J Korean Soc Neonatol.  2011 Nov;18(2):204-210. 10.5385/jksn.2011.18.2.204.

Feeding Introlerance Due to Allergic Enterocolitis in Very Low Birth Weight Infants

• Ko YM
• Kim JK
• Ahn SY
• Yoo HS
• Jeon GW
• Kim ES
• Chang YS
• Park WS

• KMID: 2099193
• DOI: http://doi.org/10.5385/jksn.2011.18.2.204

Abstract

PURPOSE
Feeding intolerance is common in very low birth weight infants(VLBWI); however, research on the etiology is limited. We investigated the incidence of allergic enterocolitis (AEC) as a cause of feeding intolerance and present the clinical characteristics of VLBWIs.
METHODS
The medical records of VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center between January 2009 and July 2010 were retrospectively analyzed. AEC was defined as patients who had feeding intolerance with eosinophila and who responded to hypoallergenic feeding intervention. Feeding intolerance symptoms included blood tinged stools, abdominal distension, residual feeding and regurgitation. Eosinophilia was defined as an eosinophil count > or =700 cells/mm3. Patients with feeding intolerance were divided into the AEC or non-AEC group.
RESULTS
Of the 181 patients, 161 (88.9%) had a feeding intolerance, and 119 (65.7%) had eosinophilia. Seventeen infants were diagnosed with AEC. No difference in mean gestational age, birth weight, antibiotics duration, TPN duration, hospitalization, or symptom onset day was observed between patients with AEC and non-AEC patients. The percentage of eosinophilia was significantly higher in patients with AEC than in non-AEC patients. Two patients (12%) improved with restricted breast milk, 10 patients (59%) with extensively hydrolyzed formula and five patients (29%) with free amino acid-based formula.
CONCLUSION
Our results suggest that AEC should be considered in VLBWIs who have clinical features of feeding intolerance and eosinophilia. An aggressive increase in feeding would be possible through feeding intervention in VLBWIs with feeding intolerance.

Keyword

Allergic enterocolitis; Preterm infant; Allergy; Eosinophilia; Necrotizing enterocolitis

MeSH Terms

Anti-Bacterial Agents
Birth Weight
Enterocolitis
Enterocolitis, Necrotizing
Eosinophilia
Eosinophils
Gestational Age
Hospitalization
Humans
Hypersensitivity
Incidence
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Medical Records
Milk, Human
Retrospective Studies
Tolnaftate
Anti-Bacterial Agents
Tolnaftate