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The Medical Intensive Care Unit (MICU) at Massachusetts General Hospital cares for patients with a wide variety of serious medical illnesses from sepsis to pneumonia, acute respiratory distress syndrome to multiple organ failure.
Sepsis in the Newborn
What is newborn sepsis?
Newborn sepsis is a severe infection in an infant less 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 fetus 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.
Which babies are the risk for newborn sepsis?
The following are things that make it more likely that your newborn will have sepsis:
- Your baby is born too early. This means before 37 weeks of pregnancy.
- Your amniotic sac is ruptured for 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.
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 (usually 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
How is newborn sepsis diagnosed?
Sepsis in the newborn can be hard to diagnose. The signs of sepsis are similar to many other health conditions. Your baby may need tests. These may include:
- Blood culture 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 to check for bacteria in the urinary system
- Other cultures to check for bacteria in other places, such as in a wound
- Blood tests to check for signs of infection
- Lumbar puncture to check for infection of the brain or spinal cord. 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 suspects 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 other medicines, oxygen, nutrition, and help with breathing, if needed.
What are the complications of newborn sepsis?
Sepsis is life-threatening for newborns. It can affect any body system. It often affects more than one system at the same time.
Can newborn sepsis be prevented?
Although newborn sepsis can’t be completely prevented, you can lower the risk. Regular prenatal care can detect 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 involve cutting or putting instruments 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 very sleepy, fussy, or not eating well
Key points about newborn sepsis
- Newborn sepsis is a severe infection in an infant less than 28 days old.
- A newborn may become infected before, during, or after birth.
- Newborn sepsis can be difficult 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.