What is necrotizing enterocolitis?

Necrotizing enterocolitis is a serious disease that affects the intestines of premature babies. This usually occurs in the first 2 weeks of life in babies who are fed formula instead of breast milk.

In this state, the bacteria invade the intestinal wall. Inflammation sets in. This can create a crack or space that allows nasty germs to seep into the abdominal cavity. If left untreated, it can lead to serious infection and death.

What are the reasons?

The doctors are not sure. They know that premature babies have weaker and less developed lungs and intestines than full-term babies. This means that their bodies are not moving blood and oxygen around properly. They also have trouble breaking down food and fighting infections.

Who is at risk?

Fortunately, necrotizing enterocolitis is rare. It affects only one in 2,000 to 4,000 births. It can occur in any newborn, but is more common in premature babies. Others that may be at risk include:

High-risk or premature babies who are fed formula by mouth or tube
Those who had a difficult delivery or have lowered oxygen levels
Infants who have too many red blood cells in circulation
Babies with existing gastrointestinal infections
Seriously ill infants and those who’ve received a blood transfusion

What are the symptoms?

They may differ from child to child. But an infant with necrotizing enterocolitis usually develops the following symptoms during the first two weeks of life:

Swollen or bloated belly
Feedings that stay in the stomach and don’t move through the intestines
Green fluid in the stomach
Bloody poop
Trouble breathing, low heart rate, or sluggishness

Other digestive disorders or medical problems cause symptoms similar to necrotizing enterocolitis. If your child develops any of the above, call your doctor.

How is it diagnosed?

Your child's doctor will take an x-ray of the abdomen and do blood tests, usually in the neonatal intensive care unit. If it is necrotizing enterocolitis, an x-ray will show the presence of gas or air bubbles in their intestinal wall. The doctor may also insert a needle into your child's abdomen. If the fluid leaks out, then they have a hole in their intestines. Blood tests in infants with necrotizing enterocolitis show low levels of white blood cells. This means that your child's ability to fight infections is weakened.

What is the treatment?

This will depend on a number of factors, including how premature your baby is, their general health and medical history, and how far the infection has spread.

Your doctor may then do one of the following:

Stop feedings
Insert a tube through their nose and into their stomach to remove fluid and keep their stomach empty.
Start intravenous fluids to keep them nourished and hydrated
Give antibiotics to fight infection
Take regular X-rays to monitor the condition
Provide extra oxygen or a breathing machine if their belly is too swollen for them to breathe on their own
Keep them away from other babies to stop the spread of necrotizing enterocolitis
Once the infection is gone, your baby can start feeding again by mouth.

If they do not get better after treatment, or if they develop a hole in their intestines, they will need surgery. This includes removing dead tissues and parts of the intestine that have ruptured or are about to rupture. In the most severe cases, children who have had surgery may need to connect the bowel or bowel to an opening in the abdomen. Doctors call this a "stoma."

What is the outlook for necrotizing enterocolitis?

Most babies with this condition make a full recovery. In some cases, the intestine is scarred or shrunken. This may lead to blocking in the future. Babies who have had a large piece of intestine removed during surgery may not be able to absorb nutrients normally. In the most severe cases, they may need a bowel transplant to survive.

Currently, there is no way to prevent necrotizing enterocolitis. But studies show that babies who are exclusively breastfed are less likely to develop the disease. This is why doctors recommend giving breast milk to at-risk babies, starting with small amounts. Many neonatal intensive care units now use donated breast milk when it is not available from the mother to reduce the incidence of necrotizing enterocolitis.

Researchers are working on promising new treatments for necrotizing enterocolitis. Among them: probiotics, which are live bacteria and yeast that are good for you to fight infection-causing bacteria and block nitric oxide. This is the gas produced as a result of necrotizing enterocolitis. It helps break down the intestinal mucosa.