Last updated September 2011. Planned review date: September 2013
Your premature baby - other conditions (Necrotising enterocolitis (NEC), jaundice, anaemia, intraventicular haemorrhage)
If your premature baby is diagnosed with any of the following conditions, take things one day at a time and ask the healthcare team to explain anything you don't understand.
Necrotising enterocolitis (NEC)
This condition is a serious complication of prematurity that affects the intestine. It involves infection and/or inflammation of the bowel wall. The cause of NEC is unclear, but it may be due to bacteria or insufficient blood flow to the gut either before or after birth.
Treatment for Necrotising enterocolitis
This involves resting the bowel by avoiding milk and giving antibiotics. Sometimes surgery is required.
Breastfeeding can help reduce the risk of necrotising enterocolitis.
Intraventricular haemorrhage
This is the name for bleeding in the ventricles (fluid-filled cavities in the brain). Some haemorrhages are very small, and are not thought to lead to long-term problems, while others are large and can be associated with later impairments such as cerebral palsy or seizures.
Treatment for intraventricular haemorrhage
The healthcare team will check how severe the haemorrhage (bleeding) is by doing an ultrasound scan through the baby's fontanelle (the soft spot of the skull). The more premature the baby, the greater the risk of intraventricular haemorrhage. It is rare among babies born at 32 weeks or over.
Jaundice 
Jaundice is common among newborns, and almost all premature babies develop it. In paler-skinned babies, jaundice shows as yellow-coloured skin, while in babies with darker skins, the yellowing may show only in the whites of the eyes. The degree of jaundice is measured from a blood sample.
Treatment for jaundice
Mild jaundice will often pass on its own, or with special light therapy called phototherapy, which involves laying the baby under bluish lights (with eye shades on) or on a fibre-optic blanket that emits light at the correct wavelength. Occasionally jaundice indicates that the baby has a more serious illness. The healthcare team will assess this and may need to carry out further tests in order to find the right treatment, which may include a blood transfusion.
Anaemia
Anaemia is common in premature babies, and more than 50 percent of babies born at less than 32 weeks develop anaemia in the weeks after birth. This happens for a range of reasons, including the baby's ability to generate red blood cells and the fact that the team has to take blood samples so often. Anaemia may also indicate a transient problem with blood group incompatibility/rhesus incompatibility.
Treatment for anaemia
Your baby's doctors will carry out tests to find out the cause. It may also indicate a rhesus problem. Symptoms include a pale complexion, lack of energy and rapid heart rate. Most cases of anaemia can be treated through good nutrition and iron supplements, although some babies need a blood transfusion or hormone treatment.
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Sources
ADAM Medical Encyclopedia (accessed Sept 2011) Necrotizing enterocolitis, PubMed Health, UN National Library of Medicine, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002133/
Baker RD and Greer FR (2010), Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anaemia in Infants and Young Children (0–3 Years of Age)
BMJ Best Practice (2011) Premature newborn care, follow up, complications, http://bestpractice.bmj.com/best-practice/monograph/671/follow-up/complications.html
Morgan JA, Young L and McGuire W (2011) 'Pathogenesis and prevention of necrotizing enterocolitis', Current Opinion in Infectious Disease; 24(3): 183-189
Neu J and Walker WA (2011) The New England Journal of Medicine. Necrotizing Enterocolitis; 364:255-264
Willacy H (2011) Infantile Intraventricular Haemorrhage, EMIS PatientPlus http://www.patient.co.uk/doctor/Infantile-Intraventricular-Haemorrhage.htm
Kenet G, Kuperman AA, Strauss T, Brenner B (2011) Neonatal IVH--mechanisms and management, Thrombosis Research, Vol 127, Suppl 3, p120-2
Rennie JM (2005) Roberton's Textbook of Neonatology, England, Churchill Livingstone
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