Treatments for Necrotizing Entercolitis

Brooklyn resident Dr. Brian Gilchrist has been a pediatric surgeon for close to 30 years. Dr. Brian Gilchrist was editor for the book The Basic Science of Necrotizing Entercolitis (NEC), published 20 years ago but still used in many neonatal units around the country.

NEC is a gastrointestinal condition that affects one in between 2,000 and 4,000 babies at birth in the US. The condition is very serious because it is a patho-physiology causing an inflammation of the intestinal wall. This inflammation leads to a bacterial invasion, which leads to cell damage and then cell death. If the condition persists, the intestines can become perforated, causing sepsis and peritonitis.

The condition commonly affects babies who were born prematurely. Babies who weigh 4.5 pounds or less make up more than 80 percent of the cases, but there have been cases of full-term newborns having this condition. The condition manifests within the first few weeks after birth, usually after milk feedings have begun.

Medical professionals believe there are a few causes of the condition. Some believe that the content of the baby’s formula or the rate of delivery could be catalysts for causing the condition. Another cause could be the immaturity of the mucus membrane. However, it is believed that children who are breast fed are at lower risk for developing the condition.

There are a variety of treatments for this condition. Typically, all feedings are discontinued and babies are fed intravenously. Physicians might also place a naso-gastric tube (extends from the nose to the stomach) to suction air and fluid from the stomach to relieve swelling. If this does not work, the physician might provide an oxygen mask to assist with breathing. Doctors might initiate an antibiotic therapy, and if the case is serious enough, a platelet and red blood transfusion might be required.