Necrotizing enterocolitis

who are nearsighted, the eyeball is too long from front to back so that the rays converge in front of the retina. This causes blurring of objects more than a few feet away from the affected child, and the farther away the objects are, the more indistinct they are.

Symptoms

Often young nearsighted children do not realize that they have a visual problem. Symptoms include squinting, holding the head at an unusual angle, eye rubbing, sitting too close to the Tv, and clumsiness. Many parents do not notice the problem until the child starts school, when it quickly becomes apparent that there are problems in seeing the blackboard. Many parents first discover a problem during a school vision screening.

Treatment

Correction for nearsightedness includes wearing glasses or contact lenses. Because a child's eyes grow and change quickly during the first seven years of life, youngsters this age may need vision checks every six months. Because contact lens require more difficult care, they are rarely prescribed for young children.

necrotizing enterocolitis (NEC) This gastrointestinal disease primarily affects premature infants, infecting, inflaming, and eventually destroying part of the infant's bowel. Although it affects only one infant in 2,000 to 4,000 births, (up to 5 percent of neonatal intensive care unit admissions), it is the most common and serious gastrointestinal disorder among hospitalized preterm infants.

Necrotizing enterocolitis (NEC) typically begins within the first two weeks of life, because premature infants have immature bowels that are sensitive to changes in blood flow and prone to infection. They may have difficulty with blood and oxygen circulation and digestion, which increases their chances of developing NEC. However, the exact cause of NEC is unknown. Experts suspect that the intestinal tissues of premature infants are weakened by too little oxygen or blood flow, and when milk feedings are begun, the added stress of moving food through the intestine allows bacteria to damage the intestinal wall. The damage may affect only a short segment of the intestine, or it may progress quickly to involve a much larger portion.

The infant will begin to look sick if bacteria continue to spread through the wall of the intestines and into the blood, and may develop mineral imbalances. In severe cases the intestine may perforate, allowing bacteria to leak into the abdomen and causing life-threatening peritonitis. Because the infant is physically immature, even with quick treatment there may be serious complications.

Some experts believe that NEC can be triggered by the type of infant formula and its rate of delivery, or the immaturity of the mucous membranes. (Babies who are fed breast milk can also develop NEC, but their risk is lower.) Another theory is that babies who have had difficult deliveries with low oxygen levels can develop NEC. When there is not enough oxygen, the body sends the available oxygen and blood to vital organs instead of the gastrointestinal tract, and NEC can result. Babies with an increased number of red blood cells also seem to be at higher risk, because too many red blood cells thicken the blood and hinder the transport of oxygen to the intestines.

NEC sometimes seems to occur in epidemics, affecting several infants in the same nursery, which suggests that in some cases the infection could be spread from one baby to another, despite the fact that all nurseries have very strict precautions to prevent the spread of infection.

Symptoms

The symptoms of NEC may vary from one baby to the next, and may mimic other digestive problems, but they include:

• poor tolerance to feedings

• food stays in stomach longer than expected

• decreased bowel sounds

• bloating and abdominal tenderness

• greenish vomit

• red abdominal skin

• increase or drop in number of stools

bloody stools

Other symptoms include periodic stoppage of breathing, slowed heart rate, diarrhea, lethargy,

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