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What Is Necrotizing Enterocolitis (NEC) in a Premature Baby?

A premature baby faces many challenges, including infections, underdeveloped lungs, and other complications. Each can put the baby at risk for death or permanent impairments. Necrotizing enterocolitis (NEC) is one of the serious illnesses that premature babies may develop.

NEC occurs when the tissue in the colon (large intestine) becomes inflamed. The inflammation can destroy or damage the tissue in the colon. Any newborn can contract NEC, but it is more common in premature infants, especially when the baby has a low birth rate and is very early.

What Causes a Premature Baby to Develop Necrotizing Enterocolitis?

NEC is a mystery. Doctors are not sure why some premature babies develop necrotizing enterocolitis. 

Some reasons that a baby could develop the condition might include:

  • A lack of oxygen and blood to the infant’s intestinal tissues
  • Bacteria from the environment

Several factors can put a baby at a higher risk for developing NEC, especially premature birth and low birth weight. Premature babies who drink formula instead of breast milk also appear to be at risk for developing NEC. Human milk is easier for the baby to digest and contains substances that help the baby fight infections.

Low oxygen levels at birth and difficult labor and deliveries also increase the odds of NEC. When a baby’s body does not receive enough oxygen, the body sends oxygen to the heart and brain first. The intestines may not receive enough oxygen, causing damage to the tissues in the colon.

If a baby has an infection or the damage to the colon tissue is severe, a hole may form in the intestinal wall, which allows liquids to leak into the baby’s abdomen. This situation is extremely dangerous and can result in severe, life-threatening infections. 

What are the Symptoms of NEC?

Babies at high risk of developing NEC should be closely monitored for symptoms of necrotizing enterocolitis. NEC symptoms may develop in the first two weeks after birth.

NEC symptoms might include:

  • Food does not move through the baby’s intestines correctly
  • The baby has bloody stool and bowel movements
  • Abdominal distention (swelling or bloating of the belly)
  • Bile (greenish-colored fluid) in the baby’s stomach
  • Diarrhea and/or vomiting
  • Unstable body temperature, heart rate, breathing, or blood pressure
  • Feeding problems

In addition to NEC signs, health care professionals and parents should also watch for signs of infection. Signs of infection may include slow heart rate, apnea (breathing that stops and starts), lethargy (sluggishness). 

NEC may be diagnosed by observing the baby for marks of necrotizing enterocolitis. Also, a doctor may order an x-ray to check the infant’s intestine for signs of NEC. The appearance of gas or air in the large veins of the baby’s liver or outside the intestines are signs that the baby has NEC.

How Do Doctors Treat Necrotizing Enterocolitis?

The treatment for NEC depends on the severity and type of symptoms your infant experiences. The child’s age and health may also factor into the decision for a treatment plan.

Treatments for necrotizing enterocolitis may include:

  • Using an IV to give the infant nutrition and fluids after stopping feedings
  • Giving the baby antibiotics to treat infections
  • Keeping the baby’s stomach empty by running a tube down the infant’s nose into the stomach (NG or nasogastric tube)
  • Giving the baby oxygen treatments using a breathing machine
  • Taking x-rays to monitor how the illness is progressing

In severe cases of NEC, an infant may need surgery to remove the damaged portion of the bowels or intestine. Doctors may need to drain the abdominal cavity or perform an ostomy (connecting part of the bowel or intestine to an opening in the abdomen. 

An infant may develop complications related to necrotizing enterocolitis. As discussed above, a hole in the intestines can result in a life-threatening infection, including sepsis

Some babies who have NEC have trouble absorbing nutrients or food. Strictures or scars may develop in the intestine. In severe cases, a baby may die because of necrotizing enterocolitis or complications from NEC.

Can NEC Be Prevented?

Unlike some other birth injuries or conditions, the exact cause of NEC remains unknown. Therefore, it is difficult to predict or prevent. However, giving premature babies breastmilk can reduce the risk of NEC. Also, regulating the amount of breastmilk after the baby is stable and slowly increasing how much the baby eats can help.

Doctors should monitor premature babies closely for signs of NEC; a healthcare professional should watch for signs of necrotizing enterocolitis and immediately begin treatment if the baby appears to have NEC.

Parents who are concerned that their doctors missed NEC or caused their baby to be injured or harmed because of medical malpractice or medical negligence should contact a birth injuries lawyer in Boston. 

Common birth injuries include, but are not limited to:

The time to file claims for labor and delivery injuries is limited. Do not wait too long to discuss your legal rights and options for seeking damages caused by negligent doctors and health care providers. 

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