A new light-based technology could catch the most feared disease in neonatal intensive care units in its earliest stages: necrotizing enterocolitis (NEC), a life-threatening intestinal inflammation of premature babies that often strikes with almost no warning.

The method exploits the near-translucent skin of preterm infants: a probe illuminates the belly with infrared and visible light, a spectrometer measures how much light is reflected back at different wavelengths, and a machine learning model interprets the results. Because NEC darkens the intestine as it loses blood supply, the color change can be detected through the abdominal wall — no incision needed.

In a pilot study of 96 infants, the scans correctly identified all ten babies with NEC — though with a significant number of false positives. "If the results hold up and can be refined, I'd like to see it in at every NICU bassinet and just a part of the routine," said Seth Goldstein, a pediatric surgeon at Lurie Children's Hospital of Chicago, whose team worked with Northwestern University.

NEC kills more than 20 percent of affected babies and can progress within hours from a distended abdomen to severe disease. It affects up to five percent of all premature infants — and 10 percent of those born weighing less than 1,500 grams. Early-stage NEC is treated with antibiotics and intravenous feeding; severe cases often require surgery to remove part of the intestine. No specific drugs exist.

Within the next year, the researchers plan a large trial scanning babies regularly to detect NEC before symptoms appear — a kind of early detection they already demonstrated in mice scanned daily. In parallel, the team is developing a low-cost handheld device. Ravi Patel, director of neonatal clinical research at Emory University, urges caution: the pilot study includes "too few cases to know how it would perform in the real world," and false positives raise the concern of overtreatment. Still, he said, the technology is "worth looking into more."

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