Sepsis in the Newborn

Newborn sepsis is a severe
infection in an infant younger than 28 days old. The infection is in your baby’s blood.
But it may affect any body system or the whole body.

Newborn sepsis is most often caused
by bacteria. But other germs can also cause it. A baby may become infected before birth
if your amniotic fluid is infected. During delivery, the newborn may be exposed to an
infection in the birth canal. Once born, a baby may be exposed to infections in the
hospital or at home.

These things make it more likely
that your newborn will have sepsis:

  • Your baby is born too early
    (premature). This means before 37 weeks of pregnancy.
  • Your amniotic sac breaks (ruptures)
    more than 18 hours before birth.
  • You have a strep infection or symptoms of infected amniotic fluid, such as a fever.
  • Your baby needs a medical procedure. This includes a urinary catheter or a central intravenous line.

Sepsis in newborns can be hard to identify. Symptoms depend on what’s causing the infection. They also depend on how severe the infection is and where it is. The newborn may have:

  • Signs of distress during labor or delivery, such as a rapid heart rate
  • Changes in temperature (often
    fever)
  • Breathing problems, such as very fast breathing
  • Digestive problems like poor appetite or an enlarged liver
  • Nervous system problems, such as drowsiness or trouble staying awake

The symptoms of sepsis are similar
to some other health conditions. Your baby will need tests to make a sepsis diagnosis
and to rule out other illnesses. These tests may include:

  • Blood culture. This is done to check
    for bacteria in the blood. Results take a few days, but treatment will start right
    away. This is the main way sepsis is diagnosed.
  • Urine culture. This checks for
    bacteria in the urinary system.
  • Other cultures. This checks for
    bacteria in other places, such as in a wound.
  • Blood tests. These check for signs of
    infection and for possible effects of sepsis on the kidneys, liver, and blood cells.
  • Lumbar puncture. This is done to
    check for infection of the brain and spinal cord (meningitis).  A small amount of
    cerebrospinal fluid is tested.
  • X-rays or other imaging tests. For example, a chest X-ray is used to check for a lung infection.

Treatment will depend on your baby’s symptoms, age, and general health. It will also depend on how severe the condition is.

Early diagnosis and treatment is
the best way to stop sepsis. If your baby’s healthcare provider thinks it may be sepsis,
your baby will get antibiotics right away, even before test results are available. Once
the provider has the test results, he or she may change the treatment.

A newborn with sepsis may be very
ill. He or she will need to stay in the newborn intensive care unit (NICU). In the NICU
your baby will be watched very closely. In addition to the antibiotics, he or she will
get fluids, other medicines, oxygen, nutrition, and help with breathing, if needed.

Sepsis is life-threatening for
newborns. It can affect any body system. It often affects more than 1 system at the same
time.

Newborn sepsis can’t be completely
prevented. But you can lower the risk. Regular prenatal care can find and treat many
problems that put a newborn at risk for sepsis.

Hospitals and other facilities have practices in place to prevent the spread of infection. These include:

  • Frequent handwashing
  • Limiting procedures that include
    making cuts or putting tools into the body

Call your baby’s healthcare provider right away if your newborn has:

  • A fever above 100.4°F (38.0°C) rectally
  • A fever lasting more than 1 day
  • Trouble breathing
  • A change in behavior, such as being
    very sleepy, fussy, or not eating well
  • Newborn sepsis is a severe infection
    in an infant younger than 28 days old.
  • A newborn may become infected before, during, or after birth.
  • Newborn sepsis can be hard to
    diagnose.
  • Early diagnosis and treatment are the best ways to stop sepsis.
  • Antibiotic medicine is started as soon as possible.

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.