Necrotizing enterocolitis (NEC) is inflammation in the intestines that can cause parts of it to die. It often happens soon after a baby starts feeding. Treatment is needed right away.
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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.
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
- The use of certain medicines, such as indomethacin or dexamethasone
NEC may cause:
- Problems feeding
- Swollen belly
- Blood in stools
- Slow heartbeat
- Lack of energy
- Breathing pauses or problems breathing
The doctor will ask about the baby’s symptoms and past health. A physical exam will be done.
The baby's blood, stool, and urine will be tested for signs of NEC.
Pictures may be taken of the baby's belly. This can be done with an x-ray.
The goal of treatment is to allow the intestines time to heal. Most babies fully recover when treated. Treatment includes:
- IV fluids and nutrition instead of oral feeding
- A tube placed through the baby's nose into the stomach to remove liquids and air
- Antibiotics to fight infection
Babies with severe NEC may need surgery to remove the damaged part of intestine. The healthy parts will be sewn together. Babies with a lot of damage may need part of the intestine connected to an opening in the belly wall. This allows waste products to pass to a bag outside the body.
The risk of NEC may be lowered by breastfeeding.
- 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.
- Necrotizing enterocolitis. Merck Manual—Professional version website. Available at: https://www.merckmanuals.com/professional/pediatrics/gastrointestinal-disorders-in-neonates-and-infants/necrotizing-enterocolitis.
- Kari Kuenn, MD
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