What Is the Necrotizing Enterocolitis Definition?

Necrotizing enterocolitis is one of the most severe complications of premature births, occurring in five to ten percent of low-birth-weight babies. Necrotizing enterocolitis, or NEC, usually occurs between the fourth day and one month after birth. While there are some known causes of NEC, one cause, in particular, has come to the forefront, as it is one of the only causes of NEC that could potentially be eliminated. Necrotizing enterocolitis is severe inflammation in the intestines of babies, usually, those born prematurely, those with low birth weights, and those with other medical issues.

Necrotizing enterocolitis has also been tied to babies being fed a bovine-based formula. Babies that are exclusively breastfed are unlikely to develop NEC, as are full-term babies who are born with no health issues. It is theorized that the underdeveloped digestive tract of a premature baby, coupled with a cow’s milk-based formula can result in inflammation that can be severe enough to cause perforations or holes in the intestines of babies. There are currently two major manufacturers of bovine-based formulas in the United States, controlling about 80 percent of the market.

Mead Johnson and Abbott Laboratories are the manufacturers of Similac and Enfamil—perhaps the most well-known brands of baby formulas. Similac and Enfamil are often fed by hospital staff to babies, even premature babies because there have been no warnings regarding the risks of feeding a cow’s milk-based formula to premature babies. Hospitals often even send these formulas home with parents, implicitly saying they are safe. One study done in the 1990s found that premature babies that are given a bovine-based formulas are much more likely to develop NEC.

Premature babies who are exclusively fed breast milk are much less likely to develop NEC, yet many premature babies are fed these cow’s milk-based formulas either as their sole source of nutrition or as a supplement to breast milk. The goal is to help these low-birth-weight babies gain weight more quickly and catch up to their full-term peers. Surgery may be necessary when there are necrotic parts of the intestine that must be removed. The surgeon will leave as much intestine as possible to help avoid future issues like short bowel syndrome and other adverse long-term effects of NEC.

What Should I Know About NEC in Infants?

There are many different necrotizing enterocolitis signs and symptoms, including belly tenderness, discoloration of the belly, and a distended belly. The infant may refuse to eat and may have one or more of the following symptoms in addition to belly pain, distension, and discoloration.

• Diarrhea, sometimes containing blood
• Lethargy
• Vomiting green liquid
• Abnormal temperature or the inability to maintain a normal temperature
• Episodes of apnea, a temporary stop in breathing
• Episodes of low heart rate
• A drop in blood pressure
• Weak pulse
• Fluid in the abdominal cavity
• Infection in the tissue lining of the stomach
• Difficulty breathing

When your doctor examines the baby, he or she will be looking for the above symptoms and will likely order an X-ray. If the X-ray shows bubbles in the intestine, necrotizing enterocolitis is suspected. Air may also be found outside the intestines, in the abdomen or there could be air or gas in the large vein of the liver. Treatments may be medical or surgical, depending on how severe your infant’s NEC is. If there are no perforations in the intestine, all oral feeding will be stopped, and the baby will receive fluids and nutrients through an IV.

A nasogastric tube from the nose to the stomach may also be used to ensure the stomach remains empty. Frequent X-rays will most likely occur, along with frequent blood tests to ensure there is no infection. Babies whose stomachs are so swollen that it interferes with breathing may receive extra oxygen or could be placed on a ventilator. The surgical route requires removal of all necrotic intestines. The intestine may be connected to an abdominal opening until it can be reconnected once the baby’s health has improved.

What Are the Long-Term Effects of NEC?

Infants with NEC that did not require surgical interventions have a much lower chance of developing long-term effects. Infants that required surgery to cut out necrotic intestines could have adverse long-term medical problems. Neurodevelopmental delays may occur, including poor educational, motor, and behavioral outcomes during early childhood along with poor memory performance into adulthood.

Failure to thrive is common among infants who lost a part of their intestines due to NEC. Failure to thrive is inadequate physical growth. Failure to thrive can also occur in infants with NEC who did not undergo surgery. When treatment options involve withholding feeding during these critical early days, physical development may be slowed. While some babies will catch up to their normal growth and development, others will not.

Intestinal strictures develop in 6 to 33 percent of infants with previous NEC. A stricture is a narrowing of the intestine that makes it difficult for food to pass through. The stricture may be the result of the damage caused by NEC, including the scarring in the intestines as it heals. Intestinal strictures can cause abdominal discomfort and pain as the child grows into adulthood and can affect the individual’s quality of life.

Cholestasis is a liver disease that is characterized by reduced or blocked bile flow. Infants suffering from NEC that required prolonged nutritional support have an increased risk of developing cholestatic liver disease. NEC can destroy sections of the intestine, which must then be removed.

When there is a substantial loss of the intestine, the infant may develop short bowel syndrome, also known as short gut syndrome. Short bowel syndrome can result in major feeding issues, as the child is unable to absorb the nutrition necessary to sustain life. NEC is the leading cause of short bowel syndrome in the United States, and there is currently no cure.

How the Ohio Statute of Limitations Could Affect Your NEC Baby Formula Lawsuit

The statutes of limitations are put into place in each state to provide a window of time in which a plaintiff has to bring a lawsuit against the negligent party for injury or harm. The statutes vary from state to state, and some states offer exceptions to the statutes in the form of the Discovery Rule or statutes of repose. The Discovery Rule allows a plaintiff who did not discover that the harm or injury was tied to the defendant extra time to bring a lawsuit.

The Discovery rule is based on “reasonableness,” that is, whether another reasonable individual would have discovered the injury or harm within the allotted statute of limitations. Some states also incorporate statutes of repose, usually in relation to product liability claims, or, occasionally, medical malpractice claims. Since these statutes vary so extensively and may depend on the Discovery Rule or the statute of repose, it is essential that you speak to a knowledgeable NEC baby formula lawsuit lawyer. In the state of Ohio, the statutes of limitations include:

• Wrongful death claims have two years from the time of the death to file a lawsuit. The Discovery Rule applies in wrongful death lawsuits when those bringing the wrongful death lawsuit were unaware and could not reasonably have been aware that there was a potential legal claim at the time of the death.
• A personal injury claim has a two-year statute of limitations in Ohio. This statute generally begins to run on the date of the injury, although the Discovery Rule can extend the time according to the date you should have discovered the injury through the exercise of reasonable care.
• An Ohio medical malpractice lawsuit has a one-year statute of limitations following the act, error, or omission that constituted the basis of the lawsuit. This period begins as soon as one of the following circumstances occurs:
  • The injury is discovered or reasonably should have been discovered
  • The relationship between the medical provider and the patient ends
  The state sets an overarching four-year period, as the absolute deadline for when a medical malpractice claim must be filed.
• Product liability lawsuits must be filed in Ohio two years from the date on which the cause of action occurs. Ohio’s statute of repose states that a plaintiff may not file a product liability claim more than ten years after the injured party purchased the product that caused the injury.

How Can an Experienced NEC Baby Formula Lawsuit Attorney Help You?

If your baby was diagnosed with necrotizing enterocolitis after being fed a cow’s milk-based formula, you could benefit from speaking to a knowledgeable NEC baby formula lawsuit attorney from Sullo & Sullo. We will comprehensively evaluate your potential Similac and Enfamil lawsuit while answering all your questions. If you live in any of the following Ohio cities, it could be very helpful to speak to an NEC baby formula lawsuit lawyer.

Columbus, Ohio

Cleveland, Ohio

Cincinnati, Ohio

Toledo, Ohio

Akron, Ohio

Dayton, Ohio

Parma, Ohio

Canton, Ohio