About necrotizing enterocolitis
What is necrotizing enterocolitis?
Necrotizing enterocolitis (NEC) is a disease that develops when the tissue in the inner lining of the small or large intestine becomes damaged and begins to die. This causes the intestine to become inflamed.
The condition usually affects only the inner lining of the intestine, but the entire thickness of the intestine may become impacted eventually.
In severe cases of NEC, a hole may form in the wall of the intestine. If this occurs, the bacteria normally found inside the intestine can leak into the abdomen and cause widespread infection. This is considered a medical emergency.
NEC can develop in any newborn within 2 weeks after birth. However, it’s most common in premature infants. Around 90 percent of all NEC cases are among premature babies.
NEC is a serious disease that can progress very quickly. It’s important to get treatment right away if your baby is showing symptoms of NEC.
What are the symptoms for necrotizing enterocolitis?
The symptoms of NEC often include the following:
- swelling or Bloating of the abdomen
- discoloration of the abdomen
- bloody stool
- poor feeding
Your baby may also show symptoms of an infection, such as:
- apnea, or disrupted breathing
- a fever
What are the causes for necrotizing enterocolitis?
The exact cause of NEC isn’t known. However, it’s believed that a lack of oxygen during a difficult delivery may be a contributing factor. When there’s reduced oxygen or blood flow to the intestine, it can become weak.
A weakened state makes it easier for bacteria from the food entering the intestine to cause damage to the intestinal tissues. This can lead to the development of an infection or NEC.
Other risk factors include having too many red blood cells and having another gastrointestinal condition. Your baby is also at an increased risk for NEC if they were born prematurely.
Premature babies often have underdeveloped body systems. This may cause them to have difficulty with digestion, fighting infection, and blood and oxygen circulation.
What are the treatments for necrotizing enterocolitis?
There are different ways to treat NEC. Your child’s specific treatment plan will depend on several factors, including:
- the severity of the disease
- the age of your child
- the overall health of your child
In most cases, however, your doctor will tell you to stop breastfeeding. Your baby will receive their fluids and nutrients intravenously, or through an IV. Your baby will likely need antibiotics to help fight the infection.
If your baby is having difficulty breathing due to a swollen abdomen, they’ll receive extra oxygen or breathing assistance.
Surgery may be necessary in severe cases of NEC. The procedure involves the removal of the damaged sections of the intestines.
Throughout the course of treatment, your baby will be monitored closely. Your baby’s doctor will perform X-rays and blood tests regularly to make sure the disease doesn’t get worse.
What are the risk factors for necrotizing enterocolitis?
Fortunately, NEC is rare. It affects just one in 2,000 to 4,000 births. It can happen in any newborn baby, but it’s most common in premature babies who weigh less than 3.25 lbs. Others who may be at risk include:
- High-risk or premature babies who are fed formula by mouth or tube
- Those who had a difficult delivery or have lowered oxygen levels
- Infants who have too many red blood cells in circulation
- Babies with existing gastrointestinal infections
- Seriously ill infants and those who’ve received a blood transfusion
Is there a cure/medications for necrotizing enterocolitis?
Most infants with this condition fully recover. In some cases, the bowel is scarred or it narrows. This may lead to a future blockage. Babies who’ve had a large piece of their intestine removed in surgery may not be able to absorb nutrients normally. In the most severe cases, they may need a bowel transplant in order to live.
Right now, there’s no way to prevent NEC. But studies show that babies who were only fed breast milk (no formula), were less likely to develop this disease. That’s why doctors recommend feeding at-risk infants breast milk, starting with small amounts. Many NICU's are now using donor breast milk when there is none available from the mother in order to reduce the incidence of NEC
Researchers are working on promising new treatments for NEC. Among them: probiotics, which are live bacteria and yeasts that are good for you, to counteract the bacteria that cause the infection, and blocking nitric oxide. That’s a gas which is produced as a result of NEC. It helps to destroy the wall of the intestine.