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Necrotizing Enterocolitis (Pediatric)

What is necrotizing enterocolitis (NEC)?

NEC is an injury to, or inflammation of, the inner surface of the bowel. The more premature the infant, the greater the chance of developing this condition. Babies who are small for their gestational age, or have poor growth while in the womb, are also at increased risk. NEC can also occur, but is much less common, in full-term infants. It is also less common in infants who consume their mother’s milk or donor milk.

The causes of NEC are not well understood, but inflammation initiated by bacteria is thought to result in the bowel injury.

What are the signs of NEC?

Affected infants are usually feed poorly. Other signs are bloating, a red an tender abdomen, diarrhea, and listlessness. The baby may also vomit bile (a green substance).

Bloody stools may result from inflammation and infection of the bowel wall. If the infection is not recognized early, the child may develop a more generalized infection affecting other organs.

How is NEC diagnosed?

If NEC is suspected, a physician will order an abdominal x-ray to check for the presence of gas or air bubbles in the wall of the intestine, or in the abdominal cavity. Blood tests may be order to check for a decreased number of platelets, needed to form blood clots and prevent bleeding, and a decreased number of white blood cells, that help fight bacterial infections.

How is NEC treated?

NEC can range in severity and is usually treated by

  • Stopping feedings and allowing the bowel to rest
  • Administering intravenous antibiotics
  • Closely monitoring vital signs, blood tests and X-rays.

Sometimes, surgery is needed. The most severe cases can be life-threatening even when full range of treatment is provided.