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Necrotizing Enterocolitis

Necrotizing enterocolitis (or NEC) occurs when the lining of the intestinal wall dies causing the death of tissue in the intestine. It occurs most often in premature or sick babies. In the majority of cases, this disease affects babies who are already ill or born prematurely.

The exact cause is unknown. However, there are a number of contributing factors such as: 

  • Being born prematurely

  • Being formula fed instead of being fed mother’s milk

  • Being seriously ill or receiving blood transfusions​​

Symptoms of NEC sometimes develop slowly, while at other times they set rapidly. Some of the major symptoms include: ​

  • Bloating of the baby’s stomach.

  • Vomiting

  • Blood in the baby’s stool

  • Diarrhoea

  • Lack of energy

  • Unsteady temperature

  • Unstable breathing

  • Change in baby’s heart rate

  • Raised or reduced blood pressure​​

If your child is experiencing any of the above symptoms at birth, immediately consult with our expert neonatologists and nurses working with the Children’s Hospital Service Line at The Aga Khan University Hospital. You can be assured of receiving multidisciplinary care under one roof at the only internationally accredited hospital in Pakistan.​​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​​

Your neonatologist working with the Children’s Hospital Service Line at The Aga Khan University Hospital can diagnose NEC by performing a physical examination and conducting various tests. A physical exam involves gently touching your baby’s abdomen to check for signs of swelling, pain and/or tenderness. 

For further detailed analysis, your doctor will perform an abdominal X-ray which gives pictures of your baby’s intestine. Your doctor will be on the alert for signs of inflammation and damage. He/she can also check your baby’s stool can for blood, which is known as a stool guaiac test.

There are also some blood tests that can be useful to check for NEC. These include tests to measure your baby’s platelet levels and white blood cell counts; a low platelet level or a high white blood cell count can indicate NEC.

  • Complete Bood count(CBC): One or more parameters related to red blood cells, white blood cells and platelets might be affected in this condition, giving a clue towards etiology and further diagnostic approach. Therefore, it is an ancillary test in the diagnostic workup of this disease

Your baby’s doctor at The Aga Khan University Hospital may also check for intestinal fluid by inserting a needle into the abdominal cavity - this usually indicates that there’s a hole in the intestine.​​

Disclaimer: Kindly consult your physician before getting the above-mentioned tests​.

Some of the treatment options for NEC include:

  • temporarily stopping all types of oral feeding and providing nutrition intravenously 

  • remove air and fluid from your baby’s stomach and intestine by inserting a tube through the nose

  • prescribed medications

  • providing extra oxygen if breathing is restricted

When your baby is able to be fed again, it is recommended to feed him or her breast milk, as it is easily digested, and boosts immunity.

Sometimes, the above treatments may not work, in which case doctors may recommend surgery. During this procedure, doctors look for a hole in the intestine or remove any dead or dying tissue in the intestines. Another type of surgery is ostomy, during which the surgeon redirects the intestine to help stool safely leave the body.

If your baby faces malabsorption (that is, your baby can’t absorb nutrients normally) then he/she may need nutrition delivered intravenously until they are recovered enough to eat normally.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.​

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​​




​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.​