Necrotizing enterocolitis, or NEC, is a serious intestinal affliction that affects one in every 2,000 to 4,000 infants. The disease process more commonly occurs in premature babies born before the 32nd week of gestation. But, the disorder has been found in babies born at full term who also have heart anomalies or other health conditions. NEC develops when the large or small intestine becomes inflamed or injured by naturally occurring bacteria. The affected site may eventually weaken, which enables the bacteria to pass through and cause a life-threatening systemic infection.
Researchers have not determined a specific cause for the disease development. However, there is a theory that a number of factors contribute to the problem.
- Abnormally high level of intestinal bacteria
- The presence of invasive bacteria or viral colonies that instigate an infection
- Insufficient blood flow and oxygen to the intestine
- Intestinal lining injury
- Baby formula
- Underdeveloped intestines
Necrotizing Enterocolitis Signs and Symptoms
Infants develop symptoms within the first month after birth. As the disorder progresses, the infant’s abdomen swells, becomes red and tender. The child may become constipated or pass dark, bloody diarrhea. The infant may vomit green bile. The baby’s body temperature, heart rate, blood pressure, and respiratory rate decrease. The infant becomes lethargic.
Once diagnosed, feedings are temporarily discontinued. The infant receives fluids and nutrition via IV supplements. A surgeon inserts a gastric or a nasogastric tube into the stomach, which enables air and fluid to escape. The presence of infection, or to prevent infection, requires antibiotic treatment. The baby undergoes frequent abdominal exams and X-rays to monitor progress. The child’s stools are monitored for stool changes. Blood tests determine anemia or infection. In severe instances, the child may require surgery.
If the child’s condition worsens or does not respond to treatment, surgery may be necessary to repair any perforation or to remove dead tissue. In the event that a large area of the intestine suffers damage, the surgeon may reroute the remaining tissue to an opening in the stomach, which is known as a stoma.
When the medical team deems that the infant’s condition is improving, they typically recommend that the child receive breast milk. Breast milk boosts immunity, is easier to digest and promotes the growth of healthy bacteria in the gastrointestinal tract.