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Necrotizing Enterocolitis (NEC)


The Manual's Editorial Staff

Last full review/revision Dec 2019| Content last modified Dec 2019
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What is necrotizing enterocolitis (NEC)?

"Necrosis" or "necrotizing" means the death of some or all of the tissue in an organ. "Enterocolitis" means inflammation of the small and large intestines.

Necrotizing enterocolitis (NEC) is a life-threatening disease of newborn babies in which parts of the lining of their intestines becomes inflamed and dies.

What causes NEC?

Doctors don't know exactly what causes NEC, but it probably involves:

  • Poor blood flow to the intestine

The poor blood flow can allow normal bacteria in the intestine to attack the lining of the intestine. The lining becomes inflamed and bleeds.

The biggest risk factor for NEC is:

Other things that increase the risk of NEC include:

What are the symptoms of NEC?

Babies with NEC usually look very sick. They usually also have:

  • Swelling of the belly

  • Poor feeding

  • Throwing up blood or green, yellow, or red-colored fluid

  • Blood in the stool

What are the complications of NEC?

NEC can progress to affect the whole wall of the intestine and cause a:

Fluid and bacteria leak out of the hole into your child's tummy and cause a serious infection called peritonitis.

After NEC heals, your child's intestine may be scarred in places. After a few months, the scarring can partly close off the intestine and make it hard for digested food to go through (intestinal obstruction).

How can doctors tell if my baby has NEC?

Doctors suspect NEC from your baby's symptoms. They can tell for sure by doing:

  • X-rays of your baby's belly

How do doctors treat NEC?

Doctors treat NEC by:

  • Stopping regular feeding to let the intestines rest and heal

  • Giving fluid and nutrition by vein

  • Putting a suction tube into your baby's stomach to suck out digestive juices and keep them out of the inflamed area

  • Giving antibiotics by vein

  • Surgery, if your baby develops a hole in the intestine

Later on, if your baby's intestine is narrow and has scars, doctors do surgery to remove the narrow section.

What can prevent my baby from getting NEC?

The following may help prevent NEC:

  • Feeding your premature baby breast milk instead of formula

  • Avoiding highly-concentrated formula

  • Avoiding low oxygen levels in your baby's blood (the hospital will monitor this)

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