Necrotising Enterocolitis (Children)

NUH doctors work closely with paediatric surgeons to manage necrotising enterocolitis (NEC).

Symptoms in premature babies can include increased gastric residues, vomiting, abdominal distension and variations in vital signs. Occasionally, blood may be present in the stools.

The specific cause of NEC is not known. High-risk groups include very premature infants, those with reduced blood flow to the intestines in utero and those not fed with breast milk.

NEC primarily affects babies with very low birth weight (VLBW). The prevention strategy for NEC includes individual assessment of premature babies for risk factors, with a strong emphasis on feeding mother’s breast milk. These infants are fed gradually increasing quantities of milk while being closely monitored for tolerance.

NEC is categorised into three stages, escalating in severity, based on clinical and X-ray findings. Mild cases may only require temporary cessation of milk feeds for a few days. Confirmed cases require stopping milk feeds for one to two weeks, initiating antibiotic therapy and consulting with surgeons. Severe cases may demand surgical intervention.

Severe NEC showing gas in the abdomen cavity

Surgical outcomes may involve creating an ileostomy or colostomy or removing non-viable sections of the intestines. Specialised care is essential for these infants.

The Early Starters Group is offers support for parents of premature babies in the Neonatal Intensive Care Unit (NICU).

The rate of NEC in the VLBW cohort ​(2015–2019) at NUH is 1.5%, compared to the Vermont Oxford Network rate of 5.6% in 2015.