Necrotizing Enterocolitis (NEC) and Preemies

What is Necrotizing Enterocolitis (NEC)?

Some premature babies develop a severe infection in their intestinal lining called necrotizing enterocolitis. This infection can be quite dangerous if it isn’t treated quickly enough because it has the potential to cause a puncture in the lining of the intestinal wall. When doctors recognize it early enough they can usually effectively treat it, although there are some cases where surgery is required. Sometimes babies become very ill with necrotizing enterocolitis. The danger is magnified by the fact that most babies who develop the disorder are preemies, and therefore less physically capable of coping with infections. Most cases of NEC occur during the first two weeks of the baby’s life, which is obviously a critical time, especially for a premature infant.

Causes

The presence of small amounts of bacteria in the intestines is normal. But with premature infants, the intestines are often more fragile than full term babies. Bacteria can sometimes get inside the intestinal wall, leading to a serious infection. Experts aren’t certain why this situation occurs, but it is thought that it has to do with lower oxygen levels in the blood stream. It also seems to be more common in cases where the birth was especially difficult, possibly due to oxygen deprivation during the birthing process.

Symptoms

Most symptoms of NEC are directly related to the digestive system. For example, a swollen stomach is a classic sign, and many children might suffer with vomiting or blood in their stool. Some babies may pass more stools than normal, while others may pass very little stool. Other signs include fever, redness in the skin around the stomach, and a lower than normal tolerance for being fed. In severe cases, the baby may also have irregular breathing.

Treatment

To treat necrotizing enterocolitis, doctors usually have to feed the child intravenously and stop providing milk. This allows the intestines to recover. Using antibiotics to kill the infection is also normally a standard part of the treatment. In cases where it takes too long for doctors to make a diagnosis, they might need to pump the child’s stomach as a way of removing infected fluids. Extremely severe cases may require surgery to remove part of the child’s intestine, which is common when the infant actually has a hole in the intestinal wall.

Prognosis

Most cases of necrotizing enterocolitis are treated without much difficulty, although it is understandably very stressful for the parents. In rare instances fatal infections are possible, usually related to bacteria leaking out of the intestines into the abdominal cavity. Even in those cases, surgery and other aggressive treatments can usually save the child’s life.

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