Necrotizing enterocolitis (NEC) is a serious condition of the intestine. The intestine digests food. It also moves food from the stomach to the anus. NEC is the swelling and destruction of a part of the intestine. This condition often occurs soon after your baby starts feeding. It is found mostly in premature and very low birthweight babies. NEC can also be found in full-term infants.
This is condition requires care from your baby’s doctor. NEC often occurs in the first two weeks of life but can occur as late as 3 months of age. The baby is often still in the hospital when NEC starts.
The exact cause of NEC is not known. Below is a possible series of events that can lead to NEC:
The risk of developing NEC is higher if your baby:
If your baby has any of these symptoms, do not assume it is due to NEC. The symptoms may be caused by other, less serious conditions. Symptoms will vary by child but may include:
Your doctor will ask about your baby’s symptoms and medical history. A physical exam will be done. Your pediatrician will work with a specialist to diagnose NEC.
Tests may include the following
Most babies who get NEC have a complete recovery. Treatment usually takes between 3 to 14 days. Talk with your doctor about the best treatment plan for your baby. Treatment options include combinations of the following:
Air or liquid in your baby’s intestine can make the condition worse. You will be asked to stop feeding your baby. A tube will be placed through the baby's nose into the stomach. This tube will remove liquid and air from your baby’s stomach. Removing these will help the intestine heal.
Nutrition and fluids will be given to your baby through an IV. An IV can deliver nutrition directly into your child's blood stream.
Antibiotics are used to fight infections caused by bacteria. Your baby may be given antibiotic to stop the current infection or prevent a new one.
NEC can cause swelling in the stomach. This may make it difficult for the baby to breathe. Oxygen may be given to improve the baby's oxygen levels. A machine called a ventilator may be used. It will help or take over breathing for the baby.
Some infections can pass easily through touch or near contact. Certain steps can keep these infections from spreading. You and your baby's caretakers may wear gowns and gloves to protect your baby and others. Regular handwashing is also important in any infection prevention.
For some, the damage to the intestine may be severe. In this case, surgery may be needed.
Surgery is done to remove the damaged part of the intestine. The healthy parts are sewn back together when possible. Sometimes there is too much damage to be able to sew the intestine back together. In this case, part of the intestine will be connected to an opening in the abdomen wall. The opening will allow waste products to pass to a bag outside the body.
Prevention is difficult since the exact cause of NEC is unknown. Some steps that may be helpful include:
American Academy of Pediatrics
National Institute of Health & Human Development
Maternal and Infant Health
Public Health Agency of Canada
DynaMed Editorial Team. Necrotizing enterocolitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 10, 2012. Accessed July 25, 2012.
Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for necrotizing enterocolitis (NEC) among very low birth weight infants. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2010 Oct 7. Accessed July 25, 2012.
Pietz J, Achanti B, Lilien L, Stepka E, Mehta S. Prevention of necrotizing enterocolitis in preterm infants: A 20-year experience. Pediatrics. 2007; 119:164-170.
Last reviewed September 2013 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.