Major Finding: Babies who subsequently developed Bell Stage I or II NEC had a greater mean and maximum number of stools per day during the first week than those who did not. The mean number of stools per day was 0.57 in controls, 0.86 in 33 infants with NEC Stage I, 1.0 in 23 NEC Stage II infants, and 0.43 in 43 Stage III babies.
Data Source: A 198-subject case-control study of stooling patterns in the first postnatal week.
Disclosures: Ms. Meller's study received an American Pediatric Society/Society for Pediatric Research Student Research Program Award. She said she had no relevant financial disclosures.
A baby's stooling pattern during the first postnatal week may predict later development of necrotizing enterocolitis.
If this finding from a 198-subject case-control study is confirmed by others, early stool pattern could provide a simple indicator of increased risk for the most common gastrointestinal emergency occurring in neonates. Necrotizing enterocolitis (NEC) affects roughly 10% of all babies admitted to neonatal ICUs. It's associated with substantial long-term morbidity, including neurodevelopmental delays and short gut syndrome, Stephanie Meller noted at the annual meeting of the Pediatric Academic Societies in Denver.
The study included 99 babies born at less than 29 weeks' gestation who developed NEC and an equal number of gestational age-matched controls. As has been shown in other studies, a first feeding with breast milk rather than formula was associated with a significantly reduced risk of later NEC. Indeed, 57% of the NEC patients and 72% of controls had breast milk for their first feeding, according to Ms. Meller, a medical student at Yale University, New Haven, Conn.
The novel study finding involved differences in early stool patterns. Babies who subsequently developed Bell Stage I or II NEC had a greater mean and maximum number of stools per day during the first week than those who did not. The mean number of stools per day was 0.57 in controls, 0.86 in 33 infants with NEC Stage I, 1.0 in 23 NEC Stage II infants, and 0.43 in 43 Stage III babies. The mean maximum number of stools per day during postnatal week 1 was 2 in controls, 3 in patients with NEC Stage I or II, and 2 in those with NEC Stage III. Thus, the early increase in stools didn't hold true for infants who later developed the most severe category of NEC. Nonetheless, infant stooling patterns warrant further study as a potential NEC predictor, she added.