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 necrotising enterocolitis is unclear, but it may be due to bacteria or insufficient blood flow to the gut either before or after birth.
Some studies have shown that breast milk could protect vulnerable babies from necrotising enterocolitis, and links have been made between formula feeding and NEC. But this does not automatically mean that formula causes NEC, some babies who are breastfed also get NEC.
If your baby is too ill to breastfeed, you may be able to express milk and it can be fed to them through a special tube instead.
Intraventricular haemorrhage is the name for bleeding in the ventricles of the brain (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 problems such as cerebral palsy or seizures. In recent years fewer premature babies have bleeding in the brain partly because steroids are often given to women at risk of giving birth prematurely and these help to protect the brain from this complication.
If your baby does have a bleed on the brain, the healthcare team will check how severe the bleeding is by doing an ultrasound scan. The more premature the baby, the greater the risk of intraventricular haemorrhage.
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.
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 in severe cases.
Anaemia means not having enough iron stores in the baby’s body, and it is common in premature babies. 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.
Your baby's doctors will carry out tests to find out the cause. If your baby has anaemia they may have pale skin, 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. The likelihood of needing a blood transfusion at some point during the NICU stay increases with younger age at the time of birth.
The following organisations can give you more information about the topics covered in this section.
The best thing you can do for your baby is to look after yourself. That way, you will be better equipped to handle the challenges that face you and your family.
The neonatal intensive care unit (NICU)/special care baby unit (SCBU)/neonatal unit is where your baby will get the treatment they need until they are healthy enough to move on.
The first few days after giving birth to your premature baby can pass in a daze. Here's what to expect...
If your baby is born very prematurely and/or is very sick, they may need to be transferred to another hospital with specialist facilities.
After your premature baby is born the medical team will immediately assess your baby's health and start treating them if necessary.
Skin-to-skin contact with your premature baby is a wonderful way for you both to bond. It also provides health benefits.
You will play an important part in your premature baby's care, even while they are in the NICU.
Your premature baby's diet will be carefully balanced to suit their tiny digestive system while meeting the needs of their growing body.
Positioning your premature baby correctly can make them feel secure, improve their breathing ability, strengthen their muscles and reduce the risk of cot death.
You may be asked if you would consider taking part in research into premature birth. We explain what this might involve.
We answer some of your questions about your premature baby's time in the hospital and neonatal unit.
You're bound to feel anxious if your premature baby needs surgery, but try to focus on the positive: the operation is likely to help improve your baby's chances.
During their stay in the baby unit, your baby will have all kinds of checks to monitor their progress.
Babies born prematurely are more likely to have problems with their eyesight and hearing, but in most cases treatment is successful.
Premature babies have less developed immune systems and are more susceptible to infection, but there are ways to reduce the risk.
It's worrying if you discover that your baby has a heart problem, but most defects are treatable and some do not even need treatment.
Many premature babies need help with breathing for a while. This is known as ventilation.
- Macdonald S and Magill-Cuerden J (2012) Mayes’ Midwifery, Fourteenth Edition, Edinburgh: Bailliere Tindall Elsevier
ℹLast reviewed on October 5th, 2016. Next review date October 5th, 2019.
By Ela (not verified) on 14 Mar 2018 - 10:17
There are strong links between NEC and formula milk yet on your website it's not highlighted enough. NEC is extremely dangerous for prem babies with mortality rate of around 30%.
My baby got sick just after few feeds. There was no other circumstances which could have affected her condition. You should raise awareness.
By Midwife @Tommys on 15 Mar 2018 - 16:16
I am so sorry to hear that your baby was sick, I do hope she has recovered and is well now. We always appreciate feedback on our information, we will review your comments for this page. If you would like feedback about this then please do email us [email protected] Many thanks, Tommy's midwives x
By Anonymous (not verified) on 18 Oct 2017 - 20:48
keep up this good information for parents thank you so very much
By Midwife @Tommys on 19 Oct 2017 - 12:19
Hi, Thank you for your comment.
We are so pleased that you find all the information helpful, if there is anything else that you think we could improve them please contact us. Take Care, Tommy's Midwives x