carried out in the early 1960s of feeding practices in six premature nurseries in the metropolitan New York City area, I found that slow, gradual feeding
GOLDMAN H. Necrotizing Enterocolitis. Am J Dis Child. 1980;134(2):207. doi:10.1001/archpedi.1980.02130140077024