Necrotizing enterocolitis (NEC) is predominantly a disease of the premature neonate. The majority of patients diagnosed with NEC are less than 32 weeks gestation. Data from population-based studies worldwide estimate the incidence of NEC to be 0.72 to 1.8 per 1000 live births.1 The incidence is highest in extremely low birth weight infants (ELBW) weighing less than 1000 g, likely reflecting the degree of prematurity. 2 7 NEC decreases proportionally as birth weight increases, and a drastic decline occurs after 35 weeks gestation. 2 , 4 , 8