Oh, sometimes when little babies are born, they have various health problems, don't they? Especially babies born at low gestational age. Today we are going to talk about a serious intestinal disease that such babies can develop. This is called necrotizing enterocolitis, or NEC for short. Don't be scared when you hear this name, let's understand it simply.
What is this necrotizing enterocolitis (NEC)?
Simply put, NEC (Necrotizing Enterocolitis) is a serious intestinal disease that affects the intestines of babies, especially premature babies . In this condition, intestinal tissue swells and begins to die. Think of it like a wound that causes the tissue to deteriorate inside the intestine.
This can be dangerous because sometimes a hole (perforation) can form in the intestine. If this happens, germs , such as bacteria, can escape through the hole, into the abdomen or into the blood. This usually occurs between two and six weeks after the baby is born.
For some babies, NEC is a mild condition that can be life-threatening. In some babies, it can be severe and life-threatening . We pronounce it as "nek-ruh-tiz-ing n-ter-o-ko-ly-tis."
What is the intestine?
The small intestine and large intestine are two very important parts of our digestive system . They help us digest the food we eat, absorb nutrients, and eliminate waste products. These waste products are ultimately excreted as feces.
Who is most likely to develop NEC? How common is it?
In fact, 9 out of 10 babies who develop NEC are born prematurely . That is, babies born before 37 weeks of gestation. Specifically:
- For babies born before 37 weeks ( premature babies ).
- Enteral nutrition is given to babies through a tube placed in their stomach. This is done because some babies have difficulty taking milk by mouth.
- For babies weighing less than 5 1/2 pounds at birth.
NEC is a common intestinal disease among premature babies. Roughly speaking, it affects about 1 in 1,000 premature babies. The risk is especially high for babies who weigh less than 2 pounds at birth.
However, full-term infants are very rare to develop NEC. Only about one in 10,000 babies will develop NEC.
Are there different types of NECs?
Yes, doctors classify NEC based on the time of onset of symptoms and the cause of the disease. There are several main types:
- Classic NEC: This is the most common type. It usually affects babies born before 28 weeks of pregnancy. It appears between three and six weeks after birth. It often occurs suddenly, without warning , when the baby is otherwise healthy and stable.
- Transfusion-associated NEC: Some babies need a blood transfusion because they have anemia , a lack of red blood cells. About 1 in 3 premature babies develop NEC within three days of receiving a blood transfusion.
- Atypical NEC: Very rarely, NEC can develop within the first week of life or even before the baby is breastfed for the first time.
- NEC in term infants: When a baby is born at term, it is often caused by a birth defect. For example, a congenital heart condition , gastroschisis , or low oxygen levels at birth.
Sometimes, NEC can spread in neonatal intensive care units (NICUs) . This is when several babies develop NEC at the same time. Bacteria such as E. coli or other germs can cause this spread. But this is also very rare.
Why does this NEC occur? What are the causes?
Doctors still don't know exactly what causes NEC, but we do know that premature babies have a weaker immune system . The immune system is what fights off infections.
Also, these babies' digestive systems are very weak and not fully developed. So, if a premature baby gets an intestinal infection, it's hard for their immune system and digestive system to fight it off.
Another thing is that babies born prematurely may have less oxygen-carrying blood flow to their intestines. This decreased blood flow can damage the intestinal tissue. This damage allows bacteria to escape from the intestines and enter the abdominal cavity or blood.
What are the symptoms of NEC?
NEC usually appears between two and six weeks after birth. It can vary depending on the type and cause of the condition. Symptoms can develop gradually over several days, or they can appear suddenly in a baby who is otherwise healthy.
Because NEC is a common problem among babies in a NICU (Neonatal Intensive Care Unit) , the doctors and nurses there are constantly aware of this.
The main symptoms of NEC are:
- Abdominal pain and swelling.
- Changes in heart rate, blood pressure , body temperature, and breathing pattern.
- Diarrhea with bloody stool .
- Green or yellow vomit.
- The baby is drowsy and lifeless ( lethargy ).
- Refusal to drink milk and lack of weight gain.
How do you find out if you have NEC?
The doctor treating your baby will examine your baby and check for any swelling or other signs of NEC.
In addition, it is possible to perform tests such as:
- Blood tests: Check the blood for bacteria or other signs of infection.
- Fecal test: Check your baby's stool for blood. Sometimes there may be blood in the stool that we can't see, and this test can detect it.
- X-rays: An X-ray of the abdomen is taken to look for gas bubbles around the intestines or in the abdominal cavity. These gas bubbles indicate that the intestines have been damaged or have a hole.
What are the possible complications of NEC?
A baby with NEC is also at risk for other problems. Some of these complications include:
- Abdominal infection: Some babies develop a hole in the wall of their intestines. This hole can allow bacteria to enter the abdominal cavity. This can cause a serious infection called peritonitis . This peritonitis increases the risk of developing sepsis , a life-threatening blood infection.
- Intestinal stricture: About 1 in 3 babies with NEC will develop a narrowing of the intestine later in life. This usually happens a few months after the baby has recovered from NEC. When the intestine becomes narrow, it becomes difficult for food and drink to pass through. Some children may need surgery to widen the narrowed intestine.
- Short bowel syndrome (SBS): This condition can occur if part of the small intestine is destroyed or damaged due to NEC. This results in the body not being able to absorb fluids and nutrients properly ( malabsorption ). Children with SBS need special care to ensure they get proper nutrition throughout their lives. Some children may need to be fed through a tube ( enteral feedings ).
- Growth failure and developmental delays: These are important long-term complications. This risk is especially high in babies who have undergone surgery. The growth and neurodevelopmental outcomes of such babies should be monitored regularly.
How is NEC treated?
The baby's intestines need to rest and heal. So the first thing to do when treating NEC is to stop feeding through a tube or by mouth. Instead, the baby is given the nutrients and fluids they need intravenously (IV) , which is like saline into a vein.
In addition, the baby may also receive treatments such as:
- Nasogastric tube: The doctor inserts a long, thin tube through the nose (sometimes through the mouth) into the stomach to drain excess air and fluids from the stomach.
- Antibiotics: These help fight bacterial infections.
About 1 in 4 babies will need surgery to remove dead parts of the intestine and repair any holes. The doctor may also perform a procedure called an ostomy . This surgery:
- A small hole, called a stoma, is created in the baby's stomach.
- The large intestine is connected to this stoma.
- Then the stool leaves the body through this stoma, into a pouch outside the body.
When the baby gets a little stronger, the doctor reconnects the intestines and places them inside the stomach.
Sometimes, if the baby is very small (weighing less than 1 pound) or too sick to undergo surgery, the doctor may place a small tube ( drain/catheter ) in the stomach. This tube is used to drain harmful, infected fluids and air from the stomach and reduce symptoms. Later, when the baby is a little older and better, surgery can be performed.
Can NEC be prevented?
If you are at risk of having a premature baby, your doctor may give you an injection of a corticosteroid . This medicine works to improve the health of the baby in the womb. It can reduce the risk of problems with the baby's lungs and intestines.
Additionally, breastfeeding has been found to reduce the risk of NEC. Some studies suggest that adding probiotics , or beneficial bacteria, to breast milk or formula may also help.
What will happen to the baby if NEC develops? (Outlook)
Roughly speaking, 8 out of 10 babies who develop NEC survive. However, some of these babies may develop long-term health problems due to NEC.
Important: When your premature baby seems fine and suddenly develops a problem like NEC, you may feel very sad and worried. This is normal. Doctors and nurses in the NICU are trained to recognize these problems and act quickly. Some babies recover with minimal treatment. Even with surgery, many babies recover and live normal lives. However, some babies may have ongoing digestive problems.
Things to ask your doctor/doctor
If your baby has NEC, it's a good idea to ask your doctor about things like:
- Why did my baby get NEC?
- What type of NEC does my baby have?
- What is the best treatment for my baby?
- What are the complications of treatment?
- What are the long-term effects of NEC?
- Do I need to give my baby a special diet?
- What complications should I watch out for when I bring my baby home?
Finally, the most important thing
NEC is a very serious condition, especially when it affects our little ones. But remember, medical science is very advanced today. The doctors, nurses, and staff in the NICU (Neonatal Intensive Care Unit) work incredibly hard to save these babies.
It's great that even simple things like breastfeeding can reduce this risk. If your baby develops this condition, don't panic, and follow the advice of your doctor . Talk to them carefully and ask them all the questions you have. Wishing you a speedy recovery!
` Necrotizing enterocolitis, NEC, preterm babies, intestinal infection, baby's health, NICU, digestive system
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න