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Necrotising enterocolitis

Enterocolitis necroticans · Nekrotizující enterokolitida

What it is

The bowel wall of a premature baby becomes inflamed and dies, usually weeks after birth; affects about 1 in 14 babies under 1.5 kg and kills a fifth to a third of them.

Symptoms & signs

  • Feeds not tolerated
  • swollen, tender abdomen
  • green (bilious) vomiting
  • blood in the stool
  • lethargy, pauses in breathing, unstable temperature
  • gas in the bowel wall on X-ray

🚩 Get help if…

  • call 112 / 911 now Swollen, tight or discoloured belly in a newborn
  • call 112 / 911 now Green vomit
  • call 112 / 911 now Blood in the stool
  • see a doctor soon Feeds not tolerated or milk coming back up

Where it strikes

Medical treatment

  • Stop feeds; drain the stomach by tube
  • IV antibiotics and nutrition
  • surgery for perforation or dead bowel — laparotomy with resection, or a peritoneal drain
  • long-term follow-up for short bowel and strictures

Natural & lifestyle

  • Mother's own milk, or donor milk rather than formula — about half the risk trials support
  • feeds increased steadily by a set plan (SIFT: faster increase not harmful)

Emerging & experimental

  • Human-milk-based fortifiers
  • near-infrared spectroscopy to detect it early
  • stem-cell and amniotic-fluid research

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Probiotic drops (Bifidobacterium, Lactobacillus) — meta-analyses: less NEC; the large PiPS trial found none, and rare sepsis from the probiotic strain itself has been reported mixed evidence
  • Lactoferrin — ELFIN trial: no fewer infections or NEC not confirmed in trials

ICD codes