Necrotizing enterocolitis (NEC) is a disease with significant morbidity and mortality. Pathophysiology remains incompletely understood. We here report systematic observations of NEC cases in our unit suggesting an increased incidence of cow’s milk allergy (CMA).
Method We reviewed all cases of NEC between 2001 and 2006 in our unit. In addition to basic information, elements related to CMA were noted: type of enteral nutrition and eosinophils count.
Results 106 patients presented with NEC in the study period; after exclusion of death and major congenital (cardiac and intestinal) anomalies, 70 patients were studied. Mean gestational age at birth (±SD): 29.8±3.6 wks, 37 (53%) born at ⩾30 wks. Male:female ratio: 1.7:1. Age at first episode of NEC: 19±11 days for the whole population but sooner in the ⩾30 wks (14±5 vs 25±9 days). There was no difference in highest eosinophils count between infants diagnosed with vs no CMA (6.2±4.3% vs 5.8±6.3%). 9 infants (13% of the whole population) were discharged home with hydrolysed formula. CMA was noted as a diagnosis in 7 infants, all born at ⩾30 wks, which represents 19% of this subgroup.
Conclusions We observe a high incidence of CMA diagnosed by the time of discharge in our population of NEC survivors compared of the incidence of 1 to 3% reported in the literature for general infant population. Furthermore, diagnosis of CMA was found only in relatively older premature infants. Whether CMA is a consequence or a risk factor for NEC remains to be determined.