necrotizing enterocolitis

What is Necrotizing Enterocolitis (NEC)?

Necrotizing enterocolitis is both a common and quite serious intestinal issue among premature babies. It’s much less common in full-term infants, but still possible. Studies show NEC occurs in 9.1% of babies born prematurely, and it affects 1 in 7 infants that weigh 1500 grams or less at birth. When a premature infant’s large or small intestine becomes injured or inflamed, it can cause the surrounding tissue to die. “Necrotizing” literally means “causing the death of tissues.” Enterocolitis is defined as inflammation of both the small intestine and colon.

Necrotizing Enterocolitis Symptoms & Diagnosis

Doctors typically look for the following signs and symptoms when diagnosing babies with necrotizing enterocolitis:

  • Difficulty feeding
  • Constipation
  • Diarrhea or dark, bloody bowel movements
  • Slowed-down heart rate (i.e., bradycardia)
  • Belly appears swollen, red, or tender to the touch
  • Pauses in breathing (i.e., apnea)
  • Green vomit that contains stomach bile
  • Lethargy/sluggishness compared to usual activity levels
  • Food not moving through the digestive tract as expected
  • Lower than expected or unstable body temperature
  • Sudden drops in blood pressure (i.e., hypotension)

An abdominal X-ray can help doctors determine if babies with these symptoms have necrotizing enterocolitis. The X-ray should reveal key indicators for diagnosing NEC, which include:

  • Air or gas in the large veins surrounding the baby’s liver
  • Intestines appear bubbly or swollen
  • Air moving from the intestines to the baby’s belly/abdominal area

If the X-ray doesn’t give a clear enough picture, the doctor may insert a needle into the baby’s abdomen to look for intestinal fluid. If fluid exists there, it indicates the baby has intestinal perforation from NEC.

How Doctors Treat Babies With NEC

As soon as doctors confirm the baby’s necrotizing enterocolitis diagnosis, treatment can begin.

  1. Pause all feedings.
  2. Insert a tube through the baby’s nose or mouth to remove air and any fluids from the stomach and intestines. The baby’s stomach must remain empty during treatment.
  3. Insert IV to deliver fluids and nutrition to the baby as needed.
  4. Antibiotics to prevent infection or treat any that currently exist.
  5. Frequent X-rays and exams to track the baby’s NEC progression.
  6. Isolation from other babies in the hospital or NICU ward to avoid potential spread of infection.
  7. Babies with abdomens swollen enough to interfere with their breathing also receive oxygen.

Severe NEC cases may require immediate surgery to remove dead tissue and drain fluids from the baby’s abdominal cavity.

If you would like to learn more about negligence and the role it plays in your case, please contact Levin, Rojas, Camassar, and Reck, LLC today.