Oral immunoglobulin for preventing necrotizing enterocolitis in preterm and low birth weight neonates

Immunoglobulin given orally for preventing emergency intestinal problems (necrotizing enterocolitis) in premature and low birth weight newborn infants. Destructive inflammation of the intestine (necrotizing enterocolitis, NEC) is caused by gas-producing bacteria that ferment milk. It is a potential problem for newborn preterm and low birth weight (less than 2500 grams) infants. Even after leaving hospital, affected infants may need frequent and prolonged hospitalisation because of continuing nutritional problems. This makes it difficult for parents both emotionally and financially. Immunoglobulins are proteins found in the blood that give the body immunity to disease. Immunoglobulins (types IgA and IgG) taken orally may protect susceptible infants from developing necrotizing enterocolitis. The review authors searched the medical literature and found three randomised controlled trials (with 2095 newborn infants). Treatment was started either in the first twenty-four hours following birth (two small studies) or following commencement of oral feeding (enteral) (one large well-controlled study). In this large study, infants generally received breast milk, whereas they received formula milk in the other two studies. Giving immunoglobulin (IgG or an IgG and IgA combination) did not reduce the incidence of NEC, need for surgery related to NEC, or death from NEC, either during or after the study period. Immunoglobulins could possibly cause breakdown of red blood cells (haemolysis), but no clinically important haemolysis was apparent. There were no other reported side effects.