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June 1980

Necrotizing Enterocolitis and Enteral Feeding: Is Too Much Just Too Much?

Author Affiliations

Department of Neonatology Shaare Zedek Medical Center POB 293 Jerusalem Israel 91-000

Am J Dis Child. 1980;134(6):545-546. doi:10.1001/archpedi.1980.02130180003001

Ever since Berdon et al1 and Mizrahi et al2 characterized neonatal necrotizing enterocolitis (NEC) as a distinct clinical entity, pediatricians have been searching for a unified concept of pathogenesis. Recent reports have attempted to synthesize the multiple factors associated with NEC and have proposed that the critical underlying pathogenic mechanism is either a defect in the integrity of the intestinal mucosal barrier3 or a primary infectious process.4

Goldman, in this issue of the Journal (see p 553), refocuses our attention on the role of enteral feeding and more specifically "overfeeding." In a 13-year review of the experience of one large neonatal unit, he noted that 25 of 26 cases of NEC developed in the three-year period when large feeding volumes (> 150 mL/kg/day) or large daily increases in volume (> 60 mL/kg/day) were the standard practice. When the nursery routine was changed back to limited