Necrotizing Enterocolitis NEC In Babies

Necrotizing enterocolitis, called NEC for short, is a neonatal bowel disease that kills the tissue of the intestinal wall, sometimes causing a hole to develop. When this happens, the contents of the intestine leak into the stomach or bloodstream. While not as commonly known as other birth conditions, NEC affects one in ten thousand full-term babies. NEC usually develops two to six weeks after the baby is born. Common symptoms include failure to eat or gain weight due to discomfort, abdominal pain or swelling, diarrhea with bloody stool, green or yellow vomit from bile backed up into the stomach, irregular heart rate, blood pressure, body temperature, or breathing. Also, a general lack of energy can be a sign of NEC. 

It is possible that some symptoms of NEC may appear like common digestive issues. If you suspect your child has NEC, immediately seek a diagnosis from your child’s doctor. Despite knowing the effects of NEC, pathologists have yet to determine a singular cause, which makes it quite challenging to research. However, studies have established a link between NEC and certain risk factors. Premature birth causes infants to be 10 times more likely to contract NEC. According to the Journal Advances in Nutrition, children born before 32 weeks are the most at risk for developing NEC, especially those weighing less than 1500 grams and experiencing cardiac complications. 

Several studies have also shown that babies who consumed formula made with cow’s milk have a greater risk of developing NEC. Scientists think this may be because formulas from cow’s milk lack the carbohydrates which are present in human breast milk to prevent the growth of the inflammatory bacteria that causes disease. Parents may be alarmed to learn that most formulas contain cow’s milk. A newborn circulatory system prioritizes their brain and heart, reducing circulation to the intestines. This makes low oxygen at birth a significant risk factor for NEC because it can stunt a newborn’s development and make the child more vulnerable to infection.

Physicians can diagnose necrotizing enterocolitis in many ways. Fecal tests evaluate your child’s stool for blood. Blood tests reveal too much acid in the baby’s blood or an irregular white blood cell count, which are both signs of NEC. X-rays can highlight air inside the bowel wall, in the vein from the bowels to the liver, or inside the stomach but outside the bowels. There are some simple treatment options for NEC, but more severe cases may require surgery. Advanced cases may not be treatable.

Children’s Hospital Los Angeles notes that appropriate treatment plans depend on the degree of the damage. A physician’s first line of defense against NEC is to put the child on an intravenous feeding schedule. As soon as the disease is diagnosed, the sooner the baby’s bowels can rest, the more quickly they can heal. Children with milder cases of NEC may need short-term treatment. More severe illness may require multiple surgeries and several weeks of recovery in between. According to the Cleveland Clinic, approximately 25 percent of children with NEC require surgical intervention, with surgeons removing damaged tissue while saving and repairing as much of the intestines as possible. 

Some NEC treatment options include a nasogastric tube to carry medicine and food to the infant’s stomach while preventing air from filling the stomach and intestines, antibiotics to directly combat infections caused by bacteria, x-rays and blood tests, which are not only used to diagnose NEC but also to monitor the effectiveness of NEC treatments, oxygen or breathing machines to help offset breathing difficulties caused by abdominal swelling, quarantine for certain vulnerable preterm infants to decrease the risk that they will contract other diseases as they receive treatment, surgery such as ostomy, which creates a pathway called a stoma for waste to exit the body, and extremely low birth weight babies may need interim catheters to drain fluid. Statistically, eighty percent of babies afflicted with NEC survive the infection. 

However, the disease can leave some survivors with recurring lifelong health problems. Children who require surgery are especially vulnerable to long-term consequences such as abdominal infections like peritonitis, intestinal strictures, which thin the intestinal passageways and make it difficult for food to pass through, short gut syndrome, which results from an only partially functioning digestive tract, and growth failure and developmental delays if nutrient absorption through the intestine is significantly affected, requiring regular specialized treatments to maintain proper growth. No family or child should have to experience the pain and fear of necrotizing enterocolitis, but you don’t have to go through any of this alone. 

The Birth Injury Center is here to help, offering consultations and abundant resources available to help you learn more for your own peace of mind, and to discover additional family forums and parent support groups. Please visit BirthInjuryCenter.org