Premature Babies

A full-term pregnancy lasts an average of 40 weeks. Babies that are born between 37 and 42 weeks are considered full term. Babies born before the 37th week of pregnancy are considered premature.

According to the March of Dimes, about 12 percent of babies born in the U.S. are premature. Women at risk for preterm delivery are those who have had a prior preterm birth, are carrying more than one baby or have certain types of uterine or cervical abnormalities. Lack of prenatal care, smoking or using illegal drugs, infection, diabetes and high blood pressure can also increase the risk for preterm labor.

Necrotizing Enterocolitis

Necrotizing enterocolitis (NEC) is an infection that causes destruction of intestinal tissue. Initially, the affected sections of the bowels are inflamed. Bacteria "eat away" at the lining, killing the tissue. Eventually, the intestinal wall is perforated.

According to the American Pediatric Surgical Association, NEC affects about 25,000 babies every year. It's usually seen in preterm or low birth weight babies and is the most common gastrointestinal condition in premature babies. Infants with NEC may have feeding difficulty, decreased bowel sounds, bloating, abdominal tenderness and bloody stools.

No one knows what causes NEC, or why premature babies appear to be at highest risk for the condition. Some people think the intestinal tissues of preemies haven't fully developed and are stressed by food moving through the bowels. That may allow bacteria that normally live in the gut to invade the walls of the intestines.

If NEC is suspected, doctors will take an X-ray. NEC causes the formation of gas bubbles on the walls of the intestines or large veins of the liver. If the intestinal wall has been perforated, gas bubbles may appear outside the intestines in the abdominal cavity.

Treating Babies with NEC

Initially, doctors may try more conservative measures to treat NEC. A suction tube is placed through the mouth or nose into the stomach and intestines to remove the gas. Antibiotic therapy is crucial. Doctors may prefer to use a combination of antibiotics for 10 days or more. If signs of NEC disappear, small, dilute amounts of formula may be given. The amount and concentration of formula is increased very slowly.

If part of the intestine has died, or the intestinal wall is perforated, the damaged area of the bowels must be removed. Surgeons will try to save as much healthy bowel tissue as possible to preserve digestive function. Once the damaged portions of the intestine have been taken out, the end of the remaining intestine is brought through the wall of the abdomen. A hole is made in the stomach wall (called a stoma) to allow intestinal contents to empty into a bag. Once the infant has gained an adequate amount of weight, doctors may reconnect the intestines and close the stoma.

Doctors are learning to recognize the signs of NEC at earlier stages and treat babies before severe complications develop. Still, the American Pediatric Surgical Association estimates that one out of every four babies with the most severe form of NEC die.

Researchers are trying to pinpoint the cause of NEC and find ways to promote healing in the intestines. David Hackam, M.D., Ph.D., a Pediatric Surgeon at Children's Hospital of Pittsburgh, is studying the signals that control healing in the intestine. He and his colleagues hope to find medications that will turn off inappropriate signals and keep the intestines from dying.

For general information on necrotizing enterocolitis, The American Pediatric Surgical Association

For information on prematurity: March of Dimes