Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-24T13:37:55.405Z Has data issue: false hasContentIssue false

Does milk fortification increase the risk of necrotising enterocolitis in preterm infants with congenital heart disease?

Published online by Cambridge University Press:  20 July 2012

Atul Malhotra*
Affiliation:
Monash Newborn, Monash Medical Centre, Melbourne, Australia Department of Paediatrics, Monash University, Melbourne, Australia
Alex Veldman
Affiliation:
Department of Paediatrics, Monash University, Melbourne, Australia The Ritchie Centre, Monash Institute for Medical Research, Monash University, Melbourne, Australia
Samuel Menahem
Affiliation:
Department of Paediatrics, Monash University, Melbourne, Australia MonashHeart, Southern Health, Melbourne, Australia
*
Correspondence to: Dr A. Malhotra, MD, FRACP, Monash Newborn, Monash University, 246 Clayton Road, Clayton, Melbourne, Victoria 3168, Australia. Tel: +61 3 9594 5192; Fax: +61 3 9594 6115; E-mail: [email protected]

Abstract

Prematurity and low birth weight adds to the risk of serious congenital heart disease in infants. It may also delay surgical intervention, especially when cardiopulmonary bypass is required, or where an aortopulmonary shunt is necessary to maintain adequate oxygenation. In this setting, neonatologists are faced with the challenge of accelerating the infant's growth to allow for early surgery. We describe the cases of two infants in whom an attempt to fortify the feeds was associated with necrotising enterocolitis, with a lethal outcome in one. The outcome suggests caution in fortifying feeds in premature infants with serious congenital heart disease.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Mukherjee, D, Zhang, Y, Chang, DC, Vricella, LA, Brenner, JI, Abdullah, F. Outcomes analysis of necrotizing enterocolitis within 11 958 neonates undergoing cardiac surgical procedures. Arch Surg 2010; 145: 389392.Google Scholar
2. McElhinney, DB, Hedrick, HL, Bush, DM, et al. Necrotizing enterocolitis in neonates with congenital heart disease: risk factors and outcomes. Pediatrics 2000; 106: 10801087.Google Scholar
3. Leung, MP, Chau, KT, Hui, PW, et al. Necrotizing enterocolitis in neonates with symptomatic congenital heart disease. J Pediatr 1988; 113: 10441046.Google Scholar
4. Ostlie, DJ, Spilde, TL, St Peter, SD, et al. Necrotizing enterocolitis in full-term infants. J Pediatr Surg 2003; 38: 10391042.CrossRefGoogle ScholarPubMed
5. Dees, E, Lin, H, Cotton, RB, Graham, TP, Dodd, DA. Outcome of preterm infants with congenital heart disease. J Pediatr 2000; 137: 653659.CrossRefGoogle ScholarPubMed
6. Lambert, DK, Christensen, RD, Henry, E, et al. Necrotizing enterocolitis in term neonates: data from a multihospital health-care system. J Perinatol 2007; 27: 437443.Google Scholar
7. Harrison, AM, Davis, S, Reid, JR, et al. Neonates with hypoplastic left heart syndrome have ultrasound evidence of abnormal superior mesenteric artery perfusion before and after modified Norwood procedure. Pediatr Crit Care Med 2005; 6: 445447.CrossRefGoogle ScholarPubMed
8. Hallstrom, M, Koivisto, AM, Janas, M, Tammela, O. Frequency of and risk factors for necrotizing enterocolitis in infants born before 33 weeks of gestation. Acta Paediatr 2003; 92: 111113.Google Scholar
9. Berseth, CL, Van Aerde, JE, Gross, S, Stolz, SI, Harris, CL, Hansen, JW. Growth, efficacy, and safety of feeding an iron-fortified human milk fortifier. Pediatrics 2004; 114: e699e706.Google Scholar
10. Reis, BB, Hall, RT, Schanler, RJ, et al. Enhanced growth of preterm infants fed a new powdered human milk fortifier: a randomized, controlled trial. Pediatrics 2000; 106: 581588.Google Scholar
11. De Curtis, M, Candusso, M, Pieltain, C, Rigo, J. Effect of fortification on the osmolality of human milk. Arch Dis Child Fetal Neonatal Ed 1999; 81: F141F143.Google Scholar