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Immunonutrition for Preterm Infants

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Immunonutrition for Preterm Infants. / Walsh, Verena; McGuire, William.

In: Neonatology, Vol. 115, No. 4, 11.04.2019, p. 398-405.

Research output: Contribution to journalReview article

Harvard

Walsh, V & McGuire, W 2019, 'Immunonutrition for Preterm Infants', Neonatology, vol. 115, no. 4, pp. 398-405. https://doi.org/10.1159/000497332

APA

Walsh, V., & McGuire, W. (2019). Immunonutrition for Preterm Infants. Neonatology, 115(4), 398-405. https://doi.org/10.1159/000497332

Vancouver

Walsh V, McGuire W. Immunonutrition for Preterm Infants. Neonatology. 2019 Apr 11;115(4):398-405. https://doi.org/10.1159/000497332

Author

Walsh, Verena ; McGuire, William. / Immunonutrition for Preterm Infants. In: Neonatology. 2019 ; Vol. 115, No. 4. pp. 398-405.

Bibtex - Download

@article{44e713acbd844afaa2e20d58f795664d,
title = "Immunonutrition for Preterm Infants",
abstract = "Care and outcomes for very preterm infants continue to improve, but important causes of mortality and acute and long-term morbidity associated with prolonged hospitalisation remain. Necrotising enterocolitis (NEC) and late-onset infection have emerged as the major causes of death beyond the early neonatal period and of neurodisability in very preterm infants. Although the pathogenesis of these conditions is incompletely understood, it appears to be related to the content and mode of delivery of the enteral diet, particularly the impact of immunonutrients from human breast milk on the microbial and metabolic balance within the immature intestine. Evidence exists to support investment in measures to help mothers to express breast milk as the primary source of nutrition for their very preterm infants. In the absence of maternal milk, pasteurised donor breast milk provides protection against NEC, but its nutritive adequacy is not clear and its cost-effectiveness is uncertain. Supplementation with individual immunonutrients, including immunoglobulins and lactoferrin, has not been shown to be effective in preventing NEC or infection in randomised controlled trials. The evidence base for prebiotics and probiotics is stronger, but concerns exist about the choice, safety and availability of formulations. Other strategies - including avoidance of drugs such as gastric acid suppressants that compromise innate immunity, as well as evidence-based progressive feeding strategies that reduce exposure to invasive interventions - are emerging as key components of care packages to reduce the burden of NEC, infection and associated growth and developmental faltering for very preterm infants.",
author = "Verena Walsh and William McGuire",
note = "{\circledC} 2019 S. Karger AG, Basel.",
year = "2019",
month = "4",
day = "11",
doi = "10.1159/000497332",
language = "English",
volume = "115",
pages = "398--405",
journal = "Neonatology",
issn = "1661-7800",
publisher = "S. Karger AG",
number = "4",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Immunonutrition for Preterm Infants

AU - Walsh, Verena

AU - McGuire, William

N1 - © 2019 S. Karger AG, Basel.

PY - 2019/4/11

Y1 - 2019/4/11

N2 - Care and outcomes for very preterm infants continue to improve, but important causes of mortality and acute and long-term morbidity associated with prolonged hospitalisation remain. Necrotising enterocolitis (NEC) and late-onset infection have emerged as the major causes of death beyond the early neonatal period and of neurodisability in very preterm infants. Although the pathogenesis of these conditions is incompletely understood, it appears to be related to the content and mode of delivery of the enteral diet, particularly the impact of immunonutrients from human breast milk on the microbial and metabolic balance within the immature intestine. Evidence exists to support investment in measures to help mothers to express breast milk as the primary source of nutrition for their very preterm infants. In the absence of maternal milk, pasteurised donor breast milk provides protection against NEC, but its nutritive adequacy is not clear and its cost-effectiveness is uncertain. Supplementation with individual immunonutrients, including immunoglobulins and lactoferrin, has not been shown to be effective in preventing NEC or infection in randomised controlled trials. The evidence base for prebiotics and probiotics is stronger, but concerns exist about the choice, safety and availability of formulations. Other strategies - including avoidance of drugs such as gastric acid suppressants that compromise innate immunity, as well as evidence-based progressive feeding strategies that reduce exposure to invasive interventions - are emerging as key components of care packages to reduce the burden of NEC, infection and associated growth and developmental faltering for very preterm infants.

AB - Care and outcomes for very preterm infants continue to improve, but important causes of mortality and acute and long-term morbidity associated with prolonged hospitalisation remain. Necrotising enterocolitis (NEC) and late-onset infection have emerged as the major causes of death beyond the early neonatal period and of neurodisability in very preterm infants. Although the pathogenesis of these conditions is incompletely understood, it appears to be related to the content and mode of delivery of the enteral diet, particularly the impact of immunonutrients from human breast milk on the microbial and metabolic balance within the immature intestine. Evidence exists to support investment in measures to help mothers to express breast milk as the primary source of nutrition for their very preterm infants. In the absence of maternal milk, pasteurised donor breast milk provides protection against NEC, but its nutritive adequacy is not clear and its cost-effectiveness is uncertain. Supplementation with individual immunonutrients, including immunoglobulins and lactoferrin, has not been shown to be effective in preventing NEC or infection in randomised controlled trials. The evidence base for prebiotics and probiotics is stronger, but concerns exist about the choice, safety and availability of formulations. Other strategies - including avoidance of drugs such as gastric acid suppressants that compromise innate immunity, as well as evidence-based progressive feeding strategies that reduce exposure to invasive interventions - are emerging as key components of care packages to reduce the burden of NEC, infection and associated growth and developmental faltering for very preterm infants.

U2 - 10.1159/000497332

DO - 10.1159/000497332

M3 - Review article

VL - 115

SP - 398

EP - 405

JO - Neonatology

JF - Neonatology

SN - 1661-7800

IS - 4

ER -