Necrotizing Enterocolitis (NEC)

Fact-Checked and Medically Reviewed by:
Katie Lavender, RN Registered Nurse
Quick Answer

Necrotizing enterocolitis (NEC) is a gastrointestinal disease often found in premature and low-birth-weight children. NEC can be extremely dangerous and even deadly in some cases. Children fed cow’s milk-based formula and human milk fortifiers have a higher risk of developing NEC. Learn how to keep your child safe.

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What Is Necrotizing Enterocolitis (NEC)?

Necrotizing enterocolitis (NEC) is a dangerous pediatric intestinal condition that commonly affects premature and low-birth-weight babies more than full-term babies.

Most cases of NEC develop in the first two weeks of an infant’s life. Cases of NEC can vary in severity. However, NEC can become serious and even life-threatening if not diagnosed and treated early.

In March 2024, an Illinois jury awarded $60 Million to the family of a child who passed away after developing NEC from Mead Johnson’s Enfamil™ formula.

Necrotizing Enterocolitis Causes

NEC develops when the small and/or large intestine is irritated or injured. Severe inflammation can lead to a hole in the intestinal wall (intestinal perforation). This hole releases waste into the abdomen and/or bloodstream.

According to the Cleveland Clinic, the exact causes of NEC aren’t known. However, there are several risk factors that could lead to NEC.

Premature babies (born before 37 weeks of gestational age) and low-birth-weight babies (less than 5 lbs 8 oz) have underdeveloped digestive systems, meaning they’re more likely to get NEC. They also have weak immune systems due to their prematurity. If they develop an infection due to NEC, their body may not be able to fight it effectively.

An infant is also at risk for NEC if they have decreased blood flow limiting oxygen to the intestines during or after birth.

Premature infants are at a greater risk of NEC if they are fed cow’s-milk based baby formula and/or milk fortifiers. Baby formula brands linked to NEC include Enfamil™ and Similac®.

It is important to be aware of the risks associated with cow’s milk-based formula products that may lead to NEC to potentially prevent this life-threatening disease.

Do you believe your child developed NEC? Speak to one of our caring registered nurses to figure out next steps.

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Necrotizing Enterocolitis Symptoms

There are several warning signs to look out for that may indicate your child has necrosis (tissue death) of the intestines.

NEC often develops in preterm infants who are around two weeks old and are fed cow’s milk formula. It is important to keep an eye out for NEC symptoms around this time to prevent serious injury or even death.

Common necrotizing enterocolitis (NEC) symptoms include:

  • Belly pain
  • Belly swelling (abdominal distention)
  • Dark, bloody stools
  • Decreased appetite
  • Fluctuating body temperature
  • Greenish vomit
  • Low blood pressure
  • Low energy
  • No weight gain
  • Slow heart rate
  • Unstable breathing (apnea)

If your child is showing any signs of NEC, it is critical to seek medical attention from a healthcare professional as soon as possible. Untreated NEC can lead to a variety of serious complications that may result in injury or death.

Some complications of NEC include:

  • Brain damage
  • Developmental delays
  • Hypoxic-ischemic encephalopathy (HIE)
  • Infection in the belly
  • Intestinal tissue scarring
  • Intestinal strictures (narrowed intestines)
  • Peritonitis (inflammation of the abdominal lining)
  • Sepsis
  • Short bowel syndrome

Once you notice any symptoms of NEC, contact your child’s pediatrician. Getting a formal NEC diagnosis is the best and only way to get proper treatment and ensure the safety of your child.

Necrotizing Enterocolitis Diagnosis

After doing an exam to check for any physical signs of NEC, your doctor will order several tests to diagnose your child.

Some tests used to diagnose NEC include:

  • Abdominal X-rays: Images of the belly will be taken to find any signs of holes or air bubbles in the intestinal tract that may show the presence of NEC.
  • Blood tests: Blood gas, complete blood count, electrolyte level, and other blood tests may be used to find evidence of bacterial infection in the bloodstream.
  • Fecal tests: This test is used to find evidence of blood in the poop that may not be visible to the naked eye.

Once your doctor is able to make a definitive NEC diagnosis, your child will be able to start treatment to heal the infection.

Prognosis for Necrotizing Enterocolitis

According to the Cleveland Clinic, about 8 in 10 babies with NEC will survive the disease. Getting prompt treatment can greatly improve the chances a child will recover from NEC.

Severe cases of necrotizing enterocolitis can lead to serious complications that may affect a child’s overall health.

A child who develops brain damage from a NEC-related infection may experience developmental delays. This may affect a child’s ability to sit up, crawl, walk, speak, and more.

Unfortunately, some cases of NEC can result in sepsis if the infection spreads throughout the body. Sepsis is a condition where the body overreacts to an infection and attacks itself and may lead to death.

Contact our team today if you believe your child developed NEC from infant baby formula. You may qualify to take legal action.

Do You Believe Your Child Has NEC?

If you believe that your child’s NEC was a result of cow’s milk formula, contact a team member today.

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Treatment for Necrotizing Enterocolitis

There are several treatment options available for NEC. Doctors will be able to determine the best course of treatment for your baby’s specific case of NEC.

Necrotizing enterocolitis treatment options include:

  • Antibiotics to treat infection
  • Increased oxygen through a ventilator
  • IV for fluids and nutrition
  • NG (nasogastric) tube insertion from the nose to the stomach to release gas and/or fluids

Doctors will also advise parents and caregivers to stop the use of formula feeding and/or feeding for a short amount of time to help the child respond to treatment. X-rays may also be used often to monitor the child’s recovery from NEC.

Severe cases of NEC may need to be treated with intensive surgery. According to the Cleveland Clinic, around 1 in 4 babies with NEC may need surgery to remove dead intestinal tissue.

Doctors may also perform an ostomy, a procedure in which a hole (stoma) is made in the child’s belly to release waste from the large intestine into a bag.

Necrotizing Enterocolitis Prevention

Although not all necrotizing enterocolitis cases can be prevented, there are some steps you can take to reduce the chances of your child developing the condition.

Some ways you can reduce the risk of NEC in your baby include:

  • Being aware of cow’s milk-based formula products that may cause NEC
  • Feeding your baby breast milk or non-cow’s milk-based formula, if possible
  • Getting check-ups at the pediatrician often
  • Knowing the symptoms of NEC

Research has shown that using probiotics may also help reduce the chance of an infant developing NEC.

NEC affects 1 to 5% of children in neonatal intensive care units (NICUs), according to Children’s Hospital Los Angeles.

Take Legal Action for NEC

Unfortunately, necrotizing enterocolitis can be life-threatening to premature babies. This serious gastrointestinal disease can greatly impact an infant’s overall health.

Some baby products can increase the risk of NEC in babies. Cow’s milk-based formula and milk fortifier products manufactured by Similac and Enfamil can cause inflammation in the intestines and may lead to NEC.

If your child was fed select cow’s milk baby formula products and developed NEC, you may be eligible for financial compensation.

Contact our team today to learn more about taking legal action.

Necrotizing Enterocolitis (NEC) FAQs

What causes necrotizing enterocolitis?

Necrotizing enterocolitis (NEC) is often caused by inflammation or damage in the small or large intestine. Children born preterm or with low birth weight have underdeveloped digestive systems, which can put them at risk of irritation in the intestinal tract.

What are the symptoms of necrotizing enterocolitis?

Common symptoms of NEC include swollen belly, bloody stools, green/yellow vomit, fatigue, low appetite, slow heart rate, and more.

If your child is showing any signs of NEC, seek medical attention right away to get treatment.

What is the survival rate of necrotizing enterocolitis?

About 8 in 10 babies diagnosed with NEC will survive, according to the Cleveland Clinic. Necrotizing enterocolitis can vary in severity and may even result in death in some cases.

Does baby formula cause necrotizing enterocolitis?

Some products such as cow’s milk baby formula and milk fortifier products can increase the risk of NEC. These products are made by Enfamil and Similac and can be extremely dangerous to premature and low-birth-weight babies.

Birth Injury Support Team
Reviewed by:Katie Lavender, RN

Registered Nurse

  • Fact-Checked
  • Editor

Katie Lavender has over 8 years of experience as a Registered Nurse in postpartum mother/baby care. With hands-on experience in Labor and Delivery and a role as a Community Educator for newborn care, Katie is a staunch advocate for patient rights and education. As a Medical Reviewer, she is committed to ensuring accurate and trustworthy patient information.

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

View Sources
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  2. Cleveland Clinic. (n.d.). Necrotizing enterocolitis (NEC): What is it, causes & treatment. Retrieved July 14, 2024, from https://my.clevelandclinic.org/health/diseases/10026-necrotizing-enterocolitis
  3. Ginglen, J. G. (2023, August 8). Necrotizing enterocolitis. StatPearls [Internet]. Retrieved July 14, 2024, from https://pubmed.ncbi.nlm.nih.gov/30020729/
  4. Patel, R. M., & Underwood, M. A. (2018, February). Probiotics and necrotizing enterocolitis. Seminars in Pediatric Surgery. Retrieved July 14, 2024, from https://www.sciencedirect.com/science/article/abs/pii/S1055858617301440?via%3Dihub
  5. U.S. Department of Health and Human Services. (n.d.). What are the symptoms of necrotizing enterocolitis (NEC)? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved July 14, 2024, from https://www.nichd.nih.gov/health/topics/nec/conditioninfo/symptoms
  6. U.S. National Library of Medicine. (n.d.). Necrotizing enterocolitis: Medlineplus medical encyclopedia. MedlinePlus. Retrieved July 14, 2024, from https://medlineplus.gov/ency/article/001148.htm