What is Necrotizing Enterocolitis (NEC)?
Necrotizing Enterocolitis (NEC) is a serious intestinal disease mainly affecting premature infants, typically within a few days to weeks after birth. It occurs when bacteria invade the intestinal wall, causing inflammation and, in severe cases, perforation. This can lead to harmful substances leaking into the abdomen or bloodstream.
Each year, about 480,000 babies are born prematurely in the U.S., with around 9,000 developing NEC. Approximately 80% of babies weighing less than 4.5 pounds develop NEC. Among very low birthweight infants (less than 3.3 pounds), 5-12% develop NEC, with 20-40% requiring surgery and 25-50% not surviving.
Many babies recover with treatment and go on to live healthy lives. However, severe cases may require surgery to remove damaged parts of the intestines, and about 30% of babies with NEC need surgery. Unfortunately, 20-30% of cases are fatal, and survivors may face long-term complications.
We continue to file cases on behalf of parents whose babies developed NEC.
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Brittany Scott Principal Atlanta, GA -
David Dearing Principal Montgomery, AL
The Connection Between Baby Formula and NEC
Over the past 30 years, research has shown a strong link between NEC and cow’s milk-based baby formulas.
- Higher Risk with Cow’s Milk Formula: Studies have found that premature babies fed cow’s milk-based formulas are significantly more likely to develop NEC than those fed human breastmilk.
- Meta-Analysis Findings: A combined analysis of six studies involving 869 preterm infants indicated that those fed cow’s milk formula had a 362% higher risk of developing NEC than those fed human breastmilk.
- Johns Hopkins Study: In 2011, research from Johns Hopkins showed that extremely premature babies (weighing less than 3.3 pounds) fed human donor milk were much less likely to develop NEC than those fed cow’s milk formula.
- Surgeon General’s Warning: In 2011, the U.S. Surgeon General highlighted the increased risk of NEC with formula feeding in premature infants and advocated for breastfeeding.
Despite these findings, major formula brands like Enfamil and Similac have not included warnings about the NEC risks associated with their cow’s milk-based products for preemies.
Types of NEC
NEC (Necrotizing Enterocolitis) can be classified into four types based on symptoms and the circumstances leading up to the condition:
- Classic NEC: This is the most common type, typically affecting infants born at 28 weeks gestation. Symptoms usually appear suddenly, without warning, about three to six weeks after birth.
- Transfusion-Associated NEC: This type occurs within three days after an infant undergoes a blood transfusion, often due to anemia.
- Atypical NEC: A rare form of NEC that occurs within the first week of life or before the first feeding.
- Term Infant NEC: This type affects full-term babies, often those with congenital disabilities or other problems at birth, such as a genetic heart condition, gastroschisis, or low oxygen levels.
Symptoms of NEC usually appear two to six weeks after birth and can either come on suddenly in infants who seem to be doing well or develop gradually over time. Some common symptoms include pain and swelling in the abdomen, changes in heart rate or blood pressure, lethargy, feeding intolerance, and lack of weight gain.
Affected Formulas
Infant formulas come in powdered and concentrated liquids, which require mixing with water or ready-to-use liquids. There are three major types of commercial formulas: cow’s milk-based, Soy-based, and Protein hydrolysate formulas.
NEC is associated with infant formulas and human milk fortifiers derived from cow’s milk. The two most common brands of infant formulas include:
- Similac (Abbott Laboratories)
- Enfamil (Mead Johnson & Company, LLC)
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