Necrotizing enterocolitis (NEC) is inflammation in the intestines that can lead parts of it to die. It often happens soon after a baby starts feeding. Treatment is needed right away.

Necrotizing Enterocolitis

Causes

The exact cause is not known. It may happen when immature intestines do not get enough blood and oxygen. This can cause bacteria to enter the intestines and cause damage.

Risk Factors

NEC is more common in premature infants and very low weight babies. It is also more common in males. Other things that may raise the risk are:

Low levels of oxygen during labor
An infection that starts soon after birth and affects the whole body
Poor circulation
Use of certain medicines, such as indomethacin or dexamethasone

Symptoms

NEC may cause:

Problems feeding
Swollen belly
Vomiting
Blood in stools
Slow heartbeat
Lack of energy
Breathing pauses or problems breathing

Diagnosis

You will be asked about your baby’s symptoms and health history. A physical exam will be done.

Your baby's blood, stool, and urine will be tested for signs of NEC.

Images may be taken of your baby's belly. This can be done with an abdominal x-ray.

Treatment

Most babies fully recover when treated. Treatment includes:

A tube placed through the baby's nose into the stomach to remove liquids and air to help the intestine heal
Antibiotics to treat infection
Oxygen or breathing support

Surgery

Babies with severe NEC may need surgery to remove the damaged part of intestine. The healthy parts will be sewn back together. Babies with a lot of damage may need part of the intestine connected to an opening in the belly wall. The opening will allow waste products to pass to a bag outside the body.

Prevention

The exact cause of NEC is not known. Some steps that may help prevent it are:

Breastfeeding
Watching for signs of early feeding problems
Probiotics

RESOURCES:

Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

National Institute of Child Health and Human Development
https://www.nichd.nih.gov

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

Athalye-Jape G, More K, et al. Progress in the field of necrotising enterocolitis--year 2012. J Matern Fetal Neonatal Med. 2013 May;26(7):625-632.

Necrotizing enterocolitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/necrotizing-enterocolitis-19. Updated November 27, 2018. Accessed January 7, 2020.

Necrotizing enterocolitis. Merck Manual—Professional version website. Available at: https://www.merckmanuals.com/professional/pediatrics/gastrointestinal-disorders-in-neonates-and-infants/necrotizing-enterocolitis. Updated October 2018. Accessed January 7, 2020.

Last reviewed September 2019 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 7/24/2020

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