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What are the Symptoms of Necrotizing Enterocolitis (NEC)

HomeAilmentsBaby

ByAgkidzone Staff
Updated: Sep 6, 2024

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Necrotizing enterocolitis (NEC) is a serious condition that primarily affects premature infants, with a prevalence of about 1 in every 2,000 to 4,000 babies. It usually develops in formula-fed babies during their second or third week of life. While it most commonly affects preterm infants, full-term babies can also develop NEC, which causes damage to the intestinal tract. The severity of this condition can range from minor mucosal injuries to severe necrosis and perforation of the intestines. With a mortality rate around 50%, it's crucial for parents, especially those of premature infants, to be vigilant about the signs and symptoms of NEC. Early detection and intervention can make a significant difference in outcomes.

Feeding Intolerance
One of the early signs of NEC is feeding intolerance. Infants with NEC often struggle to tolerate formula, and even switching to sensitive formulas or alternatives like goat's milk or soy may not help. Common signs include crying during or after feeding, gagging, excessive gas, spitting up, or vomiting. In more severe cases, doctors may decide to use a feeding tube to ensure the baby receives adequate nutrition without further aggravating the digestive system. If you notice these symptoms, it's essential to consult a healthcare provider immediately.
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Failure to Thrive
Failure to thrive is a concerning condition that can be a red flag for NEC, particularly in premature babies. Symptoms of failure to thrive include inadequate weight gain, irritability, excessive sleepiness, and quickly tiring after minimal activity. Despite parents' best efforts to feed and comfort their baby, these signs may persist, indicating underlying health issues. Keeping track of your baby's growth and development milestones is vital, and if they are not met, it’s crucial to speak with your pediatrician to rule out NEC or other health concerns.
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High Level of Gastric Residuals
Doctors may check for high levels of gastric residuals to evaluate feeding intolerance, especially if NEC is suspected. Gastric residuals refer to the fluids remaining in the stomach after a feeding session. A high level of these fluids can indicate that the infant’s stomach is not emptying properly, which is a common symptom of NEC. Infants who are fed through a feeding tube are particularly prone to this issue. Regular monitoring by healthcare professionals can help detect this early sign of NEC.
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Abdominal Distension
Abdominal distension, or swelling of the abdomen, is another common symptom of NEC. This occurs when fluids or gases become trapped in the intestines, causing the belly to appear unusually large compared to the rest of the body. The infant may also show signs of pain or discomfort due to this bloating. In cases of NEC, abdominal distension often accompanies feeding intolerance. If you notice your baby’s stomach looking swollen or if they seem uncomfortable, it's a good idea to consult a doctor immediately.
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Diarrhea
Diarrhea is often one of the earliest and most noticeable symptoms of NEC in infants. Since newborn stools are not typically solid, identifying diarrhea can be challenging. To determine if your baby has diarrhea, pay close attention to their dirty diapers. If the stool is fully absorbed by the diaper, it is likely diarrhea. However, if the stool sits on the surface, it generally has a normal consistency. Monitoring stool patterns can help catch NEC early.
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Blood in the Stool
Seeing blood in an infant’s stool is understandably alarming and is a potential symptom of NEC. Blood may appear as red streaks or in a thick, black, tarry form. It’s important to distinguish this from meconium, the black, tarry stools that babies pass in their first few days of life, which is perfectly normal and not a cause for concern. If you notice blood in your baby’s stool after this period, it is essential to seek medical attention immediately.
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Abdominal Discoloration
Another symptom of NEC is a change in the color of the skin over the abdomen. The skin may turn dark pink, deep red, blue, or even appear bruised. You might also notice visible veins under the skin in the affected area. This discoloration often appears shortly after the infant experiences bloating or discomfort due to abdominal distension. If you observe these changes, consult with a healthcare provider right away, as it could indicate NEC progression.
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Peritonitis
Peritonitis is an inflammation of the inner lining of the abdomen and is a serious complication associated with NEC. In infants, signs of peritonitis include abdominal bloating, fussiness, irritability, fever, and weight loss. During a physical examination, doctors may identify tender spots in the abdomen. This condition requires immediate medical attention, as it can rapidly worsen and lead to severe complications.
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Hypotension
As NEC progresses to more advanced stages, infants often experience hypotension, or low blood pressure. Signs of hypotension in infants include dizziness, lightheadedness, nausea, vomiting, and extreme fatigue or lethargy. In babies, these symptoms manifest as fussiness, refusal to eat, and lack of energy. A healthcare professional can check your baby’s blood pressure to confirm hypotension and provide the necessary care.
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Lethargy and Crankiness
Infants with NEC may alternate between periods of extreme lethargy and bouts of crankiness or irritability. While these symptoms can be part of normal infancy or other health issues, their presence in tandem with other signs of NEC warrants a closer look. If you notice a pattern of these symptoms, it's essential to discuss them with your doctor to ensure proper diagnosis and treatment.
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This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.

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