{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T22:01:05Z","timestamp":1776376865190,"version":"3.51.2"},"reference-count":37,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,1,1]]},"abstract":"<jats:p>OBJECTIVE. Diet, indomethacin, and early use of dexamethasone have been implicated as possible causes of necrotizing enterocolitis and intestinal perforation. Because we seldom prescribe indomethacin or early dexamethasone therapy and we follow a special dietary regimen that provides late-onset, slow, continuous drip enteral feeding, we reviewed our 20 years of experience for the incidence of necrotizing enterocolitis and bowel perforation.<\/jats:p>\n               <jats:p>METHODS. We reviewed data on all 1239 very low birth weight infants (501\u20131500 g) admitted to our level III unit over a period of 20 years (1986\u20132005), for morphologic parameters, necrotizing enterocolitis, bowel perforation, use of the late-onset, slow, continuous drip protocol, and indomethacin therapy. Outcome data were also compared with Vermont Oxford Network data for the last 4 years.<\/jats:p>\n               <jats:p>RESULTS. In 20 years, 1158 infants received the late-onset, slow, continuous drip feeding protocol (group I), whereas 81 infants had either a change in dietary regimen, use of indomethacin, or early use of dexamethasone (group II). The rate of necrotizing enterocolitis in group I of 0.4% was significantly lower than that in group II of 6%. Group I, in comparison with the Vermont Oxford Network, had significantly lower rates of necrotizing enterocolitis (0.4% vs 5.9%), surgical necrotizing enterocolitis (0.4% vs 3.1%), and bowel perforation (0.35% vs 2.2%).<\/jats:p>\n               <jats:p>CONCLUSIONS. Our 20-year experience with 1239 very low birth weight infants suggests strongly that the late-onset, slow, continuous drip feeding protocol and avoidance of indomethacin and early dexamethasone treatment contribute to the prevention of necrotizing enterocolitis.<\/jats:p>","DOI":"10.1542\/peds.2006-0521","type":"journal-article","created":{"date-parts":[[2006,12,5]],"date-time":"2006-12-05T01:33:53Z","timestamp":1165282433000},"page":"e164-e170","source":"Crossref","is-referenced-by-count":53,"title":["Prevention of Necrotizing Enterocolitis in Preterm Infants: A 20-Year Experience"],"prefix":"10.1542","volume":"119","author":[{"given":"Jeff","family":"Pietz","sequence":"first","affiliation":[{"name":"Neonatal Division, Department of Pediatrics, Fairview Hospital, Cleveland Clinic Health System, Cleveland, Ohio"},{"name":"Pediatrix Medical Group, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Babu","family":"Achanti","sequence":"additional","affiliation":[{"name":"Neonatal Division, Department of Pediatrics, Fairview Hospital, Cleveland Clinic Health System, Cleveland, Ohio"},{"name":"Pediatrix Medical Group, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Lilien","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, St Joseph Hospital, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin Clifford","family":"Stepka","sequence":"additional","affiliation":[{"name":"Neonatal Division, Department of Pediatrics, Fairview Hospital, Cleveland Clinic Health System, Cleveland, Ohio"},{"name":"Pediatrix Medical Group, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudhir Ken","family":"Mehta","sequence":"additional","affiliation":[{"name":"Neonatal Division, Department of Pediatrics, Fairview Hospital, Cleveland Clinic Health System, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2007,1,1]]},"reference":[{"key":"2021120902024775900_R1","doi-asserted-by":"crossref","unstructured":"Kliegman RM, Fanaroff AA. 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