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What is Necrotizing Enterocolitis (NEC)?

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Necrotizing enterocolitis (NEC) is a serious condition that affects the intestine of premature babies, although it may less commonly affect babies born full-term.

In babies with NEC, the intestines become damaged. In severe cases, the intestines can start to die and require surgery. In these cases, NEC can be fatal.

What causes NEC?

The causes of NEC aren't fully understood. This is an active area of research. There are many factors that may increase the risk of NEC, such as prematurity and low birth weight (less than 1,500 grams), the makeup of bacteria in the intestines, congenital heart disease ​and decreased blood flow to the intestines. Some infants who experience NEC may have more than one risk factor.

What are the symptoms of NEC?

The symptoms of NEC can vary, but common ones include:

  • Feeding difficulties, including vomiting

  • Swollen belly or abdominal distension

  • Bloody stools

  • Decreased activity (lethargy)

  • Increased spells of apnea (pauses in breathing) and bradycardia (low heart rate)

How is NEC diagnosed?

NEC can be diagnosed using x-rays and sometimes an ultrasound of the belly. Doctors may also perform blood tests to check for signs of infection.

How is NEC treated?

Treatment for NEC may include stopping milk feedings to rest the intestine, providing nutrients through a vein (IV) and giving antibiotics. In severe cases, surgery may be necessary to remove damaged parts of the intestine.

How can the risk of NEC be reduced?

We do not know how to fully protect against NEC, but there are ways to help reduce the risk. Some protective interventions include:

  • using mother's own milk for feedings as much as possible

  • using pasteurized donor human milk if needed.

  • standardized feeding protocol in the hospital

What is the long-term outlook for babies with NEC?

The long-term outlook for babies with NEC depends on the severity and whether surgery is needed. Some babies may recover fully with no long-term effects, while others may experience long-term complications such as short bowel syndrome or neurodevelopmental issues.

If your baby has been diagnosed with NEC, it is important to work closely with your doctor to discuss the treatment plan and monitor your baby's progress. With proper care, many babies with NEC are able to recover and go on to live healthy lives.

Because infants with NEC who need surgery can have long-term complications, they should be followed as they get older by pediatrics specialists. These can include surgeons, developmental specialists and gastroenterologists.


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Last Updated
4/13/2026
Source
Academy of Pediatrics Committee on Fetus and Newborn, Section on Neonatal-Perinatal Medicine, Section on Breastfeeding and Committee on Nutrition (Copyright © 2026)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.