How should feedings be reintroduced after a case of NEC?

Reintroducing feedings after a case of Necrotizing Enterocolitis (NEC) must be approached with caution to ensure the neonate's safety and promote healing of the gastrointestinal tract. The recommended method involves starting feedings slowly and using human milk or elemental formulas.

Human milk provides optimal nutrition and contains immunological factors that can help reduce the risk of infection and promote gut healing. Elemental formulas are designed for easier digestion and absorption, which is crucial for infants recovering from NEC. A slow reintroduction allows healthcare providers to monitor the neonate's tolerance to feedings, assessing for any signs of feeding intolerance or recurrence of NEC. This gradual approach minimizes the risk of reactivating gastrointestinal disturbances.

In contrast, rapidly increasing feeding volumes could overwhelm the immature and healing gastrointestinal system, leading to potential complications. Initial reliance solely on intravenous fluids does not promote gut function or the development of feeding tolerance. Reintroducing regular formulas immediately is contraindicated, as these may not be well-tolerated and could exacerbate gastrointestinal issues following NEC.