Patient education: Newborn necrotizing enterocolitis (The Basics)

What is newborn necrotizing enterocolitis? — 

Newborn necrotizing enterocolitis, or "NEC," is a condition that happens when there is a serious injury to a baby's intestines. NEC can happen in all newborn babies, but it is most common in premature babies.

NEC is a serious disease. A baby who has it needs treatment as soon as possible. This is because the injury can destroy parts of the intestine. This damage can be permanent. In some very sick babies, it can even cause death.

What are the symptoms of NEC? — 

Symptoms usually happen 10 days to a few weeks after birth. Doctors usually find NEC in babies who are already in the hospital. This is because NEC usually happens in premature babies, or sick babies who are born on time.

Symptoms can include:

●Feeding problems, such as:

•Vomiting

•Diarrhea

•Milk or formula staying in the stomach, instead of going into the intestines like it should

●Bleeding from the rectum

Some symptoms of NEC can also happen with other conditions. These symptoms include:

●Long pauses with no breathing (called "apnea")

●Acting sleepy a lot of the time – It can be hard to wake the baby up.

●Skin that feels too warm or too cool

If the doctors and nurses think your baby might have NEC, they can do an exam and treat the condition.

Will my baby need tests? — 

Yes. Doctors can order some or all of these tests:

●X-ray of the belly

●Ultrasound of the belly – This is an imaging test that uses sound waves to create pictures of the inside of the body.

●Blood tests

●Tests on a sample of the baby's bowel movement

Imaging tests such as X-ray and ultrasound show changes in the intestines caused by NEC. Blood tests and tests on a sample of bowel movement might help the doctors figure out if NEC or a different condition is causing the symptoms. Other diseases can cause symptoms like those of NEC.

How is NEC treated? — 

NEC needs treatment right away. Your baby might need to go to the neonatal intensive care unit, or "NICU." This is a part of the hospital for babies who need special care.

Treatments can include:

●Stopping all feeds through the mouth or feeding tube

●Giving fluids and nutrition through a thin tube that goes into a vein, called an "IV"

●Putting a thin tube, called a "nasogastric tube," in the baby's nose, down their esophagus, and into their stomach. (The esophagus is the tube that carries food to the stomach.) If there is extra fluid or air in their stomach or intestines, the tube can suck it up. This can relieve belly swelling and help stop vomiting.

●Giving medicines or blood transfusions to help bleeding or other problems – During a blood transfusion, the baby will get blood that was donated by someone else. The donated blood goes into a vein.

●Giving antibiotics to fight infection

●Surgery – Doctors can drain fluid from the belly or take out a part of the intestine that has serious damage.

Babies with NEC can be very sick. During treatment, they might need:

●Medicines to help their heart

●A breathing machine or oxygen to help them get enough air in their lungs

Babies getting treatment for NEC will often have X-rays, blood tests, and tests on samples of bowel movements. All these tests can show if the NEC is getting better or worse.

Can NEC be prevented? — 

If possible, feeding a baby breast milk might help prevent NEC, especially in babies born premature. Talk to your doctor or nurse about how you can give breast milk to your baby.

More on this topic

Patient education: When a baby is born premature (The Basics)
Patient education: What to expect in the NICU (The Basics)
Patient education: Pumping and storing breast milk (The Basics)
Patient education: Benefits of breast milk for premature babies (The Basics)
Patient education: Small bowel resection (The Basics)

Patient education: Pumping breast milk (Beyond the Basics)