15371 Sepsis In Newborns

Overview

Sepsis is a life-threatening reaction to an infection. When it happens in a newborn baby, it means an infection has entered the baby's bloodstream and spread through the body. Because a newborn's immune system is not yet strong, sepsis can get worse very quickly. With early treatment, most babies recover completely.

Newborn sepsis is rare. In the UK, it affects about 1 in every 1,000 to 2,000 babies born at full term. It is more common in premature babies.

It affects newborns, especially babies born before 37 weeks, babies with a low birth weight, and babies whose mothers had an infection during labour. Twice as many boys are affected as girls.

Symptoms

Common symptoms

• A fever or a low body temperature
• Breathing faster than usual or a grunting noise
• Floppiness and a weak cry
• Poor feeding, or not waking up for feeds
• A mottled or cold skin, sometimes with an unusual colour

Symptoms in children

• Fever or a body temperature that is too low
• Fast breathing or difficulty breathing
• Confusion or being unusually sleepy
• Cold, clammy skin with a rash that does not fade when pressed

Symptoms in older adults

• Confusion, disorientation, or memory loss
• Slurred speech
• A weak pulse and low blood pressure
• Breathlessness and fast breathing
• A sudden worsening of symptoms

Causes

Main causes

• Group B strep (a common bacteria) - it can be passed from mother to baby during birth
• E. coli and other bacteria that can cause infection around or after birth
• Viruses, such as herpes simplex, which can cause severe illness in newborns
• Sometimes the exact cause is not found

Risk factors

• Premature birth (before 37 weeks)
• Low birth weight
• The mother having an infection in pregnancy, such as Group B strep
• Prolonged labor or membranes breaking earlier than expected
• Use of certain medical instruments during birth, like a scalp monitor

When to see a doctor

See a doctor urgently if:

• If your baby has any of the emergency symptoms listed above, call your local emergency number (for example, 112 or 999 in many European countries) immediately.
• Do not wait to see if they improve.

Book a routine appointment if:

• If your baby is feeding less, is more sleepy than usual, or just does not seem right, contact your doctor, midwife, or health visitor the same day.
• Trust your instincts – you know your baby best.

Diagnosis

Doctors diagnose sepsis by examining your baby, asking about symptoms, and running tests to look for infection. The baby will be admitted to hospital if sepsis is suspected.

Tests that may be done

• Blood tests to check for infection and how well organs are working
• Urine test to check for a urinary tract infection
• A lumbar puncture (spinal tap) to check the fluid around the brain and spinal cord
• Chest X-ray if pneumonia is possible
• Monitoring heart rate, breathing, and oxygen levels

What to expect at your appointment

The doctors may start antibiotics very quickly, even before test results come back, because treating sepsis early is crucial. The baby will stay in the hospital or neonatal unit, where they can be watched around the clock.

Treatment

Newborns with sepsis are treated in hospital, usually in a specialist neonatal unit. The main treatment is antibiotics given through a drip (intravenously). Sometimes extra oxygen or fluids are also needed.

Self-care at home

• Do not try to treat sepsis at home. Your baby needs emergency hospital care.
• While in hospital, you can support your baby by providing comfort, holding them when possible, and expressing breast milk if you wish.

Medical treatments

Antibiotics are given directly into the vein to fight the infection quickly. Intravenous fluids keep the baby hydrated. If needed, breathing support with oxygen or a special machine helps the baby breathe. Pain relief and other supportive medicines are given if the doctor thinks they are needed.

When is surgery considered?

Surgery is rarely needed, but if the infection forms an abscess (a pocket of pus that cannot drain on its own), a doctor may drain it using a needle or a small operation.

Living with this condition

After discharge, your baby will likely be seen by a doctor for follow-up appointments to check growth, hearing, and development. Babies who recover from sepsis usually go on to live normal lives.

Lifestyle tips

• Keep up with regular check-ups and vaccinations
• Practice good hand hygiene at home, especially before handling your baby
• Avoid contact with people who have infections

Diet and exercise

Feed your baby as usual – whether breast milk or formula. In the first few weeks, babies sleep and eat on demand. There is no special exercise needed, but gentle time on their tummy when they are awake is good for development.

Mental health and emotional wellbeing

It is completely normal to feel scared, stressed, or exhausted after your baby has been in hospital. Talk to your partner, family, or a health professional. Ask for support if you need it – you are not alone.

Prevention

Not all cases can be prevented, but good maternity care helps. In your pregnancy, you may be tested for Group B strep. Simple hygiene – like hand-washing in hospital and at home – also reduces the risk.

Vaccines

Making sure you and your family are up-to-date with recommended vaccines, including flu and whooping cough during pregnancy, can help protect your baby. After birth, follow the immunisation schedule for your baby.

Screening programmes

During pregnancy, you will be offered tests for certain infections. After birth, if your baby is at higher risk, they will be watched extra closely for any signs of infection.

Complications

If left untreated

• Meningitis – an infection of the fluid around the brain and spinal cord
• Septic shock – dangerously low blood pressure and organ failure
• Lifelong disabilities in some cases, such as developmental delay or hearing loss
• In the most severe cases, death – which is why urgent treatment matters

Long-term outlook

When caught early, most newborns with sepsis survive and recover well. Some babies may have longer-term problems, especially if they were very premature or the infection was severe. Doctors will monitor your baby carefully and provide any help they need. There is every reason to hope for a healthy future.

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