Necrotizing Enterocolitis Long Term Effects

Necrotizing enterocolitis (NEC) remains the most common cause of death in very premature babies after around two weeks of age. The range of mortality rate in NEC is between 10% and 66% of infants who weigh less than 1,500 g, depending on how severe the disease is. 

On the other hand, in babies whose weight is more than 2,500 g, the mortality rate is around 20%. However, aside from its high mortality rate, NEC is also the leading cause of morbidity in preterm infants. NEC survivors have a greater likelihood of suffering from long-term physiological and neurodevelopmental impairment. 

Today, the incidence of this life-threatening gastrointestinal disease is increasing, and the cause is something very commonly given to premature infants in the intensive care unit — formula milk. 

This has prompted several parents or guardians to file a NEC lawsuit against the makers of formula milk products involved in causing necrotizing enterocolitis in preemies. And while the survival rate for NEC has not changed in the past decades despite significant medical advancements, those who managed to survive the disease are at an increased risk of suffering from its often-debilitating complications. 

Read on to learn more about the long-term effects of necrotizing enterocolitis. 

How common is necrotizing enterocolitis?

Necrotizing enterocolitis is the most common and serious intestinal medical emergency among premature babies. It affects one in 1,000 to 4,000 births, which equates to up to five percent of neonatal intensive care unit admissions. 

The risk of NEC is highest in babies who weigh less than two pounds. The disease occurs in 10 percent of babies born prematurely and may only rarely affect term infants, with only one in 10,000 full-term babies getting NEC. 

It usually develops between three and 12 days after birth of a premature infant being fed with formula milk as opposed to breast milk. And while there is no exact explanation on why NEC mainly affects preterm infants, to date, the only consistent observations made in preemies who develop the disease are the presence of prematurity and formula feeding. 

What are the complications of necrotizing enterocolitis?

NEC carries a high mortality rate and for those patients that survive, the downstream impact can be lifelong. The most common complications of necrotizing enterocolitis are listed below. 

1. Neurodevelopmental Delay

Infants who manage to survive necrotizing enterocolitis have a worse neurodevelopmental outcome than other extremely low birth weight (ELBW) infants. Furthermore, infants who develop surgical NEC or those who require surgery for the condition have an even higher risk of poor neurodevelopmental outcome than others who have only received medical treatment. A review of the existing medical literature about the disease shows that more than 50% of NEC infants have neurodevelopmental delay. 

Evidence also exists that neurodevelopmental delay in NEC survivors cannot be explained by the presence of prematurity alone, but is actually dependent on comorbid conditions, such as NEC. Those with the disease have decreased cortical thickness, which is significantly associated with cognitive impairment. 

Children who suffered from NEC as infants may also suffer from poor educational, motor, and behavioral outcomes during their early childhood. Others may experience poor memory performance in adulthood. 

2. Failure to Thrive

Failure to thrive (FTT) is a condition that is extremely common in very premature infants and can be best described as inadequate physical growth. It is estimated that 5-10% of low birth weight children and children living in poverty suffer from FTT. 

The combined effects of NEC in the gastrointestinal system of an infant and the common treatment option that involves withholding feeding may contribute to slow physical development. In minor cases of NEC, the child will likely be able to restore their normal growth and development. However, others with severe NEC that require significant medical interventions may fall further behind other children of similar age and sex.

3. Intestinal Strictures

Intestinal strictures develop in around 6% to 33% of infants with previous NEC. A stricture is a narrowing in the intestine that can make it difficult for food to pass through. Intestinal strictures are a result of the damage caused by NEC to the intestines and these can occur along with scarring in the organ as it heals. 

Post-NEC strictures can cause abdominal discomfort and pain in the afflicted child as they grow into adulthood. If the strictures end up affecting a person’s quality of life, more invasive treatments like surgery may be needed. 

4. Cholestasis

Cholestasis is a liver disease that is characterized by reduced or blocked bile flow. Prolonged long-term nutritional support in infants who suffered from NEC may cause an increased risk of developing cholestatic liver disease. This is especially true in severe NEC cases. 

5. Short Bowel Syndrome

NEC can cause damage and may even destroy a section of the small intestine. When this happens, surgery may be necessary to remove certain portions that sustained too much damage for better healing. And when there is substantial loss of intestine, the infant may develop short bowel syndrome (SBS), which is also referred to as short gut syndrome. 

This condition can cause major feeding difficulties and as a result, those who suffer from it are unable to absorb the necessary nutrition they need to sustain life and may also require long hospitalizations. NEC is the leading cause of SBS in neonates. There is no cure for this lifelong condition and it can also lead to severe, disabling, and fatal complications. 

6. Death

Tragically, not all infants with NEC manage to survive. A large percentage of preterm infants will succumb to the disease because of their fragile state. NEC remains to be the most common cause of death among very low birth weight infants. 

Can necrotizing enterocolitis come back?

Yes, necrotizing enterocolitis can come back in very rare cases. Recurrent NEC occurs in around 4%-6% of patients mainly because of the need for surgical intervention and other procedures that leave them vulnerable to germs and bacteria that can cause recurring NEC. 

What formulas cause necrotizing enterocolitis?

The formulas that can cause necrotizing enterocolitis are Enfamil and Similac, which are both cow’s milk-based infant formula products. Mounting evidence from several studies show that the risk of developing NEC in premature babies is substantially increased with formula feeding. 

Although the exact mechanism as to why the risk is increased with formula-fed babies as opposed to those fed with human milk is still poorly understood, experts speculate that his could be due to the ability of cow’s milk formulas to proliferate damaging bacteria in the underdeveloped intestines of premature infants who do not have the right defenses to protect themselves from the life-threatening condition. 

What if my child develops NEC from drinking cow’s milk-based formulas?

If your child develops NEC from drinking cow’s milk-based formulas such as Enfamil or Similac, you may be able to file a lawsuit against the companies who sell the products involved in NEC lawsuits. 

Enfamil manufacturer Mead Johnson Nutrition and Similac manufacturer Abbott Laboratories, Inc. are being accused of failing to warn the public about the risk of NEC that their products pose. Plaintiffs claim that the manufacturers also did not share the life-threatening risk with doctors who often recommend the use of these formulas to preterm infants. 

As a result, the parents or guardians of babies diagnosed with NEC were not warned of thhis potential risk as well. Needless to say, no innocent child deserves to die due to a serious gastrointestinal disease that could have been avoided if such risk was listed on the label of the formula product they were fed with. 

Unfortunately, many huge companies do not update their warning labels to avoid tainting their image and to earn continually from their unsafe products. Luckily for you, there is a way for you to stand up to these abusive companies and put an end to their evil deeds. 

If your preemie developed necrotising enterocolitis, a serious and potentially deadly disease after being fed with cow’s milk-based formula, we may be able to help you file a case against its makers. Do not hesitate to contact us today and we will put you in touch with a NEC lawyer who will help you achieve justice and maximize the financial compensation you rightfully deserve. 

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