Neonatology
Necrotizing Enterocolitis (NEC)
Necrotizing
enterocolitis (NEC) is an infection of the
intestine in premature infants after they have
begun feeding. At birth, an infant's gastrointestinal
tract contains no bacteria. Once feeding begins,
the normal process of bacterial colonization of
the intestine begins.
Older babies, children and adults have large
amounts of bacteria in their intestinal tracts,
but do not develop infections because their immune
systems and intestinal defenses are mature. In
contrast, premature infants can develop NEC because
their resistances to infection are not fully developed.
Early signs of NEC may include:
- Feeding intolerance
- Increased size of the abdomen
- Abdominal firmness and apparent discomfort
- Blood in the stool
- Lethargy
- Temperature instability
If NEC is suspected, an abdominal X-ray will
be done to look for changes in the intestine that
are characteristic of NEC. Blood tests may be
done to check for evidence of infection and the
infant started on antibiotics.
Treatment
Feedings will be stopped, and intravenous
fluids and antibiotics given. A tube may be
placed from the mouth to the stomach to remove
air that the baby swallows, in order to reduce
distention of the intestines. Occasionally, NEC
is severe and requires surgery.
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