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Breastfeeding forbabies with Necrotizing
EnterocolitisB.Wirastari Marnoto
Symphonic 2015
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Necrotizing Enterocolitis
necrotizing enterocolitis (NEC), is anaquired condition of diuse necroticinjury to the mucosal and submucosallayers of the gut
the necrosis could e!tend to themuscular bowel wall,with "otential for"erforation
hydrogen gas "oc#ets are found in the
intramural layers of the gut it in$ol$es mostly the terminal ileum
and "ro!imal colon
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Clinical signs andsym"toms
clinical signs range from mild feedingintolerance to catastro"hic disease withgut "erforation, "eritonitis and c%$colla"se
sym"toms might be insidious& subtle,such as gastric residues, abdominaldistention, bloody stools, or a suddendeterioration
'ge of onset
a""ro! * days in "rems + * w#gestation
a""ro! - days in neonates . / w#sgestation
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Bell0s clinical staging( 1234)
5tage 6 sus"ect NECclinical signs and sym"toms ,nondiagn"stic radiogra"h
5tage 66 de7nite NEC Clinical signs and sym"toms 8neumatosis intestinalis5tage 666 ad$anced NEC critically ill
"neumatosis or "neumo"eritoneumon radiogra"h
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6ncidence
the incidence $aries but stated mostoften as "er 1*** li$e births
"reterm infants account for 3*9 to 2*9 at : w#s gestation there is a shar"
decline N6C;< =5' (**1), the o$erall
incidence of "ro$en NEC was 39 in>?B@ (/** to 1-** g) and 1-9 for
infants -*1 to :**g countries with low incidence of
"rematures (Aa"an, 5weden) ha$e lower"re$alence
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NEC in fullterm infants
NEC is rare in fullterm infants 6n a -%year "eriod, Chandler found
only of : NEC cases were full%terms, also diagnosed with C;