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- Premature babies do not have fully developed intestines. This may make it difficult for the intestines to handle the stress of moving food.
- The stress may cause a decrease in oxygen or blood flow to the intestines. The loss of oxygen and blood flow can cause damage to the intestine.
- Bacteria can enter the intestine through the damaged area. The bacteria can lead to an infection and swelling. This will weaken the wall of the intestine even further.
- If the process continues it can make a hole in the intestine.
- Was born before his or her due date
- Had a difficult delivery or low oxygen levels during labor
- Has a gastrointestinal infection
- Had indomethacin or early dexamethasone treatment
- Is considered “high risk” and has started taking milk by mouth or feeding tube
- Difficulty feeding
- Feedings stay in baby’s stomach longer than expected
- A sudden increase in bowel movements, or lack of bowel movements
- Bloody bowel movements
- Baby doesn’t pass a lot of gas
- Belly may be bloated, tender to the touch, or red
- Vomit—may be greenish in color
General signs of infection, such as:
- Stopping breathing or difficulty breathing
- Low heart rate
- Temperature instability
- Cool, clammy skin
- Lab tests—complete blood count, electrolytes, and blood culture may be done. This will be done to look for infections.
- Ultrasound of the abdomen—ultrasound can create images with certain details that are difficult to catch on a standard x-ray
- X-ray of the abdomen—images of the entire abdomen which may show a leak in the intestine
Empty the Stomach
- Breastmilk may reduce the chance of NEC compared to formula
- The first feeding may be postponed until your baby is stable. Increase the feeding amount very slowly.
- Closely observe your baby for signs of feeding intolerance.
- Probiotics may help decrease the risk of NEC.
American Academy of Pediatrics http://www.healthychildren.org/
National Institute of Health & Human Development http://www.nichd.nih.gov/
Health Canada http://www.hc-sc.gc.ca/
Maternal and Infant Health Public Health Agency of Canada http://www.phac-aspc.gc.ca/
DynaMed Editorial Team. Necrotizing enterocolitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 10, 2012. Accessed July 25, 2012.
Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for necrotizing enterocolitis (NEC) among very low birth weight infants. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2010 Oct 7. Accessed July 25, 2012.
Pietz J, Achanti B, Lilien L, Stepka E, Mehta S. Prevention of necrotizing enterocolitis in preterm infants: A 20-year experience. Pediatrics . 2007; 119:164-170.
- Reviewer: Kari Kassir, MD
- Review Date: 09/2013
- Update Date: 09/30/2013