Topic Overview

What is necrotizing enterocolitis?

Necrotizing enterocolitis is
infection and
inflammation of the
intestine. It is most common in babies who are born
early (premature). Many newborns who have it go on to live healthy lives. But
if the infection becomes severe, it can cause severe damage to the intestine,
which can be deadly. Some children may have ongoing problems with digestion, growth, or development.

This condition usually happens within the
first 2 weeks after birth. But it may occur up to 3 months after birth.

What causes necrotizing enterocolitis, and can it be prevented?

Doctors
aren’t sure what causes this condition. It may occur when the immune and
digestive systems do not form in the right ways. This can happen when a baby is
born early or when there are problems during pregnancy or delivery.

Experts don’t know if feeding formula to a newborn can lead to
necrotizing enterocolitis. They do know that the disease is much less common in
babies who are fed breast milk.

Some doctors recommend probiotics to help prevent necrotizing enterocolitis in some infants who are at risk for it. Probiotics are bacteria that help maintain the natural balance of organisms (microflora) in the intestines.

What are the symptoms?

Symptoms depend on
how severe the problem is. They may include:

  • A swollen, tender, red, or shiny
    belly.
  • Constipation.
  • Dark, black, or bloody
    stools.
  • Low or unstable body temperature.
  • Chills and
    fever.
  • Fast heartbeat and breathing.
  • Not wanting to
    eat.
  • Vomiting.
  • Being less active or
    having little energy.

How is necrotizing enterocolitis diagnosed?

The doctor will ask about your baby’s symptoms
and past health. The doctor may do tests, such as:

  • An X-ray of your newborn’s belly.
  • A
    test to check for blood in your baby’s stool (fecal occult blood
    test).
  • Tests to check for bacteria in the stool, blood, urine, or
    spinal fluid.

How is it treated?

Your
baby will be treated in a hospital neonatal intensive care unit (NICU).
Treatment usually lasts 3 to 10 days. It may last longer if the condition is
severe. Treatment includes
intravenous (IV) feeding, antibiotics, and a tube that
goes in the nose to the stomach to remove extra fluids and gas from the
intestine.

If your baby does not get better with treatment or
gets a hole in the intestine, he or she may need surgery. About 1 out of 4 babies who have necrotizing enterocolitis
may need surgery.footnote 1 Surgery usually means having two procedures weeks or months apart. The first surgery removes damaged parts of the intestine and may create a colostomy or ileostomy so that the intestine can heal. (With an ostomy, stool leaves the body through an opening in the belly and collects in a bag.) A second surgery will be done to close the ostomy so that stool can pass through the body normally again.

After treatment, your baby
will be ready to leave the hospital when he or she is eating well and is not
losing weight. The nurse can show you how to feed and care for your baby at
home.

It is normal to feel overwhelmed when your baby has health
problems. It can be stressful to watch a tiny newborn get medical treatment.
You may feel frustrated if you can’t hold your baby as often as you want or
can’t breastfeed your baby. It may help to talk about your feelings and
concerns with a social worker or counselor. Be sure to ask your baby’s doctors
about anything you don’t understand.

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Frequently Asked Questions

Learning about necrotizing enterocolitis:

Getting treatment:

Other Places To Get Help

Organization

Nemours: KidsHealth for Parents/for Kids/for Teens/for Educators (U.S.)
Nemours: KidsHealth for Parents/for Kids/for Teens/for Educators (U.S.)
www.kidshealth.org

References

Citations

  1. Rosenburg A, et al. (2014). The newborn infant. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 9-74. New York: McGraw-Hill.

Other Works Consulted

  • Maheshwari A, Carlo WA (2011). Neonatal necrotizing enterocolitis. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 601-603. Philadelphia: Saunders.
  • AlFaleh K, et al. (2011). Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database of Systematic Reviews (3).
  • Brown RE, Neu J (2006). Necrotizing enterocolitis. In FD Burg et al., eds., Current Pediatric Therapy, 18th ed., pp. 293-296. Philadelphia: Saunders Elsevier.
  • Necrotizing Enterocolitis (NEC) Guideline Team, Cincinnati Children’s Hospital Medical Center (2010). Evidence-Based Guideline for Necrotizing Enterocolitis Among Very Low Birth Weight Infants. Guideline No. 28. Available online: https://www.cincinnatichildrens.org/service/j/anderson-center/evidence-based-care/necrotizing-enterocolitis.
  • Pammi M, Abrams SA (2011). Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants. Cochrane Database of Systematic Reviews (10).
  • Pammi M, Abrams SA (2011). Oral lactoferrin for the treatment of sepsis and necrotizing enterocolitis in neonates. Cochrane Database of Systematic Reviews (10).
  • Solomkin JS, et al. (2010). Diagnosis and management of complicated intra-abdominal infection in adults and children: Guidelines by the Surgical Infection Society and the Infection Society and the Infectious Diseases Society of America. Clinical Infectious Diseases, 50(2): 133-164. [Erratum in Clinical Infectious Diseases, 50(12): 1695.]

Credits

ByHealthwise Staff
Primary Medical Reviewer Sarah Marshall, MD – Family Medicine
John Pope, MD – Pediatrics
Specialist Medical Reviewer Brad W. Warner, MD – Pediatric Surgery

Current as ofMay 4, 2017