Necrotizing Enterocolitis

Topic Overview

What is necrotizing enterocolitis?

Necrotizing enterocolitis is infection and inflammation of the intestine. It is most common in babies who are born early (premature). Many newborns who have it go on to live healthy lives. But if the infection becomes severe, it can cause severe damage to the intestine, which can be deadly.

This condition usually happens within the first 2 weeks after birth. But it may occur up to 3 months after birth.

See a picture of necrotizing enterocolitis .

What causes necrotizing enterocolitis?

Doctors aren't sure what causes this condition. It may occur when the immune and digestive systems do not form in the right ways. This can happen when a baby is born early or when there are problems during pregnancy or delivery.

Experts don't know if feeding formula to a newborn can lead to necrotizing enterocolitis. They do know that the disease is much less common in babies who are fed breast milk.

What are the symptoms?

A newborn baby usually is healthy before he or she starts to have symptoms of necrotizing enterocolitis. Symptoms depend on how severe the problem is. Symptoms may include:

• A swollen, tender, red, or shiny belly.
• Constipation.
• Dark, black, or bloody stools.
• Low or unstable body temperature.
• Chills and fever.
• Fast heartbeat and breathing.
• Not wanting to eat.
• Throwing up (vomiting).
• Being less active or having little energy.

How is necrotizing enterocolitis diagnosed?

The doctor will ask about your baby’s symptoms and past health. The doctor may do tests, such as:

• An X-ray of your newborn’s belly.
• A test to check for blood in your baby’s stool (fecal occult blood test).
• Tests to check for bacteria in the stool, blood, urine, or spinal fluid.

How is it treated?

Your baby will be treated in a hospital neonatal intensive care unit (NICU). Treatment usually lasts 3 to 10 days. It may last longer if the condition is severe. Treatment includes intravenous (IV) feeding, antibiotics, and a tube that goes in the nose to the stomach to remove extra fluids and gas from the intestine.

If your baby does not get better with treatment or gets a hole in the intestine, he or she may need surgery to remove the damaged parts of the intestine. Up to half of babies who have necrotizing enterocolitis need surgery.¹ Many babies who have surgery for this condition go on to live healthy lives.

After treatment, your baby will be ready to leave the hospital when he or she is eating well and is not losing weight. The nurse can show you how to feed and care for your baby at home.

It is normal to feel overwhelmed by having a baby with health problems. It can be stressful to watch a tiny newborn get medical treatment. You may feel frustrated if you can't hold your baby as often as you want or can't breast-feed your baby. It may help to talk about your feelings and concerns with a social worker or counselor. Be sure to ask your baby’s doctors about anything you don't understand.

Frequently Asked Questions

Learning about necrotizing enterocolitis:	What is necrotizing enterocolitis? What are the symptoms? Who gets necrotizing enterocolitis? What increases my child's risk? How can I prevent it?
Being diagnosed:	How is necrotizing enterocolitis diagnosed?
Getting treatment:	How is it treated? Will my child need surgery to treat it?
Ongoing concerns:	How can I help my child at home? What complications can happen?

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Author:	Maria G. Essig, MS, ELS	Last Updated: May 5, 2009
Medical Review:	Michael J. Sexton, MD - Pediatrics Jennifer Merchant, MD - Neonatal-Perinatal Medicine
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