NEC

NEC stands for necrotizing enterocolitis which basically is death of intestinal tissue. It is a very scary and unpredictable preemie problem. One of the scary things with NEC is that we do not know exactly what causes it or how to prevent it in preemies. It appears to be related to feedings and ischemic injury (lack of blood flow to an area).

While in the NICU, we try to give preemies feedings as early as possible once they are fairly stable to help the gut begin to work as it should. Normally in development there will be no food entering the digestive system, although now that they are outside the womb, preemies must continue development in a different environment and there will be a whole host of other problems if we delay feedings too long unnecessarily.

Often preemies breath sporadically and have small pauses in their breathing. This can cause a drop in the oxygen concentration of their blood for a short time. If the pause is too long - there is a chance for injury to happen to different body tissues due to lack of oxygenation. Neonatologists feel that this may be part of the cause of NEC.

There are different types of NEC and different ways of treating it depending on the type and seevarity. Medical NEC is often treated with antibiotics and resting the gut i.e. holding regular feedings. There is also NEC that needs to be treated surgically to remove the dead tissue and attempt to save the tissue that remains alive within the infant.

Amazingly many preemies who develop NEC can go from normal to very sick within a few hours and sometimes they die within a few hours of developing intestinal issues. Usually we are able to provide some treatment and can help to save much of the intestines. Thankfully many of the babies that now develop NEC do improve and eventually go home.

Still, it remains to be a major problem for our patients and we continue to try and do our best to first prevent and then treat NEC.