What is NEC?Many parents feel angst and confusion when they hear the term NEC or necrotizing enterocolitis for the first time. Most have never heard of this dangerous condition and are unaware of its life-threatening risk until it afflicts their child. NEC is a severe gastrointestinal disorder that can wreak havoc on a baby's digestive organs. NEC can emerge when the intestines of a baby suffer an injury or otherwise become inflamed due to bacteria or germs that attack the intestinal walls and cause holes or perforations to occur. This then allows the bacteria to travel outside of the intestines and into the abdomen and also potentially into the baby's bloodstream. Ultimately, portions of the intestines of the baby can die, and other life-threatening complications and challenges can develop as a result.
How Does a Baby Develop NEC?NEC is a condition that most commonly develops in newborn babies. The vast majority of cases of necrotizing enterocolitis occur in the first few weeks of life after the birth. While NEC can happen to a baby born in any stage of gestation, nearly 90 percent of the babies that develop NEC were born prematurely. (Prematurity generally refers to babies born before they are medically considered full-term at 37 weeks.) Although infants at any age can potentially develop NEC, certain babies are at the highest risk of developing the condition. They include babies:
- Born weighing under three pounds;
- Born with existing health complications and illnesses;
- Who require blood transfusions during their medical care;
- Who experience a shortage of oxygen during or after labor; and
- Who receive formula containing cow's milk or its derivatives.
Is NEC Preventable?Doctors can avoid many NEC cases in babies with proper medical care. Infants, particularly newborns and premature babies, are fragile and susceptible to dangers in a hospital environment that can increase their risk of contracting NEC. Avoidable causes of NEC may include:
- Baby given formula containing cow's milk - Several studies have shown a link between a higher incidence of NEC development in newborns and infants who are given formulas with cow's milk ingredients and derivatives. In many cases, a hospital or provider will use this feeding option as a means to lower costs, but in doing so can put certain babies at risk of this condition.
- Deprivation of oxygen during delivery - Lack of oxygen or hypoxia during delivery can cause challenges for a newborn. The low oxygen levels in an infant's organs and tissues in these circumstances can weaken their bodies and make them more susceptible to developing NEC.
- An outbreak of NEC causing virus or bacteria in a medical facility - While NEC is not contagious, it develops because of a virus, bacteria, or other germs. Failures in maintaining hygiene within a hospital or NICU can cause an NEC outbreak. Multiple babies developing NEC in the same ward or NICU can indicate an external factor at work and that a hospital has failed to take sufficient precautions to prevent its development.
What Complications Does a Baby with NEC Face?A baby who develops NEC can face life-threatening complications. The chances of survival often depend on the baby receiving prompt and appropriate medical care for the condition. Tragically, some babies with NEC do not survive the invasive condition, and many of the infants that do survive face serious health complications.
Complications in the Short-termNecrotizing enterocolitis is the culprit in many health complications suffered by a newborn. Once the condition develops, it puts many aspects of an infant's health at risk. Common complications that can arise in the weeks and months following the development of NEC can include:
- Infection and sepsis - The biggest threat to the life of a baby with NEC is the spread of infection through their bodies. NEC can be aggressive and develop quickly. If it is not detected right away, the harm to the infant can be severe and possibly fatal. The growth and spread of bacteria in the infant's body can make it much more difficult to recover and increase their chance of developing life-threatening sepsis.
- Failure to thrive - The direct effect on the gastrointestinal system of a newborn in combination with the treatment options for NEC that often involve withholding feeding, commonly, can stunt a baby's normal growth and development. In cases in which NEC resolves with minor impacts, the child will likely get back on track in a relatively short time, but those with severe cases of NEC who require significant medical interventions may fall further behind as they battle the condition over the longer term.
- Death - Unfortunately, not all babies that suffer from NEC survive. Studies indicate it is the leading cause of death in premature infants with low birth weights. The fragile state of very low birth weight infants increases the likelihood of fatality with an NEC diagnosis.
Long-term ComplicationsBabies that survive severe cases of NEC will likely deal with challenges to their health, some of which may last throughout their lifetimes. NEC can cause permanent damage and chronic health challenges, such as:
- Short gut syndrome - When NEC begins to take over, surgery may be necessary to remove portions of the intestines that have sustained too much damage to recover or heal. If the removal of a significant portion of the intestine occurs, the infant may develop short gut syndrome, also referred to as short bowel syndrome. This lifelong condition does not have a cure, although some medical interventions can help an individual live more comfortably and avoid the most debilitating complications. People with short gut syndrome are unable to absorb critical nutrition that is necessary to sustain their life. As a result, many with severe cases need constant medical support and must receive nutrition in ways other than eating and drinking, such as through feeding tubes and intravenous fluids, which come with a host of other challenges and complications when used long-term.
- Neurodevelopmental delays - Infants that develop NEC have a higher likelihood of developing neurodevelopmental delays that they may never overcome. The weeks after the birth of a baby are critical to their health and overall physical wellbeing. Challenges during this time can have debilitating consequences on a baby's ability to develop normally and reach the milestones necessary as they grow. Pre-term infants that develop NEC are linked to neurodevelopmental challenges such as vision and/or hearing problems, cerebral palsy, cognitive impairments, and psychomotor impairments. These complications will not only have effects on how a child grows, but also on their social and intellectual abilities, and, in turn, how they live their lives.
- Growth restrictions - Infants unable to absorb nutrients are also unable to grow at a normal rate. This will often lead to the infants remaining in the lower percentiles of height and weight as they grow older.
- Intestinal strictures - NEC can cause severe damage to the intestines. As the intestines of a baby heal, scarring within the intestine can cause adhesions and strictures. This leads to narrowing of the intestines and can cause abdominal discomfort and pain for the child and as they grow into adulthood. If the strictures begin to affect the quality of life of the individual more invasive treatments such as surgery may be necessary.
- Recurrent NEC - Although very rare, it is possible for a small percentage of neonatal patients that suffer NEC to suffer from the condition repeatedly, sometimes due to the need to undergo surgery and other procedures that leave them vulnerable to bacteria and germs that can cause recurring NEC.
- Liver disease - Infants that suffer from NEC may need long-term nutritional support. When a newborn must feed for a prolonged period through these means and is unable to eat on their own, they can increase their risk of developing cholestatic liver disease. The correlation between the two conditions is not clear but is a common occurrence in severe NEC cases.
What Kind of Treatments Might a Baby with NEC Undergo?Watching a newborn or infant fight NEC is traumatic for parents. Babies may need to undergo several treatments and procedures to fight off the invasive NEC condition. The type of approach taken in the care of a baby's NEC depends on the severity of each case, the timeline of diagnosis and detection, and the overall state of their health at the time the condition develops. Common treatment options for NEC can include:
- Draining of fluids from the abdomen;
- Withholding of oral feedings;
- Stomach tube or IV feeding;
- Ostomy procedures; and
What Can You Do If You Believe Your Baby's NEC Diagnosis Is the Fault of Another Party?Necrotizing enterocolitis is not something any new parent prepares for or even thinks about until it happens to their child. Parents of children diagnosed with NEC understandably need assurance that their baby will get the care and support necessary to address the condition as much as possible. If you believe there is a possibility that your baby's development of NEC was due to a medical error or the formula fed to your baby while in a NICU or hospital, you may have the right to seek damages from the at-fault medical provider. Mistakes that lead to NEC in an infant can constitute medical malpractice, for which you and your child deserve significant financial compensation. An experienced medical malpractice attorney can advise parents of children diagnosed with NEC as to their rights and legal options for pursuing compensation. In addition, an attorney can help those parents explore the facts and circumstances of their child's development of NEC. Skilled medical malpractice attorneys routinely work with medical experts who can help to identify instances in which a medical provider's unreasonable decision or dangerous conduct led to a child contracting NEC. Finally, an attorney, when appropriate, can represent parents in legal actions seeking compensation for the harm done to their client, which may include payment for:
- Medical expenses related to treating a child's NEC and related health complications NEC causes;
- Other expenses parents would not have incurred but for their child developing NEC;
- Lost wages parents do not earn because they must take time off from work to care for a child with NEC;
- A child's lost future earning potential, if impacted by NEC;
- A child's pain, suffering, and diminished quality of life stemming from NEC and its long-term complications.