Pediatricians should use caution when advising families to use thickening products containing xanthan gum or similar agents for management of swallowing disorders in infants at high risk for necrotizing enterocolitis (NEC). This includes infants born before 37 weeks’ gestation until they are at least 44 weeks postmenstrual age.

It is unknown if infants with other conditions at increased risk for NEC, including those with intestinal wall defects and congenital heart disease, also should avoid these products.

On May 20, the Food and Drug Administration (FDA) warned that use of a product called SimplyThick should be stopped immediately in hospitalized infants born before 37 weeks’ gestation and premature infants discharged from the hospital in the last 30 days ( This warning was based largely on reports circulated via listservs and then reported to the FDA. Approximately 15 babies were reported to have developed NEC after using this product. Two...

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