In Reply.—I agree with Dr Goldman that the relationship between changed feeding patterns for premature infants and the increased incidence of neonatal NEC is striking. Unfortunately, we were unable to study feeding patterns within each hospital before and during the epidemics for evidence of significant change. In our studies, only two of the 53 control infants were not fed within a time period comparable to that of case infants. The number of infants fed within 24, 48, or 72 hours of birth did not differ between the two groups, nor did the number of infants who received their first oral feeding after the fifth day of life. We were able to compare the average daily mean volume of formula received by case and control infants during the first five days of life only in hospital C, and found no significant difference between the two groups.
Book et al1