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Necrotizing Enterocolitis in Children


What is necrotizing enterocolitis?

Necrotizing enterocolitis (NEC) is a disease that causes infection and inflammation in your baby's bowel. It usually happens within the first 2 weeks after birth and is more common in premature infants.

What increases my child's risk for necrotizing enterocolitis?

The cause of NEC is unknown. Bacteria are thought to be a possible cause. The following may increase your child's risk:

  • Premature birth: Your baby was delivered before the 37th week of pregnancy or had low birth weight.
  • Low oxygen or blood supply: A difficult delivery may have caused decreased oxygen or blood flow to your baby and may have harmed his bowel.
  • Formula feeding: Milk formula that is too concentrated or given too quickly may stress your baby's bowel and increase his risk for infection.
  • Infections: The bacteria that causes NEC may be spread from one baby to another.

What are the signs and symptoms of necrotizing enterocolitis?

  • Abdominal pain or bloating
  • Green vomit or bloody bowel movements
  • Breathing problems, such as apnea (breathing stops for more than 20 seconds)
  • Body temperature that changes quickly from very low to a fever
  • Frequent crying, fussiness, or sleeping more than usual
  • Poor sucking or feeding problems

How is necrotizing enterocolitis diagnosed?

  • Blood tests: These tests may be done to check for infection.
  • Bowel movement sample: A sample of your baby's bowel movement may sent to a lab for tests. This can help find the cause of the infection.
  • Abdominal x-rays: These are pictures of your baby's abdomen. Healthcare providers use these to look for problems, such as blockages. These may also check for air in his bowel or abdomen.

How is necrotizing enterocolitis treated?

Your baby may need to be given food and medicine through a tube into his stomach or through an IV.

  • Medicines:
    • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
    • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell healthcare providers if his pain continues or gets worse.
  • Special milk formulas and vitamins: These help make sure your baby gets proper nutrition. Your baby may need formulas that have fats and oils, which are easy to digest.
  • Surgery: Your baby may need surgery repair or remove a part of his bowel. He may also need a colostomy, which is a surgery where part of his bowel is connected to an opening on his abdomen. His bowel may be connected back when the infection and swelling have healed.

What are the risks of necrotizing enterocolitis?

  • Your child may get an infection or bleed after surgery. Scars may lead to narrowing of his bowel and a blockage. Babies with NEC are at higher risk for slow growth and poor nutrition.
  • If NEC is not treated, your baby's bowel cannot work well. He may not be able to absorb enough milk, food, and nutrients needed by his body. Damage to his bowel may lead to bleeding, fistulas (tunnel-like wound between the bowel and the skin), or perforations (holes). This allows bacteria to leak out and can cause sepsis (blood infection) and peritonitis (swelling in the abdominal covering). If the infection spreads, it may be life-threatening.

Further information

  • American Academy of Family Physicians
    11400 Tomahawk Creek Parkway
    Leawood , KS 66211-2680
    Phone: 1- 913 - 906-6000
    Phone: 1- 800 - 274-2237
    Web Address:

When should I contact my child's healthcare provider?

  • Your baby has a fever.
  • Your baby is irritable or crying more than usual.
  • Your baby's skin is itchy, swollen, or has a rash.
  • You have questions or concerns about your child's condition or care.

When should I seek immediate care or call 911?

  • Your baby has trouble breathing or his lips and fingernails turn blue.
  • Your baby is not able to eat or drink or urinates less or not at all.
  • Your baby has a seizure.
  • Your baby looks very weak or sleeps more than normal.
  • There is blood in your baby's vomit or diaper.
  • Your baby's wound or bandage has pus or smells bad.

Care Agreement

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's healthcare providers to decide what care you want for your baby. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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