Case Study Literature Review: Neonatal NEC and SimplyThick

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The case study that I chose to focus my literature review on is concerning premature babies who developed Necrotising Enterocolitis (NEC) from a milk thickener that was given to them while while was on the Neonatal Intensive Care Unit (NICU), and which some babies were discharge home on. In one example of this occurrence, which I will use to guide my search for literature, the staff on the NICU had noticed that the baby’s heart rate slightly slowed down when he ate, so they thought that he was having difficulty feeding. To combat this difficulty the staff added a thickener, SimplyThick, to his feedings. When he was discharged home they gave the thickener to the parents to take home with them. Thickening foods makes them easier to swallow because it allows them to move more slowly in the mouth giving more time for a patient to close their airway, which can prevent aspiration (Queensland Health Dietitians, 2007). SimplyThick is a thickener made of Xanthan Gum, which is a substance commonly added to thicken foods for adults. There is a lack of information on how safe Xanthan Gum is for babies. SimplyThick was marketed to speech language pathologists as being easy to dissolve in breast milk as well as maintaining its consistency when mixed. These pathologists recommended SimplyThick as an additive to milk for babies with problems swallowing.
Two weeks after he was discharged the baby who had received SimplyThick was readmitted, according to Saint Louis (2013) because of a distended abdomen and what seemed to be inconsolable pain. Soon after he was readmitted the baby passed away from NEC. A month after the incident the U.S. Food and Drug Administration (F.D.A.) issued a statement about SimplyThick stating that it should not be give...

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... units? A multilevel analysis. Critical Care Medicine, 37(1), 61-67. doi:10.1097/CCM. 0b013e31819300e4
Suresh, G., Horbar, J., Plsek, P., Gray, J., Edwards, W., Shiono, P., & ... Goldmann, D. (2004). Voluntary anonymous reporting of medical errors for neonatal intensive care. Pediatrics, 113(6 Part 1), 1609-1618.
U.S. Food and Drug Administration. (2011). FDA: Do not feed simplythick to premature infants. [Press release]. Retrieved from PressAnnouncements/ucm256253.htm
IBR Advisor. (2010). Voice of patients missing in adverse event reporting: patient reports could unearth problems sooner. IRB Advisor, 10(5), 53-55.
Woods, Oliver, Lewis, & Yang, (2012). Development of necrotizing enterocolitis in premature infants receiving thickened feeds using SimplyThick. Journal Of Perinatology, 32(2), 150-152. doi:10.1038/jp.2011.105

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