ArticlePloS one2014
Delayed initiation but not gradual advancement of enteral formula feeding reduces the incidence of necrotizing enterocolitis (NEC) in preterm pigs.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Protective effects of different doses of human milk on neonatal necrotizing enterocolitis.Medicine · 2020Pooled it
- Mesenchymal stromal cell therapy restores intestinal integrity and attentuates inflammation in a preterm piglet model of necrotizing enterocolitis.Pediatric surgery international · 2026Article
- Enteral and intravenous supplementation of arginine and citrulline fail to prevent necrotizing enterocolitis in preterm neonatal pigs.JPEN. Journal of parenteral and enteral nutrition · 2026Article
- Local Peritoneal Cytokine Response IL-1β, IL-6, TNF-α in a Standardized Neonatal Rat Model of Necrotizing Enterocolitis.International journal of molecular sciences · 2026Article
- Necrotizing Enterocolitis and Neurodevelopmental Impairments: Microbiome, Gut, and Brain Entanglements.Biomolecules · 2024Review
- Preterm Pigs Fed Donor Human Milk Have Greater Liver β-Carotene Concentrations than Pigs Fed Infant Formula.The Journal of nutrition · 2023Article
- Superior performance of biofilm versus planktonic Limosilactobacillus reuteri in protection of the intestines and brain in a piglet model of necrotizing enterocolitis.Scientific reports · 2023Article
- Probiotics and Human Milk Differentially Influence the Gut Microbiome and NEC Incidence in Preterm Pigs.Nutrients · 2023Article
- Models of necrotizing enterocolitis.Seminars in perinatology · 2023Review
- Development of a novel definitive scoring system for an enteral feed-only model of necrotizing enterocolitis in piglets.Frontiers in pediatrics · 2023Article
- Increased Circulating Cortisol After Vaginal Birth Is Associated With Increased FGF19 Secretion in Neonatal Pigs.Endocrinology · 2022Article
- Tissue-specific mechanisms of bile acid homeostasis and activation of FXR-FGF19 signaling in preterm and term neonatal pigs.American journal of physiology. Gastrointestinal and liver physiology · 2022Article
- Review
- Parenteral lipid emulsions induce unique ileal fatty acid and metabolomic profiles but do not increase the risk of necrotizing enterocolitis in preterm pigs.American journal of physiology. Gastrointestinal and liver physiology · 2021Article
- The Neonatal and Juvenile Pig in Pediatric Drug Discovery and Development.Pharmaceutics · 2020Review
- Animal models of necrotizing enterocolitis.World journal of pediatric surgery · 2020Review
- Prematurity blunts the feeding-induced stimulation of translation initiation signaling and protein synthesis in muscle of neonatal piglets.American journal of physiology. Endocrinology and metabolism · 2019Article
- Prematurity reduces citrulline-arginine-nitric oxide production and precedes the onset of necrotizing enterocolitis in piglets.American journal of physiology. Gastrointestinal and liver physiology · 2018Article
- Metabolomic signatures distinguish the impact of formula carbohydrates on disease outcome in a preterm piglet model of NEC.Microbiome · 2018Article
- The intestinal-renal axis for arginine synthesis is present and functional in the neonatal pig.American journal of physiology. Endocrinology and metabolism · 2017Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
Enteral formula feeding is a risk factor for necrotizing enterocolitis (NEC) in premature infants, yet studies are conflicting regarding the safest timing for introduction and advancement of feeds. Our aim was to test the effects of early vs. late initiation and abrupt vs. gradual advancement of enteral feeding of an intact vs. hydrolyzed protein formula on NEC incidence and severity in preterm pigs. In Experiment 1, preterm pigs received total parenteral nutrition (TPN) at birth with abrupt initiation of enteral formula feeds (50% full intake) on d of life (DOL) 2 (EA) or 5 (LA) while PN continued. Pigs were also fed formula containing either intact or hydrolyzed protein. In Experiment 2, preterm pigs received TPN at birth with enteral, hydrolyzed-protein formula feeds introduced on DOL 2 either abruptly (EA; 50% full feeds) or gradually (EG; 10-50% full feeds over 5 d) while PN continued. NEC incidence and severity were assessed based on macroscopic and histological scoring. In Experiment 1, NEC incidence (41% vs. 70%, P<0.05) and severity were reduced in LA vs. EA groups and LA was associated with a higher survival rate, daily weight gain and jejunum villus height. Piglets fed hydrolyzed vs. intact protein formula had lower stomach content weights and similar NEC incidence. In Experiment 2, NEC incidence and severity were not different between pigs the EG vs. EA group. Proinflammatory gene expression (IL-1β, IL-6 and S100A9) in the ileum was lower in both LA and EG vs. EA groups. In conclusion, delayed initiation but not gradual advancement of enteral feeding is protective against NEC in preterm pigs. Feeding hydrolyzed vs. intact protein formula improved gastric transit without affecting the NEC incidence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.