Patient Care

Necrotising Enterocolitis (Children)

What is Necrotising Enterocolitis in Children (NEC)?

NEC is one of the conditions affecting babies with very low birth weight (VLBW).

To prevent this from occurring, premature babies are evaluated individually for this risk and mother's breast milk is strongly advocated for feeding. The premature baby at risk for NEC is usually fed with a slow and gradual increase in milk quantity, and will be watched very closely to see that the baby tolerates the milk feeds.

No specific cause of NEC is known. However, several sub-groups of babies are known to be at high risk of NEC such as babies who are very premature, with reduced blood flow to the intestines in the womb and whom are not fed with breast milk.

What are the signs & symptoms of NEC?

Premature babies with NEC can present with increased gastric residues, vomiting, abdominal distension and also changes in vital parameters. Blood can occasionally be passed out in the stools.

How is NEC diagnosed?

NEC is normally diagnosed based on clinical and X-ray findings. NEC X-Ray

Severe NEC showing gas in the abdomen cavity

What are the treatment options for NEC?

NEC can be divided into three stages with increasing severity, based on clinical and X-ray findings. In mild cases, treatment is stopping milk feeds temporarily for a few days. In confirmed cases, milk feeds are stopped for about one to two weeks, while antibiotics are started and referral made to the surgeons. In severe cases of NEC, surgery may be required.

Depending on the extent of the intestines affected, an ileostomy or colostomy (an opening from the intestines to the skin of the abdomen) may be created. Certain lengths of the intestines may also be removed if the intestines appear to be not viable. Specialised care will be required for these babies.

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