Necrotizing enterocolitis is a serious condition that predominantly affects premature newborn babies. It is a gastrointestinal disease that causes the walls of the large and/or small intestine to become inflamed and to eventually die. There is a research-proven link between NEC and cow’s milk-based infant formulas.
Many cases of necrotizing enterocolitis (NEC) can be effectively treated when caught early and managed appropriately. Infants generally respond to treatments within 72 hours, and most are able to make a full recovery. The highest fatality rates are seen among newborns with the lowest birthweights and most advanced stages of the disease.
What Are the Treatments for NEC?
Treatments for necrotizing enterocolitis aim to give the infant’s intestine the opportunity to rest and recover while robust supportive care is administered concurrently with ongoing diagnostic and monitoring efforts.
The combination of treatments recommended by your treating care team will depend primarily on your baby’s health condition and disease progression. Common treatments for necrotizing enterocolitis include:
- Temporary intravenous feedings (IV tube feedings) and the stopping of any oral feeding
- Use of a nasogastric tube which extends from the patient’s nostril to the stomach, removing fluid and air by suction
- Antibiotic medications
- Supplemental oxygen therapy
- Mechanically-assisted breathing (use of a ventilator)
- Platelet and red blood cell transfusions
- Surgery
A physician and team will continually monitor an infant’s condition and the illness’ progression to determine which of these therapies are required. Monitoring will be conducted through actions such as:
- Taking blood samples
- Checking the baby’s abdomen for swelling
- Monitoring blood for stools
- Abdominal X-rays
- Watching for other symptoms of necrotizing enterocolitis
Do All Babies Need Surgery To Treat Necrotizing Enterocolitis?
Most research puts the percentage of infants requiring surgical intervention to treat NEC somewhere between 27% and 52%, or roughly between 20% and 40%.
Less-invasive treatments like medication and the manual removal of air and fluid from the stomach will typically be tried first. When only a small area of the intestine is affected, these non-surgical options will usually prove to be successful.
However, if a perforation (hole) forms in the infant’s intestine, surgery becomes critical. A perforation allows bacteria to leak into the abdomen and bloodstream, putting the baby at severe risk. If left untreated, this level of bowel deterioration can kill a newborn in a matter of days.
In situations like these, surgeons can perform a procedure known as a laparotomy. During the operation, the surgical team will work to remove the necrotic (dead) tissue that caused a hole to form in the wall of the intestine. After the damaged section is removed, the two healthy ends of the intestine can be rejoined.
Another option in some cases is for a surgeon to perform an ostomy, in which a stoma is created. A stoma is when a portion of the bowel is brought outside the body through an opening in the abdomen. After the intestine has had time to heal, a second surgery can be performed to reposition the intestine back inside the body once it is again healthy and functional.
Stages of Necrotizing Enterocolitis
Necrotizing enterocolitis can be divided into three stages of progression, also known as Bell stages. Knowing the stage of the baby’s illness is essential to physicians and other health care professionals in creating a treatment and care plan.
Stage 1 (Suspected NEC)
The first stage is characterized by early symptoms of NEC, including:
- Bloody stools
- Mild abdominal swelling
- Lethargy
- Vomiting
- Low or fluctuating body temperatures
- Slowed heart rate
- Difficulty feeding
When these symptoms are observed, doctors will often advise immediate intravenous feeding as the existing symptoms are closely monitored for change.
Stage 2 (Definite NEC)
The second stage shows a continuation and worsening of the indicators found in the first stage. In addition to Stage 1 symptoms, infants diagnosed with Stage 2 will also exhibit:
- Pronounced abdominal bloating
- Reduced blood platelet levels
- Pain when the abdomen is touched
- Lack of bowel movements
- Excess lactic acid
At this stage, a treating team of medical professionals may start the baby on a regimen of antibiotic medications while maintaining monitoring efforts and intravenous feeding.
Stage 3 (Advanced NEC)
At this critical stage of the disease’s development, symptoms from Stages 1 and 2 will be accompanied by:
- Low blood pressure
- Irregular breathing
- Redness and increased pain, and distension in the abdomen
- Lack of urination
- Blood clot formation
- Lowered white blood cell count
If necrotizing enterocolitis has reached this stage, it is often necessary for the baby to undergo emergency surgery.
Getting Help After an NEC Diagnosis
Necrotizing enterocolitis is treatable if detected early and managed by an expert team of care providers. While NEC has a good prognosis under the right conditions, it can cause the family of newborn stress, worry, emotional anguish, and the high cost of specialized medical care. In some cases, the baby can suffer health issues that will remain with them for the rest of their life. In the most tragic cases, the infant can lose their life before ever leaving the neonatal care unit.
Regardless of the outcome, many cases of NEC never should have happened. If your family suffered the effects of an NEC diagnosis after your child consumed milk-based formula, you may be entitled to take legal action against an infant formula manufacturing company. Frost Law Firm, PC specializes in representing families injured by corporate negligence.
Contact our office to discuss your case at no cost to you. We’ll schedule a free case evaluation to review your rights after a necrotizing enterocolitis diagnosis.
