Abstract
Objective: To determine the characteristics of full term and preterm neonates with isolated rectal bleeding (IRB), and to follow the outcome of these low risk patients.
Design: A retrospective case-control study consisting of 147 cases (83 full term and near term infants and 64 preterm infants) and 147 controls in a single institution.
Results: A feeding regimen that did not include breast milk was the only variable found to predict IRB. In full term and near term babies (gestational age ⩾ 35 weeks), 52.6% of the study group were breast fed compared with 83.1% of the controls (p < 0.0001). In preterm babies (gestational age ⩽ 34 weeks), 45.9% of the study group were breast fed compared with 74.2% of the controls (p = 0.0014). No obvious systemic infection cause was detected. None of the patients showed clinical or radiological deterioration in the days after diagnosis of IRB.
Conclusions: The outcome of a group of low risk neonates with IRB was excellent. It is questionable whether antibiotic treatment is required and feeding needs to be stopped. Breast feeding, even if only partial, should be encouraged.
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Selected References
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- Anveden-Hertzberg L., Finkel Y., Sandstedt B., Karpe B. Proctocolitis in exclusively breast-fed infants. Eur J Pediatr. 1996 Jun;155(6):464–467. doi: 10.1007/BF01955182. [DOI] [PubMed] [Google Scholar]
- Benno Y., Sawada K., Mitsuoka T. The intestinal microflora of infants: composition of fecal flora in breast-fed and bottle-fed infants. Microbiol Immunol. 1984;28(9):975–986. doi: 10.1111/j.1348-0421.1984.tb00754.x. [DOI] [PubMed] [Google Scholar]
- Dupont C., Badoual J., Le Luyer B., Le Bourgeois C., Barbet J. P., Voyer M. Rectosigmoidoscopic findings during isolated rectal bleeding in the neonate. J Pediatr Gastroenterol Nutr. 1987 Mar-Apr;6(2):257–264. doi: 10.1097/00005176-198703000-00017. [DOI] [PubMed] [Google Scholar]
- Kilshaw P. J., Cant A. J. The passage of maternal dietary proteins into human breast milk. Int Arch Allergy Appl Immunol. 1984;75(1):8–15. doi: 10.1159/000233582. [DOI] [PubMed] [Google Scholar]
- Lake A. M. Food-induced eosinophilic proctocolitis. J Pediatr Gastroenterol Nutr. 2000;30 (Suppl):S58–S60. doi: 10.1097/00005176-200001001-00009. [DOI] [PubMed] [Google Scholar]
- Levene M. I. Rectal bleeding in the first month of life. Postgrad Med J. 1979 Jan;55(639):22–23. doi: 10.1136/pgmj.55.639.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lucas A., Cole T. J. Breast milk and neonatal necrotising enterocolitis. Lancet. 1990 Dec 22;336(8730):1519–1523. doi: 10.1016/0140-6736(90)93304-8. [DOI] [PubMed] [Google Scholar]
- Sakata H., Yoshioka H., Fujita K. Development of the intestinal flora in very low birth weight infants compared to normal full-term newborns. Eur J Pediatr. 1985 Jul;144(2):186–190. doi: 10.1007/BF00451911. [DOI] [PubMed] [Google Scholar]
- Thompson E. C., Brown M. F., Bowen E. C., Smith L. M., vander Griten D. Causes of gastrointestinal hemorrhage in neonates and children. South Med J. 1996 Apr;89(4):370–374. doi: 10.1097/00007611-199604000-00003. [DOI] [PubMed] [Google Scholar]
- Walker W. A. Host defense mechanisms in the gastrointestinal tract. Pediatrics. 1976 Jun;57(6):901–916. [PubMed] [Google Scholar]
- Walker W. A., Isselbacher K. J. Uptake and transport of macromolecules by the intestine. Possible role in clinical disorders. Gastroenterology. 1974 Sep;67(3):531–550. [PubMed] [Google Scholar]
- Yoshioka H., Iseki K., Fujita K. Development and differences of intestinal flora in the neonatal period in breast-fed and bottle-fed infants. Pediatrics. 1983 Sep;72(3):317–321. [PubMed] [Google Scholar]