[2026 Guide] Common Necrotizing Enterocolitis (NEC) Symptoms in Babies

Necrotizing enterocolitis (NEC) is one of the most dangerous and rapidly progressing gastrointestinal conditions that affect premature infants, often developing within the first two weeks of life.

NEC primarily involves the inflammation and necrosis of the intestines, which can lead to severe complications if not diagnosed and treated promptly.

The exact cause of NEC remains unclear, but it is believed to stem from a combination of factors including an underdeveloped immune system, bacterial invasion, and feeding practices, particularly the introduction of cow’s milk-based formulas.

The signs of a serious infection can be devastating on their own, especially for babies who are already weak.

The underdeveloped intestines of preterm infants are especially vulnerable to bacterial overgrowth, which can trigger an inflammatory response leading to tissue death.

As the disease progresses, it can cause intestinal perforation, allowing bacteria to enter the bloodstream and cause life-threatening infections like sepsis.

Despite advances in neonatal care, NEC continues to have a high mortality rate, especially when surgery is required to remove dead tissue.

Survivors may face long-term health challenges, including developmental delays and the need for prolonged nutritional support.

Early detection and intervention are crucial to improving outcomes, but even with timely treatment, the impact of NEC can be devastating for both the infant and their family.

The Physical Toll of NEC on Premature Babies

Necrotizing enterocolitis (NEC) takes an immense physical toll on premature infants, affecting not only their intestines but also their entire body.

The initial infection in the intestines causes localized swelling and inflammation, damaging the bowel’s protective lining and compromising its integrity.

As the infection progresses, the intestinal wall may perforate, allowing stool and bacteria to leak into the abdominal cavity, leading to peritonitis, a severe and often fatal condition.

When this rupture occurs, the risk of systemic infection or sepsis increases, which can quickly spread throughout the body and overwhelm the infant’s already fragile immune system.

Surgical intervention may be required to remove necrotic sections of the bowel, but this procedure often leads to further complications, such as short bowel syndrome, a condition that severely impairs nutrient absorption and leaves the infant dependent on long-term nutritional support.

Beyond the gastrointestinal system, NEC can have devastating effects on other organs.

The infection and resulting inflammation can compromise the infant’s heart, liver, kidneys, and lungs.

In some cases, the brain is affected, either through direct infection or due to prolonged low oxygen levels, leading to developmental delays or permanent brain damage.

These cascading health issues create a constant battle for survival, with many infants facing a lifetime of health challenges.

For families, watching their child endure multiple surgeries, infections, and the long-term impact of NEC is emotionally exhausting and deeply traumatic.

In a neonatal intensive care unit (NICU), where premature infants often reside for extended periods, the development of necrotizing enterocolitis (NEC) is a frightening and rapidly progressing condition that can go unnoticed by parents at first.

Unlike typical illnesses, the symptoms of NEC are often identified first by medical professionals who monitor the infant’s vitals and feeding patterns closely.

For parents, the initial signs of NEC might not be immediately apparent because premature infants in the NICU are already undergoing intensive care, with frequent interventions like tube feeding and monitoring.

However, once medical staff detect the early warning signs—such as abnormal feeding responses, increased irritability, or changes in bowel movements—parents are typically informed.

The staff may describe symptoms like abdominal swelling or distress, which can seem subtle but are red flags in a NICU setting.

As NEC progresses, these symptoms escalate quickly, and the gravity of the situation becomes evident.

The hospital environment can be overwhelming, and hearing terms like “intestinal perforation” or “sepsis” can be terrifying for families unfamiliar with these medical complications.

Often, parents may not even be present when the initial symptoms are detected, leaving them reliant on updates from the medical team.

By the time parents are fully briefed on their baby’s condition, NEC may have advanced significantly, requiring immediate medical intervention.

Understanding these symptoms and their progression is crucial, even if parents aren’t the first to notice the signs.

Common symptoms of NEC in premature babies include:

• Abdominal swelling or bloating (abdominal distention): This occurs when the intestines become inflamed and filled with gas, causing visible swelling in the infant’s abdomen, which can indicate a serious gastrointestinal problem.
• Refusal to feed or difficulty feeding: Infants with NEC may refuse to feed or struggle with feeding due to discomfort or abdominal pain, as the disease impacts the digestive system.
• Bloody stools: The presence of blood in the stool is a key sign of internal damage in the intestines, often indicating that the tissue lining of the bowel is being destroyed.
• Vomiting bile (yellow or green): Vomiting bile occurs when the intestines are blocked or inflamed, leading to a build-up of digestive fluids that are expelled through vomiting.
• Lethargy or lack of energy: Infants with NEC may become unusually tired or inactive due to the systemic effects of infection and the body’s struggle to combat it.
• Low blood pressure: As the infection spreads, it can cause sepsis, leading to a dangerous drop in blood pressure that requires immediate medical attention.
• Temperature instability (fever or low temperature): An unstable body temperature, either a fever or hypothermia, is often a response to infection or inflammation and signals that the body is under distress.
• Rapid breathing or heart rate: NEC can cause the infant’s body to compensate for the infection by increasing breathing and heart rate, as it tries to deliver more oxygen to the affected organs.
• Discoloration of the abdomen: The skin over the baby’s abdomen may appear red or purple, which is a sign of severe inflammation or tissue death in the intestines.
• Apnea (pauses in breathing): Breathing interruptions occur as the infection or inflammation spreads, affecting the infant’s overall condition and putting additional strain on their fragile systems.

How NEC is Diagnosed

Necrotizing Enterocolitis (NEC) is typically diagnosed through a combination of clinical signs, laboratory tests, and imaging.

Medical professionals often observe the baby’s symptoms, such as abdominal swelling, vomiting, and bloody stools, which can prompt further investigation.

Blood tests are commonly used to check for signs of infection or abnormal white blood cell counts, which may indicate an underlying problem.

X-rays of the abdomen are a critical diagnostic tool, revealing characteristic signs like air in the bowel wall (pneumatosis intestinalis), which is a hallmark of NEC.

In some severe cases, ultrasound may be used to assess blood flow to the intestines or to detect free air in the abdomen, signaling a bowel perforation.

Treatment for NEC depends on the severity of the condition.

In mild cases, doctors may halt oral feedings and administer antibiotics to control infection while supporting the baby with intravenous fluids and nutrition.

If the disease progresses or the baby’s condition worsens, surgical intervention may be required to remove the damaged sections of the intestines.

This can lead to long-term complications such as short bowel syndrome, where the infant has difficulty absorbing nutrients.

Post-treatment care often involves a combination of specialized feeding and ongoing medical monitoring to manage the baby’s recovery and long-term health outcomes.

One-quarter of infants diagnosed with NEC will require intestinal removal due to necrotic tissue, as reported by the Cleveland Clinic.

According to the Boston Children’s Hospital, the Children’s Hospital of Pittsburgh, and the National Institute of Child Health and Human Development, treatment for NEC may include the following:

• Stopping feedings
• Inserting a nasogastric (NG) tube (nose into stomach) to keep the stomach empty
• Intravenous fluids (IV) for fluid replacement and to absorb nutrients
• Antibiotics to fight infection
• Frequent x-rays to monitor the progress of the disease
• Extra oxygen or mechanically assisted breathing
• Isolation procedures (such as protective gowns and gloves) to stop the spread of the infection from the intestinal tract
• Blood transfusion
• Use of a breathing machine

In more severe NEC cases, babies with NEC may require surgery to have the intestine removed or conduct a bowel transplant, or connect intestinal tissue to an ostomy.

There are many medical treatments available to fight bacterial infections in your premature baby and an experienced child’s doctor should have the knowledge to combat the symptoms of Necrotizing Enterocolitis (NEC).

When Do Babies Have a Higher Risk of NEC?

When a baby’s oxygen supply is low, the body goes into “triage mode,” redirecting blood and nutrients away from the digestive system and toward other, more urgent functions.

The decreased oxygen supply can impede intestinal development, making it ripe for the onset of NEC.

NEC can potentially exacerbate an already present intestinal infection.

As a result of the NEC’s perforations, invading bacteria from the intestine can spread throughout the body.

Infants typically develop NEC within the first few weeks of life.

This lines up with the time they are most likely to receive infant formula in the hospital.

If they can’t nurse or feed by mouth, they typically receive baby formula through a tube that goes into their stomachs.

Necrotizing enterocolitis (NEC) can lead to a range of severe complications, both immediate and long-term, especially for premature infants.

These complications often arise from the body’s response to the infection and inflammation within the intestines.

The most severe outcomes can affect not only the digestive system but also other vital organs as the infection spreads.

For babies and their families, dealing with these complications can mean facing extended hospital stays, multiple surgeries, and long-term medical care.

The effects of NEC can be life-altering, leading to chronic health issues that persist into childhood and beyond.

Newborns with NEC often experience complications like:

• Sepsis: A life-threatening infection that spreads through the bloodstream, leading to systemic inflammation and organ failure.
• Intestinal perforation: NEC can cause the intestinal wall to tear, allowing bacteria and waste to leak into the abdominal cavity, resulting in severe infection.
• Short bowel syndrome: When significant portions of the intestine are surgically removed due to NEC, it can lead to long-term digestive problems and difficulty absorbing nutrients.
• Developmental delays: Due to prolonged medical treatments and lack of adequate nutrition, infants with NEC may experience delays in reaching developmental milestones.
• Chronic lung disease: NEC can complicate pre-existing respiratory issues in premature infants, leading to long-term breathing problems and lung damage.
• Failure to thrive: Infants who survive NEC often struggle to gain weight and grow properly due to chronic digestive and nutritional challenges.
• Neurodevelopmental impairment: The severe infections caused by NEC can impact brain development, leading to cognitive and motor skill deficits as the child grows.
• Death: Unfortunately, for some infants, the complications from NEC are too severe, leading to fatal outcomes despite medical intervention.

Due to their underdeveloped immune systems, newborns are especially at risk for NEC. NEC affects roughly one in every 1,000 preterm infants.

In neonatal intensive care units (NICU), NEC is the leading cause of death from gastrointestinal causes in premature infants.

Premature newborns with NEC have a mortality rate between 20% and 50%.

Even though NEC’s underlying causes remain highly debated, peer-reviewed research has shown that preterm newborns who are fed breast milk have a significantly lower risk of developing NEC than those who are given infant formula made from cow’s milk.

A study published in The Lancet in 1990 found that premature babies who were exclusively given cow milk based formula were 6 to 10 times more likely to develop NEC than breastfed infants.

There are many ways a premature infant could contract NEC, but the failure of a baby formula manufacturer to warn about the potential for NEC from their products is particularly worrying.

Mothers may need assistance with formula feeding if they’ve recently given birth prematurely and are still healing from the physical strain of labor.

Premature babies often have formula added to their diets, especially when the mother is unable to breastfeed due to complications during delivery.

Several popular brands of infant formula, including Similac Infant Formula and Enfamil Premature Infant Formula, contain cow’s milk-based formulations that have been related to an increased risk of NEC.

There is a higher chance of NEC for infants who receive these products while in the hospital (or, subsequently, at home).

Though certain unfortunate instances of medical negligence have been linked to NEC, most doctors and nurses are committed to the safety of the infants in their care and take all necessary measures to avoid and identify NEC.

However, if NEC isn’t detected early, it might develop into a fatal infection that a baby’s underdeveloped immune system may be unable to fight off, leading to major difficulties, lifelong disabilities, or even death.

Parents in multiple states have filed NEC Infant Formula Lawsuits against Abbott Laboratories and Mead Johnson, the makers of Similac and Enfamil, respectively, for allegedly failing to warn about the dangers of giving cow’s milk formula to premature infants.

NEC Lawsuits further claim that the defendants falsely advertised their products as “comparable” to human milk when, in reality, premature infants were at a higher probability of suffering NEC when fed these formulas.

If your child or a loved one’s child developed necrotizing enterocolitis (NEC) after receiving an Enfamil cow’s milk-based formula or fortifier, you may be eligible to pursue an Enfamil NEC lawsuit.

Contact TorHoerman Law for a free consultation.

You can also use the chat feature on this page to find out if you qualify for an NEC Lawsuit instantly.

TorHoerman Law Secures $495 Million Verdict in Premature Infant Formula Trial vs. Abbott Laboratories

In a landmark case, TorHoerman Law secured a $495 million verdict against Abbott Laboratories in a lawsuit involving Similac baby formula and its link to necrotizing enterocolitis (NEC) in premature infants.

The verdict included $95 million in compensatory damages and $400 million in punitive damages, reflecting the jury’s recognition of Abbott’s negligence in failing to warn parents and healthcare providers about the dangers of cow’s milk-based formulas.

The case, filed on behalf of a family whose child suffered severe complications after consuming Similac, marked a significant victory for families affected by NEC.

This result highlights the grave impact of NEC on premature infants and the responsibility of companies like Abbott Laboratories to ensure the safety of their products.

This case sets a powerful precedent for future lawsuits in the ongoing NEC Baby Formula litigation.

TorHoerman Law continues to represent families in NEC litigation and is currently accepting new NEC claims involving Enfamil products manufactured by Mead Johnson.

TorHoerman Law is no longer accepting NEC clients with claims against Similac.

If your child developed NEC after receiving an Enfamil formula or fortifier, you may be eligible to pursue an Enfamil NEC claim.

Reach out today for a free consultation to discuss your case.

Is There a NEC Class Action Lawsuit?

No, there is not a Baby Formula NEC Class Action Lawsuit.

Rather, the increasing volume of claims resulted in the establishment of the NEC Infant Formula MDL (Multidistrict Litigation).

The NEC Baby Formula MDL, centralized in the United States District Court for the Northern District of Illinois, operates differently than a class action lawsuit.

Those who file claims in an MDL proceeding are recognized as distinct individuals and are afforded the same protections as they would be in an individual lawsuit.

Infant Formula NEC Lawsuits are also being filed in state courts across the country, both jointly and individually.

Families with potential Enfamil NEC claims can contact TorHoerman Law for a free consultation.

TorHoerman Law is currently accepting NEC claims involving Enfamil products manufactured by Mead Johnson and is no longer accepting NEC clients with claims against Similac.

What Similac and Enfamil Baby Formulas are Mentioned in the NEC Lawsuits?

The Enfamil and Similac products mentioned in NEC lawsuits are specialized formulas typically administered in neonatal intensive care units (NICUs) and maternity wards to premature and low-birth-weight infants.

These products are not available for retail sale and are instead provided directly to hospitals, where they are used under medical supervision.

Hospitals rely on these formulas for nutritional support in cases where breast milk is unavailable or insufficient.

However, concerns have been raised about the increased risk of necrotizing enterocolitis (NEC) associated with these cow’s milk-based formulas, prompting legal actions against the manufacturers.

Similac Baby Formulas mentioned in NEC Lawsuits include:

• Similac Alimentum
  • Similac Alimentum Expert Care
• Similac Special Care
  • Special Care 30
  • Special Care 24
  • Special care 24 High Protein
  • Special Care 20
• Similac Human Milk Fortifier
  • Similac Human Milk Fortifier Hydrolyzed Protein – Concentrated Liquid
  • Similac Human Milk Fortifier Powder
• Similac Liquid Protein Fortifier

Enfamil Baby Formulas mentioned in NEC Litigation include:

• Enfamil Human Milk Fortifier Powder
  • Human Milk Fortifier Liquid High Protein
  • Human Milk Fortifier Liquid Standard Protein
  • Human Milk Fortifier Acidified Liquid
• Enfamil NeuroPro Enfacare
• Enfamil Premature
  • 20 Cal
  • 24 Cal
  • 24 Cal/fl oz HP
  • 30 Cal
• Enfamil 24 and DHA & ARA Supplement

If your child developed necrotizing enterocolitis (NEC) after receiving an Enfamil cow’s milk-based formula or fortifier in the NICU, you may be eligible to pursue an Enfamil NEC lawsuit.

Parents of premature infants affected by NEC are seeking justice from baby formula manufacturers for failing to warn about the increased risk of this serious gastrointestinal disease.

Filing a Baby Formula NEC Lawsuit can help families recover compensation for medical expenses, long-term care, and the emotional toll of their child’s suffering.

TorHoerman Law is currently accepting NEC claims involving Enfamil products manufactured by Mead Johnson.

Contact our law firm for a free consultation about a potential Enfamil NEC claim.

Use the chat feature on this page to find out if you qualify for the NEC Infant Formula Lawsuit instantly.

Medical records, NICU feeding histories, product information, treatment records, and documentation of resulting injuries may provide important evidence in an Enfamil NEC claim.

Gathering Evidence for NEC Baby Formula Lawsuits

Building a strong case for an NEC Baby Formula Lawsuit requires gathering substantial evidence to prove that cow’s milk-based formula increased the risk for a child’s necrotizing enterocolitis (NEC).

Evidence relevant to an Enfamil NEC claim may include medical records, NICU feeding records, product-identification information, diagnostic testing, surgical records, and documentation of long-term complications.

These records may help document the Enfamil product administered, the timing of formula exposure and NEC diagnosis, and the injuries and treatment that followed.

Evidence in NEC Lawsuits may include:

• Medical and Feeding Records: Documenting what formula was given and tracking the infant’s health throughout treatment.
• Hospital Records: Including treatment notes and documentation of the infant’s NEC diagnosis.
• Doctor’s Notes and Recommendations: Information about the decision to use formula and the infant’s response to it.
• Medical Bills and Receipts: Proof of all expenses incurred due to NEC treatment.
• Photographs of the Infant’s Condition: Capturing physical symptoms of NEC as they progressed.
• Expert Testimony: Medical experts who can attest to the link between the formula and NEC.
• Witness Statements: From family members or hospital staff about the baby’s condition and care received.

Each of these pieces of evidence can play a pivotal role in proving liability in NEC cases.

Types of Damages in Lawsuits Involving Infant Formulas

Damages refer to the compensation sought for the effects necrotizing enterocolitis (NEC), taking into account both economic and non-economic losses.

The damages sought in an Enfamil NEC lawsuit may depend on the severity of the child’s injuries, medical expenses, long-term care needs, lost income, and other losses recognized under applicable law.

Common types of damages that may be sought in NEC Lawsuits include:

• Medical Expenses: Compensation for all past, present, and future medical bills related to NEC diagnosis and treatment.
• Long-term Care Costs: Costs associated with ongoing medical care, rehabilitation, and special treatments required due to lasting complications.
• Pain and Suffering: Damages for the physical and emotional distress endured by the infant and their family.
• Loss of Quality of Life: Compensation for the diminished quality of life the child may experience due to long-term health problems.
• Wrongful Death Damages: In cases of fatal NEC, families may seek compensation for funeral expenses and the emotional toll of losing a child.
• Lost Wages: If parents had to leave work or reduce hours to care for their child, they may recover lost income.
• Punitive Damages: In cases where the manufacturer’s negligence was egregious, punitive damages may be awarded to punish the defendant and deter future misconduct.

The damages available in an individual NEC lawsuit depend on the facts of the case and the law that applies to the claim.

TorHoerman Law represents families pursuing NEC claims involving Enfamil products manufactured by Mead Johnson.

Our law firm has experience in NEC baby formula litigation, including obtaining a $495 million jury verdict in a 2024 case against Abbott Laboratories.

If your child developed necrotizing enterocolitis (NEC) after receiving an Enfamil cow’s milk-based formula or fortifier in a hospital or NICU, you may be eligible to file an Enfamil NEC lawsuit.

TorHoerman Law is no longer accepting NEC clients with claims against Similac. We are still accepting clients with claims against Enfamil.

Contact our law firm for a free consultation.

You can use the chat feature to see if you qualify for the NEC Baby Formula Lawsuit instantly.

Let us handle the legal battle for you so you can concentrate on what matters — your child’s well-being.