Necrotizing enterocolitis is an acquired disease, primarily in premature infants or sick newborns, in which intestinal tissue dies. The causes of NEC are unknown, but it is thought that a decreased blood flow to the bowel keeps the bowel from producing the normal protective mucus. Bacteria may also be a factor. Risk factors include small, premature infants, outbreak among other infants in the nursery, the feeding of concentrated formulas, and infants who have received blood from transfusions. Symptoms include abdominal distention, vomiting and feeding intolerance, blood in the stool (visible or microscopic), lethargy, temperature instability, and diarrhea. Tests include abdominal X-ray, stool for occult blood test (guaiac), elevated white blood cell count in a CBC, thrombocytopenia (low platelet count), and lactic acidosis. Treatment of an infant with suspected NEC are, feedings are stopped, and the bowel is decompressed of gas by inserting a small tube into the stomach. Intravenous fluid is started to replace feedings of formula or breast milk. Antibiotic therapy is started. The infant's condition is monitored with abdominal X-rays, blood tests, and blood gases.If intestinal perforation (hole) or peritonitis (inflammation of the abdominal wall) develops, surgery is indicated. The dead bowel tissue is removed and a colostomy or ileostomy is performed. The bowel is then reconnected several weeks or months later when the infection and inflammation have healed. Necrotizing enterocolitis is a serious disease with a death rate of over 30%. The outcome is improved by aggressive, early treatment.There is not much that can be done as far as avoiding feeding concentrated formula. As maternal/ child health, nurses told me, there have been few cases in their small maternity unit. I do not think this is something that we need to be too concerned about that an epidemic could break out but I do think that we should try to find a bett...
