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Patient education: Newborn necrotizing enterocolitis (The Basics)

Patient education: Newborn necrotizing enterocolitis (The Basics)

What is newborn necrotizing enterocolitis? — Newborn necrotizing enterocolitis, or "NEC," is a condition that happens when there is a serious injury to a baby's intestines. NEC can happen in all newborn babies, but is most common in premature babies.

NEC is a serious disease. A baby who has it needs treatment as soon as possible. This is because the injury can destroy parts of the intestine. This damage can be permanent. In some very sick babies, it can even cause death.

What are the symptoms of NEC? — Symptoms usually happen 10 days to a few weeks after birth. Doctors usually find NEC in babies who are already in the hospital. This is because NEC usually happens in premature babies, or sick babies who are born on time.

Symptoms can include:

Feeding problems, such as:

Vomiting

Diarrhea

Milk or formula that stays in the stomach, instead of going into the intestines the way that it should

Bleeding from the rectum

Some symptoms of NEC can also happen with other conditions. These symptoms include:

Long pauses with no breathing (called "apnea")

Acting sleepy a lot of the time – It can be hard to wake the baby up.

Skin that feels too warm or too cool

If the doctors and nurses taking care of your baby think that they might have NEC, they can do an exam and treat the condition.

Will my baby need tests? — Yes. Doctors can order some or all of these tests:

X-ray of the belly

Ultrasound of the belly – An ultrasound is an imaging test that uses sound waves to create a picture of the inside of the body.

Blood tests

Tests on a sample of the baby's bowel movement

Imaging tests such as X-ray and ultrasound show changes in the intestines caused by NEC. Blood tests and tests on a sample of bowel movement might help doctors tell if NEC or a different condition is causing the symptoms. Other diseases can cause symptoms like those of NEC.

How is NEC treated? — A baby with NEC needs treatment right away. Treatments can include:

Stopping all feeds through the mouth or feeding tube

Giving fluids and nutrition through a thin tube that goes into a vein, called an "IV"

Putting a thin tube, called a "nasogastric tube," in the baby's nose, down the esophagus, and into the stomach. (The esophagus is the tube that carries food to the stomach.) If there is extra fluid or air in the stomach or intestines, the tube can suck it up. This can relieve belly swelling and help stop vomiting.

Giving medicines or blood transfusions to help bleeding problems or other problems – During a blood transfusion, the baby will get blood that has been donated by someone else. The donated blood goes into a vein.

Antibiotics to fight infection

Surgery – Doctors can drain fluid from the belly or take out a part of the intestine that has serious damage.

Babies with NEC can be very sick. During treatment, they might need:

Medicines to help the heart

A breathing machine or oxygen to help them get enough air in the lungs

Babies getting treatment for NEC will often have X-rays, blood tests, and tests on samples of bowel movements. All of these tests can show if the NEC is getting better or worse.

This topic retrieved from UpToDate on: Jan 01, 2023.
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