Reducing Incidence of Necrotizing Enterocolitis

Clin Perinatol. 2017 Sep;44(3):683-700. doi: 10.1016/j.clp.2017.05.004. Epub 2017 Jul 5.


Necrotizing enterocolitis (NEC) is a multifactorial disease that occurs when multiple risk factors and/or stressors overlap, leading to profound inflammation and intestinal injury. Due to its multifactorial nature, there has been much uncertainty in identifying clear strategies for prevention of NEC. Despite these obstacles, the incidence of NEC has gradually been decreasing over the past 10 years, in part due to quality improvement (QI) initiatives to prevent NEC. Current QI strategies primarily target the various predisposing conditions. This article reviews the evidence on which QI interventions to prevent NEC have been based and provides examples of successful QI interventions.

Keywords: Anemia; Antibiotics; Feeding guidelines; Human milk; Necrotizing enterocolitis; Probiotics; Quality improvement; Transfusion.

Publication types

  • Review

MeSH terms

  • Anemia / epidemiology
  • Anemia / therapy
  • Anti-Bacterial Agents / therapeutic use
  • Blood Transfusion / statistics & numerical data
  • Enteral Nutrition / methods*
  • Enterocolitis, Necrotizing / epidemiology
  • Enterocolitis, Necrotizing / prevention & control*
  • Histamine H2 Antagonists / therapeutic use
  • Humans
  • Incidence
  • Infant, Newborn
  • Milk, Human*
  • Practice Guidelines as Topic
  • Probiotics / therapeutic use
  • Protective Factors
  • Quality of Health Care*
  • Risk Factors
  • Tissue and Organ Procurement


  • Anti-Bacterial Agents
  • Histamine H2 Antagonists