Robert Wood Johnson University Hospital
 

Necrotizing Enterocolitis

High-Risk Newborns - Necrotizing Enterocolitis

What is necrotizing enterocolitis?

Necrotizing enterocolitis (NEC) is a serious intestinal illness in babies.

Although NEC may develop in low-risk newborns, most cases occur in premature babies. NEC is more common in babies weighing less than 1,500 grams (3 pounds, 4 ounces).

It is not clear exactly what causes NEC. It is thought that the intestinal tissues are somehow weakened by too little oxygen or blood flow. When feedings are started and the food moves into the weakened area of the intestinal tract, bacteria from the food can damage the intestinal tissues. The tissues may be severely damaged and die, which can cause a hole to develop in the intestine. This can lead to severe infection in the abdomen.

Who is affected by necrotizing enterocolitis?

Why is necrotizing enterocolitis a concern?

Damage to the intestinal tissues can lead to perforation (a hole) in the intestines. This allows the bacteria normally present in the intestinal tract to leak out into the abdomen and cause infection. The damage may only exist in a small area or it may progress to large areas of the intestine. The disease can progress very quickly. Infection in the intestines can be overwhelming to a baby and, even with treatment, there may be serious complications. Problems from NEC may include the following:

What are the symptoms of necrotizing enterocolitis?

The following are the most common signs of necrotizing enterocolitis. However, each child may experience symptoms differently. Symptoms usually develop in the first 2 weeks and may include the following:

The symptoms of necrotizing enterocolitis may resemble other digestive conditions or medical problems. Always consult your child's physician for a diagnosis.

How is necrotizing enterocolitis diagnosed?

NEC is diagnosed by examining the baby for the signs listed above. An x-ray of the abdomen may show a bubbly appearance in the intestine and signs of air or gas in the large veins of the liver. Air may also be outside the intestines in the abdomen. A needle may be inserted into the abdominal cavity. Withdrawing intestinal fluid from the abdomen is often a sign of a hole in the intestines.

Treatment for necrotizing enterocolitis:

Specific treatment for necrotizing enterocolitis will be determined by your baby's physician based on the following:

Treatment may include the following:

Severe cases of NEC may require:

Prevention of necrotizing enterocolitis:

Because the exact causes of NEC are unclear, prevention is often difficult. Studies have found that babies who have had only breast milk (rather than formula) are less likely to develop NEC. Also, starting feedings after a baby is stable and slowly increasing feeding amounts have been recommended.

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