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Neonatal Sepsis

Definition:
Neonatal sepsis is a bacterial infection in the blood. It is a condition found in infants less than three months old. This is a potentially serious condition that requires care from your baby’s doctor. If you suspect your baby has this condition, contact the doctor immediately.

Spread of Infection Via the Blood to the Entire Body in an Infant

Causes:
The cause of neonatal sepsis is related to the baby’s exposure to bacteria. Sepsis that develops within the first week is usually acquired from the mother, via the placenta or from passage through the birth canal. Sepsis that develops after one week is usually acquired from the caregiving environment.

The incidence of culture-proven sepsis is approximately 0.2%, but the mortality rate can be as high as 50% if not treated.

Some factors related to your pregnancy or health also add to the chance that your baby can get this condition. These include:

  • You have labor complications resulting in traumatic or premature delivery.
  • Your water has broken more than 18 hours prior to giving birth.
  • You have a fever or other infection while you are in labor.
  • You need to have a catheter for a prolonged period of time while you are pregnant.
Risk Factors:
The following factors increase your child’s chances of developing neonatal sepsis:
  • Your baby is born more than three weeks before your due date (premature).
  • You go into labor more than three weeks before your due date.
  • Your baby is in distress before being born.
  • Your baby has a very low birth weight.
  • Your baby has a bowel movement before being born, and meconium (fetal stool) is present in the uterus.
  • The amniotic fluid surrounding the baby has a bad smell, or the baby has a bad smell right after being born.
  • Male babies are at greater risk for neonatal sepsis than female babies.
Symptoms:
In 85% of the cases, symptoms of neonatal sepsis are present within 24 hours of birth. In almost all cases, they will be present within 48 hours of birth. If your baby experiences any of these symptoms do not assume it is due to neonatal sepsis. These symptoms may be caused by other, less serious health conditions. However, if your baby does experience any one of them, see your doctor. Some of these symptoms are things the doctor will need to check for.
  • Fever or frequent changes in temperature
  • Poor feeding from breast or bottle
  • Decreased or absent urination
  • Bloated abdomen
  • Vomiting yellowish material
  • Diarrhea
  • Extreme redness around the belly button
  • Skin rashes
  • Unexplained high or low blood sugar
  • Difficulty waking the baby or unusual sleepiness
  • Jaundiced or overly pale skin
  • Abnormally slow or fast heartbeat
  • Breathing rapidly, difficulty breathing, or periods of no breathing (apnea)
  • Bruising or bleeding
  • Seizures
  • Cool, clammy skin
Diagnosis:
Your doctor will ask about your baby’s symptoms and medical history, and perform a physical exam.

Tests may include the following:

  • Complete blood count
  • Cultures of:
    • Blood
    • Urine
    • Cerebrospinal fluid
    • Skin lesions
  • X-rays of the chest or abdomen
Treatment:
Talk with your doctor about the best treatment plan for your baby. Treatment for suspected neonatal sepsis depends on how severe the condition is. Treatment may last between 2-21 days. In general, neonates suspected of sepsis are hospitalized for a minimum of two days to wait for culture results.

A well-appearing infant may be monitored without antibiotics and sent home when cultures are negative. Infants who appear ill may receive antibiotics for a minimum of two days while awaiting culture results. Culture-proven sepsis is treated for 7-21 days, depending on the location of the infection. Many babies with neonatal sepsis are admitted to the NICU (Neonatal Intensive Care Unit).

Treatment options include:

Antibiotics
Antibiotic medication may have to be given intravenously (through an IV).

Intravenous Fluids
The baby may need to receive fluids, glucose, and electrolytes through an IV.

Oxygen
The baby may need to be given oxygen or have help with his or her ventilation (breathing).

Prevention:
To help reduce your baby’s chances of getting neonatal sepsis, your doctor may take the following steps:
  • If you have given birth to a baby with neonatal sepsis before, your doctor may give you antibiotics close to your due date. This can help kill dangerous bacteria in the birth canal before the baby is exposed to it.
  • The doctor can test you for the bacteria before your due date and give you antibiotics to get rid of it if necessary.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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