Necrotizing Enterocolitis

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in a newborn baby.

NEC most often happens in babies born premature, but can also happen in full-term babies.

NEC occurs in about 10 percent of all babies born weighing less than 3½ pounds.

NEC is an illness which happens when the tissue in the small or large intestines is injured. If the injury continues to spread, a hole in the intestinal wall may occur that allows bacteria to leak out and cause an infection. The section of injured intestine may need to be surgically removed. These babies can become very sick.

While there appears to be no single cause of NEC, research has identified that prematurity is the most significant risk factor.  

Since the early signs of NEC look like other medical problems, this illness is often difficult to diagnose. However, symptoms might include:

  • A swollen and / or tender stomach
  • Skin over stomach looks red
  • Bloody bowel movements
  • Little or no interest in feeding
  • Green colored vomit or drainage  
  • Signs of infection, such as lethargy or long pauses in breathing (apnea)
  • Low or high temperature

Abdominal X-rays are done to look for NEC. An X-ray may show multiple small bubbles within the wall of the intestine. Ongoing X-rays help to track the illness. In severe cases, the X-ray may show extra air or gas from a hole in the intestines.

Close follow-up with the doctor is needed once the baby goes home. Sometimes the baby needs to see a special doctor for gut and nutrition problems. Babies who survive NEC may have a greater chance of having developmental problems than other babies, especially if they need surgery for NEC. Each baby’s plan will be different depending on their special needs.

Last Updated 04/2020

Reviewed by Patricia Froese, DNP, APRN, NNP
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