Necrotizing Enterocolitis

Topic Overview

What is necrotizing enterocolitis?

Necrotizing enterocolitis is infection and inflammation of the intestines. The disease is most common among premature newborns. Many newborns who develop necrotizing enterocolitis survive and go on to live healthy lives. But if the infection becomes severe, it can cause serious damage to or holes in the intestinal tissue, which can be life-threatening.

Necrotizing enterocolitis most commonly develops 10 to 16 days after birth, usually while a premature newborn is still in the hospital. In some cases, necrotizing enterocolitis develops up to 3 months after birth.

See a picture of necrotizing enterocolitis.

What causes necrotizing enterocolitis?

The cause of necrotizing enterocolitis is not clear. It is believed to occur when the immune and digestive systems do not develop properly. This can happen when a baby is born prematurely or when there are complications during pregnancy or delivery.

Experts do not know if feeding a newborn formula can lead to necrotizing enterocolitis, but they do know that the disease is much less common in babies who are fed breast milk.

What are the symptoms?

Often, a newborn baby is feeding well, healthy, and growing before he or she develops any symptoms of necrotizing enterocolitis. A baby's symptoms depend on how severe the condition is. If your baby has necrotizing enterocolitis, he or she may:

• Have a swollen, tender, red, or shiny belly.
• Not want to eat, or may be throwing up (vomiting).
• Be constipated.
• Have dark, black, or bloody stools.
• Have low or unstable body temperature.
• Not be very active, or may have little energy.

How is necrotizing enterocolitis diagnosed?

Necrotizing enterocolitis is diagnosed from a newborn's symptoms, medical history, and test results. Tests may include an abdominal X-ray to provide a picture of your newborn's intestines; a test to check for blood in the stool (fecal occult blood test); and other tests to check for bacteria in the stool, blood, urine, or spinal fluid.

How is it treated?

If your newborn has necrotizing enterocolitis, he or she will need to be treated in a hospital, often in a neonatal intensive care unit (NICU). In newborns who have mild to moderate necrotizing enterocolitis, treatment consists of intravenous (IV) feeding, antibiotics, and removing extra fluids and gas from the intestine. This treatment usually lasts between 3 and 10 days.

If your newborn does not improve with treatment, or if he or she gets a hole in the intestines, surgery to remove damaged parts of the intestines may be necessary. Up to half of newborns with necrotizing enterocolitis need surgery.¹ Many newborns who have surgery for necrotizing enterocolitis survive and go on to live healthy lives.

Frequently Asked Questions

Learning about necrotizing enterocolitis:	What is necrotizing enterocolitis? What are the symptoms? Who is affected by necrotizing enterocolitis? What increases my child's risk for necrotizing enterocolitis? 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 manage necrotizing enterocolitis at home? What complications can arise?

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Author:	Debby Golonka, MPH	Last Updated: July 20, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Jennifer Merchant, MD - Neonatal-Perinatal Medicine Anne C. Poinier, MD - Internal Medicine
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