What is the initial treatment for necrotizing enterocolitis?

The initial treatment for necrotizing enterocolitis (NEC) focuses on stabilizing the affected infant and preventing further harm. Stopping oral feeds is a critical first step as it allows the intestines to rest and reduces the risk of further injury or inflammation. This approach often includes inserting a nasogastric (NG) tube to help decompress the stomach and remove any excess gas or contents, thereby relieving pressure on the gastrointestinal tract.

Intravenous fluids are also essential to support hydration and provide necessary nutrients while feeding is paused. However, the key component of the initial management is indeed the cessation of oral feeds and the use of an NG tube. Surgery may be necessary in advanced cases or when there are signs of perforation, but it is not typically the first response. Similarly, corticosteroids are not used as a primary treatment for NEC and are not indicated in this acute setting. Thus, stopping feeds and providing an NG tube is rightly considered the best immediate initial treatment for NEC.