Earlier re-initiation of enteral feeding after necrotizing enterocolitis decreases recurrence or stricture: a systematic review and meta-analysis

Abstract

Objective To assess the effects of earlier vs. later re-initiation of enteral feeds after necrotizing enterocolitis (NEC). Study design We reviewed the literature to assess timing of enteral feeding after NEC using fixed effects models. Results Three studies met inclusion criteria; no randomized trials. After removal of Bell’s Stage I infants, the earlier refeeding group (p = 0.012). Individually, NEC recurrence (pooled OR = 0.34; 95% Cl = 0.09–1.29; p = 0.112) or stricture (OR = 0.34; 95% Cl = 0.09–1.26; p = 1.06) did not differ between groups. Conclusions There was no increase in negative outcomes with earlier refeeding after NEC. Earlier initiation of enteral feeds resulted in a significantly lower risk for the combined outcome of recurrent NEC and/or post-NEC stricture.