The nutritional management of short bowel syndrome in a very low-birthweight neonate

Abstract

Necrotising enterocolitis (NEC) is the most common gastrointestinal disease in preterm neonates.¹ The aetiology of NEC remains poorly understood. Proposed preventive strategies include the provision of breast milk as an enteral feed, monitoring the advancement of feeds and modulating the gut microbiome by providing probiotics.^1,2 Some patients who present with NEC require surgical intervention for the resection of a necrotic bowel which may result in short bowel syndrome (SBS). SBS may also result from congenital defects or disease-associated loss of absorption, and is characterised by the inability to maintain protein, energy, fluid, electrolyte or micronutrient balance when on a conventionally accepted, normal diet.³ The clinical course and nutritional management of a preterm infant with SBS is described in this case study. New developments in the prevention of NEC are briefly discussed. Relevant evidence with regard to nutritional management is reviewed, and practical aspects of the management discussed.