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 given to premature babies because of its possibility to cause NEC.
This was not the only baby who died after receiving this thickener. There were 19 other cases found by the Journal of Pediatrics (2012) of NEC that were possibly linked to SimplyThick. The 19 cases included several deaths as well as babies who needed major surgery. Some of these babies were not premature, and the F.D.A. released a statement in 2011 that SimplyThick should not be given to any infants including term babies. NEC is common for premature babies, however the F.D.A.’s concerns with SimplyThick were the term babies developing NEC and that the premature babies developed NEC later then they usually do, sometimes after discharge from the hospital.
There are two possibilities for how the thickener contributed to the babies developing NEC. One is that the Xanthan Gum may be damaging to the premature newborn’s digestive system, which is very fragile. The second possibility is that the thickener ingested by these infants was contaminated with bacteria. The F.D.A. inspected the plants used to make SimplyThick in order to rule out the second possibility, but they actually found the company was not using proper techniques to destroy bacteria. The batches...