Sir.—The surprising results of Samm and colleagues'1 study on necrotizing enterocolitis (NEC) in infants of multiple gestation differ from my experience. In reviewing all of my patients with NEC over the past six years, I found that seven cases involved multiple-gestation infants. Four of the six twins were B twins, and the triplet with NEC was a C infant.
Was Samm and colleagues' study population too small to conclude that firstborn twins are at higher risk for NEC? Perhaps there were differences between our study populations that are not apparent (eg, resuscitation and feeding practices).
Stine MJ. Necrotizing Enterocolitis: Higher Risk in Firstborn Twin?. Am J Dis Child. 1987;141(5):480. doi:10.1001/archpedi.1987.04460050022019