Sepsis in the Newborn

What is newborn sepsis?

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.

What causes newborn sepsis?

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 germs in the birth canal. Once born, a baby may be exposed to germs in the hospital or at home.

Which babies are at risk for newborn sepsis?

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 the strep germ in your vagina or have symptoms of infected amniotic fluid, such as a fever.
Your baby needs a medical procedure. This includes a urinary catheter or a central IV (intravenous) line.

What are the symptoms of newborn sepsis?

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 and grunting
Digestive problems like poor appetite or an enlarged liver
Nervous system problems, such as drowsiness or trouble staying awake
Irritability

How is newborn sepsis diagnosed?

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. They also check 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.

How is newborn sepsis treated?

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, they may change the treatment.

A newborn with sepsis may be very ill. The baby 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, they will get fluids, other medicines, oxygen, nutrition, and help with breathing, if needed.

What are possible complications of newborn sepsis?

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

Can newborn sepsis be prevented?

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. One example of this is that all pregnant women are screened for group B strep infection and treated if they have it.

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

When should I call my baby’s healthcare provider?

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

Key points about newborn sepsis

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.

Next steps

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 and when they should be reported.
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, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.