What Is Necrotizing Enterocolitis (NEC)?
Necrotizing Enterocolitis, or NEC, is a dangerous intestinal disease that affects thousands of premature babies each year. It strikes fast—often within the first few weeks of life—and can lead to serious complications, including infection, surgery, and even death. For families with preemies, understanding NEC isn’t just important—it’s essential.
Each year in the U.S., about 480,000 babies are born prematurely. Of those, around 9,000 develop NEC. The risk is highest in babies weighing under 4.5 pounds. Among the smallest infants—those under 3.3 pounds—up to 12% may be affected. While many recover with treatment, about 30% require surgery, and 20–30% of cases are fatal. Survivors may face long-term health challenges, including feeding issues and developmental delays. As of July 2025, there are 744 active NEC-related lawsuits pending in federal court.
The Connection Between Baby Formula and NEC
For more than 30 years, studies have pointed to a troubling link between NEC and cow’s milk-based baby formulas. Premature babies fed these formulas are significantly more likely to develop NEC than those fed human breast milk.
- A major analysis of six studies found a 362% higher risk of NEC in babies fed cow’s milk formula.
- A Johns Hopkins study showed that donor breast milk dramatically reduced NEC risk in extremely premature infants.
- The U.S. Surgeon General has publicly warned about the dangers of formula feeding in preemies.
Despite this, leading formula brands like Similac and Enfamil have not added NEC warnings to their cow’s milk-based products for premature infants.
Affected Products
NEC has been linked to cow’s milk-based infant formulas and milk fortifiers, especially:
- Similac (Abbott Laboratories)
- Enfamil (Mead Johnson & Company)
These products are sold in powdered, concentrated liquid, and ready-to-feed forms.
Know the Signs: Types and Symptoms of NEC
NEC isn’t one-size-fits-all. It can appear in different forms:
- Classic NEC: The most common type, usually appearing 3–6 weeks after birth.
- Transfusion-Associated NEC: Occurs shortly after a blood transfusion.
- Atypical NEC: Rare, and can appear even before a baby’s first feeding.
- Term Infant NEC: Affects full-term babies with other health complications.
Symptoms may include a swollen or tender belly, feeding difficulties, lethargy, abnormal heart rate or blood pressure, and poor weight gain. These signs can appear suddenly—even in babies who seemed to be doing well.
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