The study was a prospective cohort study in which the very low birth weight babies were grouped based on the proportion of human milk in the enteral feeds "babies who received less than 50 percent feeds”were grouped under High Human Milk or HHM category and those who received more than 50 percent fell into another category called Low Human Milk or LHM category. While the incidence of NNEC was seen only in 3.2 percent of babies with HHM, the incidence was 10.6 percent in the LHM group. Based on these reports, the authors concluded that "enteral feeding containing at least 50% HM in the first 14 days of life was associated with a sixfold decrease in the odds of NEC." The level of evidence of this study is 2b (Oxford, 2001). This study addresses the PICO problem NNEC in VLBW preterm infants and it answers the PICO question by ascertaining the role of human breast milk in decreasing the risk of NNEC when compared to formula feedings.McGuire and Anthony (2003) evaluated the benefits of donor breast milk compared to formula milk in decreasing the risk of NNEC in very low birth weight preterm infants. For this purpose, they conducted meta-analysis of randomized controlled trials which compared the benefits of breast feeds versus formula feeds in the development of NNEC. The authors found that "infants who received donor human milk were three times less likely to develop NEC (RR 0.34; 95% confidence interval (CI) 0.12 to 0.99), and four times less likely to have confirmed NEC (RR 0.25; 95% CI 0.06 to 0.98) than infants who received formula milk." The level of evidence of this study is 1a (Oxford, 2001).NNEC is an important health issue in. Neonatal Necrotizing Enterocolitis.
Evans, D. (2003). Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interventions. Journal of Clinical Nursing, 12(1), p. 77 – 84.
McGuire, W., and Anthony, M.Y. (2003). Donor human milk versus formula for preventing necrotizing enterocolitis in preterm infants: systematic review. Arch Dis Child Fetal Neonatal Ed., 88, 11-14.
Oxford Centre for Evidence-based Medicine. (2001). Levels of Evidence. Retrieved on 26th January, 2009 from http://www.cebm.net/index.aspx?o=1047
Sisk, P.M., Lovelady, C.A., Dillard, R.G., Gruber, K.J, OShea, T.M. (2007). Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants. J Perinatol., 27(12), 808.
Quigley, M.A., Henderson, G., Anthony, M.Y., and McGuire, W. (2007). Formula milk versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev., (4), CD002971
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