Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition that primarily affects premature babies and occurs when the intestinal tissue becomes inflamed. The dead tissue eventually creates a hole in the intestinal wall that causes waste and bacteria to leak out, possibly entering the bloodstream. While a clear cause has yet to be identified, NEC can lead to a life-threatening infection.
Typically developed within the first two to four weeks of life, NEC affects one in every 2,000 to 4,000 babies. As many as 10 percent of premature infants – born before 32 weeks – are impacted and necrotizing enterocolitis is responsible for 20 percent of neonatal intensive care cases.
One common cause of NEC is the consumption of cow’s milk-based formula, including the Enfamil and Similac brands. In addition to premature birth affecting the lungs and oxygen circulation, children born with a heart defect are more prone to NEC. Learn more about this dangerous medical issue.
Common Symptoms of NEC
If you’re the parent of a newborn, watch for the following signs of NEC during the first few weeks of life:
- The child does not tolerate or suddenly stops accepting feedings.
- They don’t appear to digest food and particles may remain in the stomach.
- They display abdominal distension – visibly significant bloating – and the area may appear red or bluish and tender.
- They express pain when someone touches the abdominal area.
- Their stools appear bloody, which can indicate an intestinal infection, they have diarrhea or stools have increased in volume and frequency.
- They may also be constipated or vomit up bile or green-yellow fluid.
- Their behavior suddenly changes, often characterized by lethargy and lack of activity.
- The child experiences shock, due to decreased blood pressure.
- Their body can’t keep a consistent temperature or their temperature suddenly becomes low.
- Their heart rate or breathing suddenly and sharply decreases
The latter three symptoms can indicate a more advanced or severe case of NEC and may be accompanied by a weak pulse. At this stage, bacteria-laden fluid may be gathering in the abdominal cavity, creating pressure and affecting how well an infant breathes. Infection and inflammation may have progressed through the body, including to the stomach lining.
Emergency care may involve the insertion of a breathing tube or use of a ventilator. The doctor overseeing the child’s care may recommend emergency surgery to remove dead intestinal tissue or repair the hole that has developed.
It’s also important to know that not all symptoms emerge at once and vary from child to child. In most cases, symptoms of NEC become apparent over several days.
Diagnosis of NEC
Unfortunately, symptoms of NEC present like other digestive issues, which can result in a delayed diagnosis or misdiagnosis. To confirm it’s NEC, the doctor may:
- Conduct imaging to identify abnormal gas patterns, including intestinal bubbles or air within the liver or abdominal area.
- Take a fluid sample from the abdomen to confirm the presence of a hole in the intestines.
- Request a blood test to determine if an infection is present.
- Request a sample of fecal matter to detect blood.
Treatment after a confirmed NEC diagnosis may entail:
- Temporarily stopping all feedings
- Draining fluid buildup from the intestines and abdominal area
- Replacing lost fluids and nutrition via IV
- Continuing to conduct imaging for the presence of air, to examine stool quality and check the blood for anemia
- Temporarily using a ventilator until swelling decreases
- Scheduling surgery
Many children recover from NEC. At this stage, feedings can resume and breast milk is recommended to supply the intestinal tract with sufficient bacteria. Especially for premature babies, these factors help strengthen the immune system’s ability to fight off infections.
However, some children may live with the effects of NEC long term, including absorption issues from short-gut syndrome and developmental delays. They may also temporarily live with a stoma or need to have nutrition delivered intravenously.
Did your child develop necrotizing enterocolitis after being fed a cow’s milk-based infant formula? Thirty years of research supports this correlation and parents are coming forward to hold manufacturers accountable for product liability and deceptive marketing practices. To find out if you have a claim, contact Trantolo & Trantolo today.
