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(NEC)

Definition

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
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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-enterocolitisUpdated October 2018. Accessed January 7, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 01/07/2020