Preemies and Necrotizing Enterocolitis
Preemies and Necrotizing Enterocolitis
It can be a frightening thing to deliver a baby prematurely. Often, premature babies (born earlier than 37 weeks) struggle for life during the initial weeks and months after birth. Because their little bodies are underdeveloped, health complications such as infection and disease happen more frequently in preemies, including heart defects, trouble breathing, and an intestinal disease called necrotizing enterocolitis (NEC).
What is NEC?
Necrotizing enterocolitis is an intestinal disease that can become quite serious for preemies and high-risk infants. NEC happens when the intestine is injured or begins to die, resulting in swelling and inflammation or even a hole in the intestine. This perforation allows digestive waste to leak out into baby’s abdominal cavity. Some signs and symptoms include a swollen, tender belly, not feeding well, constipation or diarrhea, an unstable body temperature, and serious infection. It occurs most commonly in babies born earlier than 32 weeks or babies weighing less than 3 lbs. 4 oz. (1500 g).
Necrotizing enterocolitis usually develops when baby is between 2-4 weeks old and can be transmitted from one baby to another. In fact, 5% of NEC cases occur in NICU babies. Because no one knows exactly how NEC is caused, there is no sure way to prevent it. However, babies exclusively fed breastmilk seem less likely to develop NEC.
How is NEC treated?
If your baby has necrotizing enterocolitis, treatment almost always begins with a temporary suspension of feedings. Further treatment for necrotizing enterocolitis depends on your baby’s overall condition and the severity of the disease. These options include:
- IV fluids – Nutrients and fluids are given to your baby through an intravenous tube while the regular feedings are on hold.
- Antibiotics – If the intestine has been perforated and leakage is occurring, the bacteria which naturally occurs in the intestines can cause infection.
- X-rays – Because intestinal leakage can be seen in an x-ray, several x-rays may be conducted during the treatment period to monitor the progress of the disease.
- Nasogastric drainage – A tube runs from the nose to the stomach which drains air and fluids from the digestive system.
- Monitoring abdominal girth – Your baby’s belly will be measured frequently. Abdominal swelling indicates infection and/or leakage. If the abdomen become so swollen that baby’s breathing is affected, he may need additional oxygen or a ventilator.
- Surgery – For severe NEC, the diseased or perforated section of the intestine can be surgically removed. Ideally, the remaining healthy pieces of intestine are sewn together. However, if a large piece of intestine was removed or if baby is very sick, surgeons create an ostomy, which is an opening through the body where feces can pass through the body safely.
Are there any lasting problems from necrotizing enterocolitis?
Most preemies diagnosed with NEC make a strong recovery and have no lasting problems with digestion or feedings. After treating necrotizing enterocolitis, breastmilk is always the recommended source of food for the baby. Some babies who have had surgery to correct necrotizing enterocolitis may have lasting problems with nutrient absorption. These babies might depend on an IV for nutrients until the intestine has healed enough to handle normal feedings. In addition, the intestine could scar or narrow and require additional surgery.
Necrotizing enterocolitis can progress quickly from mild to severe for high-risk babies. Preemies are especially susceptible to infection and disease because many of the body’s systems are not fully developed. With prompt diagnosis and treatment, the damaging effects of the disease can be minimized.
Have you had any experience with necrotizing enterocolitis? We’d love to hear your story in the comments below.