What is Necrotising Enterocolitis?

Necrotising enterocolitis (NEC) is a serious and potentially life-threatening condition that affects the intestines of newborn infants, most commonly those who are born prematurely.

What happens in NEC?

In NEC, portions of the intestinal tissue become inflamed, and this can lead to:

• Tissue death (necrosis) in the intestinal wall

• Perforation (a hole) forming in the intestine

• Bacteria leaking into the abdomen and bloodstream, leading to sepsis

Who is at risk?

• Premature infants, especially those born before 32 weeks of gestation

• Babies with very low birth weight (<1500 grams)

• Infants with congenital heart disease

Symptoms of NEC

• Swollen or tender belly

• Feeding intolerance or vomiting (especially green bile)

• Bloody stools

• Temperature instability

• Lethargy or apnea (pauses in breathing)

Diagnosis and Treatment

• Diagnosed with abdominal X-rays, blood tests, and clinical signs

• Treatment depends on severity and may include:

  • Stopping feedings temporarily

  • IV fluids and antibiotics

  • Surgery, if there is a perforation or dead bowel tissue

Prevention

• Breast milk feeding (especially mother’s own milk) is highly protective

• Some NICUs use probiotics (still under investigation in some settings)

• Careful feeding practices and close monitoring of at-risk infants

Prognosis

Many babies recover with early treatment, but NEC can lead to:

• Long-term digestive problems

• Short bowel syndrome (if a large portion of intestine is removed)