Definitions for the grades of recommendations (Strong, Weak, Further research needed) and level of evidence (Strong, Moderate, Low, Very Low) are provided at the end of the "Major Recommendations" field.
When and How Should Feeds Be Started in Infants at High Risk for Necrotizing Enterocolitis (NEC)?
The authors suggest that minimal enteral nutrition should be initiated within the first 2 days of life and advanced by 30 mL/kg/d in infants ≥1,000 g. (Weak)
Does the Provision of Mother's Milk Reduce the Risk of Developing NEC Relative to Bovine-Based Products or Formula?
The authors suggest the exclusive use of mother's milk rather than bovine-based products or formula in infants at risk for NEC. (Weak)
Do Probiotics Reduce the Risk of Developing NEC?
There are insufficient data to recommend the use of probiotics in infants at risk for NEC. (Further research needed)
Do Certain Nutrients Either Prevent or Predispose to the Development of NEC?
The authors do not recommend glutamine supplementation for infants at risk for NEC. (Strong)
There is insufficient evidence at this time to recommend arginine and/or long-chain polyunsaturated fatty acid supplementation for infants at risk for NEC. (Further research needed)
When Should Feeds be Reintroduced to Infants with NEC?
There are insufficient data to make a recommendation regarding time to reintroduce feedings to infants after NEC. (Further research needed)
Level of Evidence
High: Further research is very unlikely to change the authors' confidence in the estimate of effect
Moderate: Further research is likely to have an important impact on the authors' confidence in the estimate of effect and may change the estimate
Low: Further research is very likely to have an important impact on the authors' confidence in the estimate of effect and is likely to change the estimate
Very Low: Any estimate of effect is very uncertain
Grade of Recommendation
Strong: Net benefits outweigh harms
Weak: Tradeoffs for patient are important
Further research needed: Uncertain tradeoffs