[size=20px]An infant is born at 26 weeks gestational age. Other than using maternal breast milk, the most effective strategy to reduce the risk of necrotizing enterocolitis is:

 

A Delay initiation of enteral feedings for 7 days

 

B Advance enteral feedings by 18 ml/kg/day

 

C Daily administration of Bifidobacteriuminfantis

 

D Enteral administration of metronidazole

 

E Use of pasteurized breast milk​[/size]

C

correct answer

C Daily administration of Bifidobacteriuminfantis

​

Other than feeding with breast milk, no intervention has been shown to reduce the incidence of NEC more than probiotics. Bifidobacteriuminfantisis the most promising probiotic in experimental and clinical studies. There is no benefit from routine delay in the initiation of enteral feedings in premature infants. Similarly, slow advancement strategies (e.g., 18 ml/kg/day) do not reduce the incidence of NEC compared to more rapid advancement strategies (e.g., 30 ml/kg/day). Early antibiotic administration is associated with the development of NEC and is not protective. Pasteurization of breast milk is associated with impaired growth and has no impact of the risk of NEC.