Effect of Melatonin on Feeding Intolerance and Incidence of Necrotizing Enterocolitis in Preterm Infants

Abstract

Feeding intolerance is an extremely common problem in preterm infants. Our main concern is to give preterm infants sufficient intake by fast increments of feeds providing the needed calories, macro and micronutrients, to reach full oral intake as soon as possible so as to be able to remove intravenous lines, parenteral nutrition and minimize risk of sepsis. Melatonin has proved to be effective in reducing molecular damage, tissue loss and improving physiologic outcome as chronic lung disease, perinatal brain injury, NEC and sepsis. Our current prospective study focused on melatonin as a free radical scavenger to minimize oxygen free radicals that are involved in pathogenesis of necrotizing enterocolitis. Two study groups each of 45 preterm neonates were involved in the study that were recruited at the start of symptoms of feeding intolerance where Group I received a single dose of 20 mg of melatonin in addition to traditional treatment and Group II received traditional treatment only. We found that Group I had less bilious feeding residue after 72 hours of treatment and reached full enteral feeding significantly earlier than Group II. On the other hand, Group II needed withholding feeds more than Group I and subsequently