Necrotizing Enterocolitis in Babies – Causes, Symptoms And Treatment

6 min read

Written by Editorial Team

Editorial Team

Necrotizing Enterocolitis in Babies

Preterm babies are relatively more exposed to different kinds of health issues than term babies. Is your baby born prematurely?  Underdeveloped lungs are not the only issue you should be concerned about.  There is another serious condition that adversely affects the intestine of preterm babies called Necrotizing Enterocolitis. It is very important to understand its symptoms and get treatment right away as this issue tends to progress very quickly and can take a dangerous turn.

While the disease is related to the baby’s digestive system, it is only diagnosed in babies with lower body weight than normal. In this guide, we shall cover all the important points about the causes and diagnosis of this disease, and its effective treatment to keep your baby’s body healthy and sound. So, let’s get started!

In This Article

What Is Necrotizing Enterocolitis?

NEC or Necrotizing Enterocolitis refers to a serious condition that affects the intestine of preemies. The condition, more often than not, affects the inner lining of the small intestine. It can also affect the colon. NEC usually occurs within the first two weeks after the baby is born, especially if the baby is fed formula instead of breast milk. In severe cases of NEC, a hole may form in the wall of the intestine that permits the bacteria, which are normally found inside the intestine, to seep out into the abdomen. This calls for a medical emergency because if the bacteria get into the bloodstream and other parts of the body, it can be life-threatening.

How Common is Necrotizing Enterocolitis in Babies?

How Common is Necrotizing Enterocolitis in Babies?

This disease is quite common among newborn babies who have less than normal body weight. NEC is most common in premature infants (especially those babies born before 32 weeks of gestation). It is rarely seen in full-term babies (though it is seen in some full-term babies with heart issues). Nearly 10% of preemies contract NEC.

Causes of Necrotizing Enterocolitis in Babies

The exact causes of Necrotizing Enterocolitis are not yet known. But here are some factors that may influence the condition.

  1. An underdeveloped intestine is the major reason for NEC.
  2. Formula feeding
  3. Any kind of injury to the intestinal lining
  4. A shortage of oxygen or blood in the newborn can trigger the functioning of the whole body, which creates massive damage to the intestinal cells.
  5. Abnormal increase of intestinal bacteria
  6. Babies of age group 2 to 4 years suffering from congenital heart disease are more prone to NEC.

Risk Factors For NEC in Babies

Risk Factors For NEC in Babies

Babies are the most beings owing to the fact that most of their organs still do not fully develop at birth. For underweight or premature babies, their bodies are not fully developed to digest the bacteria present around them. Thus, the following are some of the risk factors that might lead to necrotizing enterocolitis:

  1. Lack of standardized feeding protocol
  2. Cardiac disease with poor perfusion
  3. Antibiotics
  4. Extremely low birth weight
  5. Reduction in gastric acidity
  6. Acute hypoxia
  7. The quick advancement of feeds
  8. Baby’s Feeding Formula
  9. Preemies having tube feeding
  10. Babies born with a gastrointestinal infection
  11. Babies with an increased number of RBC are prone to NEC

Symptoms Of Necrotizing Enterocolitis in Babies

There are a plethora of signs and symptoms that may lead to the disease of necrotizing enterocolitis.

  • Vomiting
  • Diarrhea
  • Poor Feeding
  • Lethargy
  • Discoloration of the abdomen
  • Disrupted breathing
  • Bloody stool
  • Fever
  • Swelling of the abdomen

Diagnosis of NEC in Babies

Diagnosis of NEC in Babies

Here are some of the ways in which a doctor will diagnose necrotizing enterocolitis in babies.

1. Physical Examination

The first step is to examine the symptoms. If the baby shows any of the typical symptoms of the disease, the doctor may decide to run a few tests.

2. X Ray

A simple X-ray of the abdomen showing results of some bubbly appearance in the lower part of the intestine and the availability of air in the large veins of the liver. Also, air might be present on the outer part of the intestines in the abdomen. The technician or doctor will insert a small needle in the abdomen area to check for the presence of NEC disease and to check for withdrawal of intestinal fluid from the abdomen hole.

Complications of NEC in Babies

NEC might lead to the enlargement of the intestinal wall creating an intestinal blockage. Perforation in the intestinal wall is another complication. Perforation takes place in the areas of the colon, terminal ileum, and the proximal small bowel. Another complication that arises due to NEC is malabsorption. In this condition, the intestine fails to absorb nutrients. It’s more likely to develop if a section of the intestine is removed as a part of treatment.

Treatment of Necrotizing Enterocolitis in Babies

Treatment of Necrotizing Enterocolitis in Babies

The condition of necrotizing enterocolitis can be treated quickly using the doctor’s guidelines and medications. It also depends on the severity and overall health condition of the child. Irrespective of the treatment, the baby will be under continuous monitoring. Now, let’s have a look at the specific treatments suggested for the baby suffering from NEC:

  1. Antibiotics to fight the infection
  2. Surgical removal of damaged/dead part of the intestine
  3. The extra oxygen in the case of a swollen abdomen which is in interfering with the breathing process.
  4. Nasogastric tube to keep the stomach empty
  5. Intravenous fluids (IV) for nutrition and fluid replacement.
  6. Isolation procedures to keep any infection from spreading
  7. Stopping feedings
  8. Frequent X-rays for monitoring the progress of the disease.
  9. Connecting part of the intestine or bowel to an ostomy.

How To Prevent NEC in Babies?

Given below are some of the most effective preventive measures for NEC:

1. Mixed Flora Probiotics

Supplements that have probiotics and beneficial yeast or bacteria are excellent for preventing NEC in babies.

2. Breast Milk Feeding

Mother’s milk is powerful enough to provide all the vital nutrients to fight any type of baby’s problems.

3. Cautious Feeding Strategy

Formula milk can be unsafe for babies. Hence it is important that babies exclusively have mother’s milk during this period.

4. Fluid restriction

It is advised to delay feeding in this phase until the baby gets out of threat.

It is important not to neglect Necrotizing Enterocolitis as your baby may be prone to severe conditions if this is ignored. Also, follow all the guidelines provided by the doctor religiously and try keeping your baby in intensive care for quick recovery.


1. Can a Baby Survive NEC?

Most babies do recover from NEC. In rare cases, some babies may develop issues related to the digestive system such as issues with the bowels and intestines. These issues will ultimately affect the absorption of nutrition and need surgeries to correct the conditions.

2. What Are The Stages of NEC?

There are three identified stages for NEC- Stage 1 or Suspected NEC which symptoms such as bloody stools, lethargy, slow heart rate, stomach bloating and vomiting; Stage 2 or Definite NEC with additional symptoms of reduced platelet count, slightly elevated lactic acid levels, reduced or no intestinal movement, and abdomen that is painful to the touch and  Stage 3 or advanced NEC with additional symptoms of low blood pressure, low white blood cells, blood clotting etc.

3. How Long is Bowel Rest For NEC?

This depends on the stage of the NEC and the severity of the condition. For Stage 2 or definite NEC bowel rest of 7 days is recommended and for stage 3 or advanced NEC, bowel rest for 2 weeks along with related treatments is recommended

Editorial Team,

With a rich experience in pregnancy and parenting, our team of experts create insightful, well-curated, and easy-to-read content for our to-be-parents and parents at all stages of parenting.Read more.

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