Necrotizing enterocolitis (NEC) is the death of tissue in the intestine. It occurs most often in premature or sick babies.
Necrotizing enterocolitis occurs when the lining of the intestinal wall dies. This problem nearly always develops in an infant who is ill or premature. It is likely to occur while the infant is still in the hospital.
The exact cause of this disorder is unknown. A drop in blood flow to the bowel can damage the tissue. Bacteria in the intestine may also add to the problem. Also, premature infants have an undeveloped immune response to factors such as bacteria or low blood flow. An imbalance in immune regulation appears to be involved in NEC.
Babies at higher risk for the condition include:
Infants who are fed formula rather than human milk. (Human milk contains growth factors, antibodies and immune cells which may help prevent the problem.)
Infants in a nursery where an outbreak has occurred
Infants who have received blood exchange transfusions or have been seriously ill
Symptoms may come on slowly or suddenly, and may include:
Liver problems from prolonged inability to tolerate enteral feeds and need for parenteral (IV) nutrition
Short bowel syndrome if a large amount of intestine is lost
When to Contact a Medical Professional
Get emergency medical care if any symptoms of necrotizing enterocolitis develop. Infants who are hospitalized for illness or prematurity are at higher risk of NEC. They are watched closely for this problem before they are sent home.
Caplan M. Necrotizing enterocolitis of the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap. 94.
Kimberly G Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.