by EBSCO Medical Review Board
(Sepsis, Neonatal)

Definition

Neonatal sepsis is an infection in a newborn baby’s blood. It can appear any time from the first day after birth to at least 28 days.

Neonatal sepsis is a serious problem. Medical care is needed right away.

Spread of Infection
infant sepsis
Copyright © Nucleus Medical Media, Inc.

Causes

Sepsis is caused by germs that the baby comes in contact with. Bacteria is the most common cause. Some sepsis can be caused by viruses or fungus, but this is less common. The germs may pass to the baby from:

  • Amniotic fluid or placenta during pregnancy
  • Birth canal during or right after birth
  • People caring for newborn or medical devices needed for support of newborn

    • A baby’s immune system needs time to develop. This can make it hard for the baby to fight an infection. A baby could get very ill quickly.

    Risk Factors

    Sepsis is more common in male babies. It is also more likely in babies who are:

    • Born very early
    • Born with a low birth weight

    Other things that may raise the risk are:

  • Water breaks more than 18 hours before the baby is born
  • The pregnant parent has Group B streptococcal bacteria in their vaginal or rectal areas
  • Antibiotic treatment for Group B streptococcal bacteria in parent was not strong enough during birth
  • The baby needs early medical care, such as a catheter

    • Symptoms

    The baby may have:

    • A fever or many changes in temperature
    • Problems feeding or vomiting
    • Fussiness or a high-pitched cry
    • Lack of energy
    • Yellow, blue, or pale skin
    • Bruising or bleeding
    • Skin rashes or cool, clammy skin
    • Fast breathing, problems breathing, or times when they are not breathing
    • Diarrhea
    • Swollen belly
    • Little or no urine (pee)
    • Tremors

    Diagnosis

    The doctor will ask about the baby's symptoms and any health issues. A physical exam will be done. The doctor may suspect an infection based on symptoms. The specific cause of infection may be found by testing:

    • Blood
    • Urine
    • Fluid around the brain and spinal cord
    • Fluid that may come out with cough

    Treatment

    It is important to treat sepsis as soon as possible for the best outcomes. A severe infection can hurt organs like the brain, kidneys, or lungs. Medicine can help to treat the infection. They may include:

  • Antibiotics—for infections caused by bacteria
  • Antivirals—for infections caused by virus
  • Antifungal—for infections caused by fungi

    • The baby may also need support during illness. Support may include:

  • IV fluids
  • Breathing support if the baby is having a hard time getting enough oxygen

    • Prevention

    Neonatal sepsis may be prevented by good prenatal care. This could mean stopping any germs in the pregnant parent from spreading to the baby.

    People caring for the newborn should wash their hands often. This can help stop germs from spreading.

    RESOURCES

    American Congress of Obstetricians and Gynecologists  http://www.acog.org 

    Centers for Disease Control and Prevention  https://www.cdc.gov 

    CANADIAN RESOURCES

    Health Canada  http://www.canada.ca 

    Sick Kids—The Hospital for Sick Children  http://www.sickkids.ca 

    References

    Early-onset neonatal sepsis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/early-onset-neonatal-sepsis. Accessed April 18, 2022.

    Late-onset neonatal sepsis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/late-onset-neonatal-sepsis. Accessed April 18, 2022.

    Neonatal sepsis (sepsis neonatorum). The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pediatrics/infections%5Fin%5Fneonates/neonatal%5Fsepsis.html. Accessed April 18, 2022.

    Neonatal sepsis. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed April 19, 2022.

    Shane AL, Sánchez PJ, et al. Neonatal sepsis. Lancet, 2017; 390 (10104): 1770-1780.

    Revision Information