Learn About Necrotizing Enterocolitis
Necrotizing enterocolitis (NEC) is the death of tissue in the intestine. It occurs most often in premature or sick babies.
NEC occurs when the lining of the intestinal wall dies. This problem nearly always develops in an infant who is ill or premature. It is likely to occur while the infant is still in the hospital.
The exact cause of this disorder is unknown. A drop in blood flow to the bowel can damage the tissue. Bacteria in the intestine may also add to the problem. Also, premature infants have an undeveloped immune response to factors such as bacteria or low blood flow. An imbalance in immune regulation appears to be involved in NEC.
Babies at higher risk for the condition include:
- Premature infants
- Infants who are fed formula rather than human milk. (Human milk contains growth factors, antibodies, and immune cells which may help prevent the problem.)
- Infants in a nursery where an outbreak has occurred
- Infants who have received blood exchange transfusions or have been seriously ill
Symptoms may come on slowly or suddenly, and may include:
- Abdominal bloating
- Blood in the stool
- Diarrhea
- Feeding problems
- Lack of energy
- Unstable body temperature
- Unstable breathing, heart rate, or blood pressure
- Vomiting
Treatment for a baby who may have NEC most often includes:
- Halting enteral (GI tract) feedings
- Relieving gas in the bowel by inserting a tube in the stomach
- Giving intravenous (IV or into a vein) fluids and nutrition
- Giving IV antibiotics
- Monitoring the condition with abdominal x-rays, blood tests, and measurement of blood gases
The infant will need surgery if there is a hole in the intestines or inflammation of the abdominal wall (peritonitis).
In this surgery, the surgeon will:
- Remove dead bowel tissue
- Perform a colostomy or ileostomy
The bowel may be reconnected after several weeks or months when the infection has healed.
Catherine Hunter is a Pediatric Surgeon and a General Surgeon in Chicago, Illinois. Dr. Hunter is rated as an Elite provider by MediFind in the treatment of Necrotizing Enterocolitis. Her top areas of expertise are Necrotizing Enterocolitis, Necrosis, Pectus Carinatum, Appendectomy, and Gastrostomy. Dr. Hunter is currently accepting new patients.
Steven Mcelroy is a Neonatologist and a Pediatrics provider in Sacramento, California. Dr. Mcelroy is rated as an Elite provider by MediFind in the treatment of Necrotizing Enterocolitis. His top areas of expertise are Necrotizing Enterocolitis, Premature Infant, Viral Gastroenteritis, and Patent Ductus Arteriosus.
Henri Ford is a General Surgeon and a Pediatric Surgeon in Miami, Florida. Dr. Ford is rated as an Elite provider by MediFind in the treatment of Necrotizing Enterocolitis. His top areas of expertise are Necrotizing Enterocolitis, Necrosis, Diaphragmatic Hernia, and Congenital Diaphragmatic Hernia. Dr. Ford is currently accepting new patients.
NEC is a serious disease. Up to 40% of infants with NEC die from it. Early, aggressive treatment can help improve the outcome.
Complications may include:
- Peritonitis
- Sepsis
- Intestinal perforation
- Intestinal stricture
- Liver problems from prolonged inability to tolerate enteral feeds and need for parenteral (IV) nutrition
- Short bowel syndrome if a large amount of intestine is lost
Get emergency medical care if any symptoms of necrotizing enterocolitis develop. Infants who are hospitalized for illness or prematurity are at higher risk for NEC. They are watched closely for this problem before they are sent home.
Summary: In the Netherlands, more than 85% of the preterm infants born \<32 weeks gestational age get antibiotics directly after birth because of the risk of infection with a bacteria. However, only 1 in 70 of these preterm babies actually has a bacterial infection. The use of antibiotics after birth can lead to problems on short term (bowel infection, infection with a bacteria later on or death) or long t...
Summary: Lactose, a disaccharide that includes the monosaccharides glucose and galactose, is the main carbohydrate found exclusively in mammalian milk. Lactase is found in the intestinal mucosa and is located at the ends of the villi, while it is a factor of maximum clinical importance in milk tolerance and in the occurrence of diarrheal disease. Developmental lactase deficiency is defined as the relative ...
Published Date: April 06, 2025
Published By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Greenberg JM, Narendran V, Brady JM, Nathan AT, Haberman BB. Neonatal morbidities of prenatal and perinatal origin. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 73.
Maqbool A, Liacouras CA. Normal development, structure, and function of the stomach and intestines. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 374.