Necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is a condition that can affect the intestines/bowel of premature babies. Although rare it can also occur in term babies. It results from a combination of infection and inflammation of the intestines and can cause a perforation (hole) in the intestines that results in stools leaking into the abdomen. Even without perforation, NEC often results in severe or overwhelming infection especially in already fragile premature babies.

Initial management of non-complicated/non-perforated NEC is medical and includes antibiotics and intravenous nutritional support. All feeds are stopped to allow the intestines time to rest and heal. During this time your baby might require a special drip/line to allow us to give them intravenous nutrition (TPN).

If NEC is complicated by perforation or further deterioration in the baby's general condition, then surgery may be needed. This can involve placing a drain in your baby’s abdomen to allow the stools to drain and/or an open operation to remove the diseased portion of the bowel.

Many babies who develop NEC recover completely and do not have further problems. Some however can develop NEC again at a later stage and others might have scarring or narrowing of the intestines that results in an obstruction. They will then need an operation to relieve the obstruction.

Some babies with NEC, particularly those who require surgery, may not be able to absorb their feeds properly for a long time after the surgery. These babies are managed in conjunction with the specialist paediatric gastroenterologists and may require long term central lines and intravenous nutrition as well as further operations.