Julie Rackliffe Lucey, MS
Necrotizing enterocolitis (NEC) is a serious condition of the intestine. The intestine digests food as it propels it through the digestive tract. NEC involves intestinal inflammation and tissue death. This condition often occurs soon after your baby starts feeding.
NEC can be a serious condition and requires immediate care. It often occurs in the first 2 weeks of life, but can occur as late as 3 months of age. The baby is often still in the hospital when NEC starts.
The exact cause of NEC is not known. Below is a possible series of events that can lead to NEC:
NEC is mostly found in premature and very low birthweight babies, but it can occur in full-term infants. Factors that may increase your baby's chance of NEC include:
NEC may cause:
General signs of infection include:
You will be asked about your baby’s symptoms and medical history. A physical exam will be done. Your baby's doctor will work with a specialist to diagnose NEC.
Your baby's bodily fluids will be tested. This can be done with:
Images may be taken of your baby's bodily structures. This can be done with:
Most babies who get NEC have a complete recovery. Treatment usually takes between 3 to 14 days. Talk with your doctor about the best treatment plan for your baby. Treatment options include combinations of the following:
Air or liquid in your baby’s intestine can make the condition worse. You will be asked to stop feeding your baby. A tube will be placed through the baby's nose into the stomach. This tube will remove liquid and air from your baby’s stomach. This helps the intestine heal.
Nutrition and fluids will be given to your baby through an IV. An IV can deliver nutrition directly into your child's blood stream.
Antibiotics are used to fight infections caused by bacteria. Your baby may be given antibiotics if an infection is present or possible.
X-rays will be done often. They will help your doctor see the progress of the NEC.
NEC can cause swelling in the stomach. This may make it difficult for the baby to breathe. Oxygen may be given to improve the baby's oxygen levels. A ventilator may be used to help or take over breathing for the baby.
Some infections can pass easily through touch or near contact. Certain steps can keep these infections from spreading. You and your baby's caretakers may wear gowns and gloves to protect your baby and others. Regular handwashing is also important for infection prevention.
For some, the damage to the intestine may be severe. In this case, surgery may be needed.
Surgery is done to remove the damaged part of the intestine. The healthy parts are sewn back together when possible. Sometimes there is too much damage to be able to sew the intestine back together. In this case, part of the intestine will be connected to an opening in the abdomen wall. The opening will allow waste products to pass to a bag outside the body.
Prevention is difficult since the exact cause of NEC is unknown. Some steps that may be helpful include:
Healthy Children—American Academy of Pediatrics
National Institute of Child Health and Human Development
Public Health Agency of Canada
Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for necrotizing enterocolitis (NEC) among very low birth weight infants. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2010 Oct 7. Accessed July 25, 2012.
Necrotizing enterocolitis. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T115939/Necrotizing-enterocolitis. Updated June 30, 2016. Accessed September 26, 2016.
Pietz J, Achanti B, et al. Prevention of necrotizing enterocolitis in preterm infants: A 20-year experience.
Pediatrics. 2007; 119:164-170.
Last reviewed September 2016 by Kari Kassir, MD
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