Necrotizing Enterocolitis Information

This page is done in memory of Our Triplet Angel Kelsey who died from complications of NEC. You can view her page and read our triplets story by clicking the link at the end of this page.
All information on this page was compiled from a variety of resources and articles on NEC.

In Necrotizing Enterocolitis (NEC), the lining of the intestinal wall dies and the tissue sloughs off. The cause for this disorder is unknown, but it is thought that a decreased blood flow to the bowel keeps the bowel from producing the normal protective mucous. Bacteria in the intestine may also be a causative factor.

Although 10% of all cases of NEC occur in TERM infants, it is more commonly seen in PRE-TERM infants. The incidence appears to be similar among male and female infants, but it is more common among black infants.
NEC is 10 times more common among infants who have been fed compared to those who have not received enteral nutrition, and it occurs more commonly among infants fed formula compared to those fed breast milk. NEC, however, does occur among infants who have never been fed and who have received breast milk feedings.

YES, babies can lose some of their bowel from it. Some babies die of NEC. For this reason doctors may start treatment on simply the suspicion that your baby might be developing symptoms of NEC. This suspicion is sometimes referred to as "rule out NEC", "possible NEC" or a "NEC scare."
*~*NEC is a serious disease with a death rate of over 30%. The outcome is improved by AGGRESSIVE, EARLY TREATMENT.*~*

~*~Small, premature infants
~*~Outbreaks among other infants in a nursery (suggesting an infectious cause)
~*~The feeding of concentrated formulas
~*~Infants who have received blood exchange transfusions
~*~Low blood pressure or low blood volume
~*~Asphyxia (too little oxygen reaching the tissues) and/or hypoxia (lack of oxygen in the blood or body tissues.)
~*~Cold stress
~*~Patent ductus arteriosus (when the vessel that leads from the pulmonary artery to the aorta does not close.)
~*~Polycythemia (an excess of red blood cells)

~*~General signs of being "sick": less active, more apnea(temporary cessation of breathing), increased respiratory problems, difficulty keeping his/her body temperature normal.
~*~Poor tolerance to feedings, vomiting or not putting through the milk placed in the stomach (called aspirates or residuals). These may be greenish in color.
~*~Abdominal distention or increased size of the tummy.
~*~Redness or an abnormal color to the tummy.
~*~Blood in the stool (visible or microscopic)
~*~Diarrhea

If NEC is suspected, any or all of the following might be done.
~*~All regular feedings will be stopped. The baby will have an IV started so s/he can be fed by vein. This could go on for weeks to let the bowel heal.
~*~A tube placed into the stomach either from the mouth or nose. The tube removes air and fluids from the baby's stomach and intestines.
~*~The tummy size will be measured with a tape measure and watched carefully.
~*~X-rays of the tummy (may be done every 8-12 hours to check for rupture of the bowel wall.)
~*~Antibiotics will be started in case of an infection.
~*~A sample of the blood will be sent to the laboratory to see if it contains bacteria.
~*~More frequent blood tests to look for signs of infection.
~*~The baby may require supplemental oxygen or ventilation because of apnea and shock.

If intestinal perforation (hole) or peritonitis (inflammation of the abdominal wall) develop, SURGERY is indicated. If only the innermost lining of the bowel dies, the body can slowly regrow it. It the entire thickness of a piece of bowel dies, then that part of the bowel must be removed. The end of the bowel above the removed segment may be brought to the surface of the skin (called an ostomy). At some later time, after the baby has recovered and grown much bigger, the two ends of the bowel can be sewn back together again.

Approximately 75% of infants who develop NEC survive. Most babies who recover from NEC do not have further problems; but future problems are possible. These include:
~*~scarring and narrowing of the bowel causing an obstruction or blockage of the bowel. These complications may require surgery later on.
~*~Malabsorption or inability of the bowel to absorb nutrients normally.
~*~Infants with NEC may also develop signs of shock or problems with blood clotting.
~*~If the disease is extensive, the amount of healthy bowel remaining may be quite short and unable to absorb enough nutrients and water from the stool. This is called "Short Bowel Syndrome," or "Short Gut." Babies with short gut require intravenous nutrition (TPN) for a prolonged period of time. They also need special formula and nutrient supplements.

I have not found a lot of information about NEC as it is still a mystery as to the cause. I hope this site has helped a little. The March of Dimes currently has three research studies going on right now about NEC.