What is neonatal sepsis?
Neonatal sepsis, a bacterial infection in the blood that may become a serious condition, is sometimes found in infants during the first month of life.
Neonatal sepsis is caused when the fetus or baby is exposed to bacteria. Early-onset sepsis that develops within the first week of birth comes from the pregnant woman (through the placenta or from passing through the birth canal). Late-onset sepsis that develops one week after birth comes from the caregiving environment. Intrapartum antibiotics have prevented early-onset bacterial sepsis.
Some factors related to a woman’s pregnancy or health also add to the chance that the fetus or newborn can get this condition. These factors include labor complications resulting in traumatic or premature delivery, the breaking of the woman’s “water” more than eighteen hours before giving birth, a fever or other infection while in labor, and the long-term need for a catheter while pregnant.
In addition to the foregoing risk factors, the following increase a fetus’s or a newborn’s chance of developing neonatal sepsis: the baby is born more than three weeks before the due date (it is premature); the woman goes into labor more than three weeks before the due date; the fetus is in distress before being born; the newborn has a low birth weight; the fetus has a bowel movement before being born and the uterus contains fetal stool; and the amniotic fluid that surrounds the baby has a bad smell or the baby has a bad smell at birth. Newborn boys are at greater risk for neonatal sepsis than are newborn girls.
In most cases, symptoms are present within twenty-four hours of birth. In almost all cases, they will be present within forty-eight hours of birth. The following symptoms are not necessarily caused by neonatal sepsis; they may be caused by other, less serious health conditions. However, one should consult a doctor if the baby displays any of the following: a fever or frequent changes in temperature; poor feeding from breast or bottle; decreased or absent urination or a bloated abdomen; vomiting of yellowish material; diarrhea; extreme redness around the belly button; skin rashes; unexplained high or low blood sugar; difficulty waking or unusual sleepiness; jaundiced or overly pale skin; abnormally slow or fast heartbeat; rapid breathing; difficult breathing; periods of no breathing (apnea); bruising or bleeding; seizures; and cool, clammy skin.
A doctor will ask about the baby’s symptoms and medical history and will perform a physical exam. Tests may include a complete blood count; cultures of the blood, urine, cerebrospinal fluid, and skin lesions; and X rays of the chest or abdomen.
One should consult the doctor about the best treatment plan. Treatment depends on the severity of the condition and may last two to twenty-one days. In general, neonates suspected of having sepsis are hospitalized for a minimum of two days to wait for culture results. A well-appearing infant may be monitored without antibiotics. The infant is sent home when cultures are negative. Culture-proven sepsis is treated for seven to twenty-one days, depending on the location of the infection.
The baby may also need to receive antibiotic medication, fluids, glucose, and electrolytes intravenously,or to receive oxygen to help with ventilation (breathing).
To reduce the chance that a fetus or newborn will get neonatal sepsis, the doctor may prescribe antibiotics near the due date for women who have given birth to a baby with neonatal sepsis. The antibiotics will kill dangerous bacteria in the birth canal. The doctor also may test the woman for the bacteria before the due date and prescribe antibiotics, and he or she may recommend breast-feeding, which can help prevent sepsis in some infants.
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Martin, Richard J., Avroy A. Fanaroff, and Michele C. Walsh, eds. Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 2 vols. 8th ed. Philadelphia: Mosby/Elsevier, 2006.
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