One of the greatest achievements of modern medicine is the ability to identify and treat infections with antibiotics. We are very successful in treating infections in babies with antibiotics. Sepsis is a medical term for an infection that, if left untreated, can cause widespread effects throughout the body. However, if caught early, treatment is extremely successful.

Newborn babies are particularly vulnerable to infection as their immune systems are yet to develop and they have not naturally encountered any bugs in the environment yet.

Why might your baby be investigated for sepsis?

The medical team will consider certain factors to decide whether your baby requires investigation and treatment for sepsis. Often your baby may look very well, but our aim is to treat them before they become unwell. Broadly speaking there two areas to consider: antenatal (before birth) risk factors and postnatal (after birth) baby indicators (i.e. what your baby looks like when we examine them).

For example, antenatal risk factors include prolonged rupture of membranes – i.e. when there has been a significant period of time between waters breaking and onset of labour. Similarly an unprompted premature labour is a risk factor. Mothers can develop infections which may pass to the baby.

Occasionally, babies are born and require medical support, requiring immediate admission to the neonatal unit. Other times they may be well when born but over a few hours become less well. For example, they may start to breathe harder. If this happens, paediatricians from the neonatal team will assess your baby.

What happens next?

If your baby is identified as being at risk of developing sepsis, there are a few potential options.

If the risk is mild then they may simply require observation on the postnatal ward for 24 hours or so. This is non-invasive, involving monitoring (e.g. temperature, heart rate, breathing rate).

Another option is that they may require some blood tests to look for infection. Normally, we will treat these babies with antibiotics just in case. These babies may be well enough to stay on the postnatal ward to receive their antibiotics.

If we want to keep a closer eye on your baby we will discuss admitting them to the neonatal unit for their antibiotics. We know this can be a scary time for new parents, who would like their new baby to remain with them. Don’t worry – we are very sensitive to these concerns and can help support you in visiting, feeding, changing and just acting like any other parent while you are on the unit. We will also try and get your baby back to you as soon as possible!

The duration of antibiotics will completely depend on what the initial tests look like and on what your baby looks like. We will usually repeat some tests within the first 24 hours to check the infection markers. Occasionally, we have to perform other tests, such as a lumbar puncture, which involves taking a small sample of fluid from the back to check for infection.

Conclusion

Sepsis is not just something that can affect newborn babies. Infections can be caught at any point in life, but particularly within the first few months when they are most vulnerable and unimmunised. All parents should be aware that a fever is an emergency in a small child. If your baby develops a fever or appears unwell, then medical attention should be sought immediately. If you are unsure, you can always call your GP for advice on where to take them to be assessed.

Main points

• Sepsis is the medical term for an infection that can cause widespread effects throughout the body if left untreated.
• As newborn babies do not have developed immune systems, they are particularly susceptible to infection and sepsis.
• The medical team may decide to investigate your baby for sepsis based on antenatal risk factors and any indicators present after birth.
• Antenatal risk factors include a prolonged rupture of the membranes and unprompted premature labour.
• If your baby is at risk of sepsis, their treatment will depend on the severity of the risk. Your baby may simply require non-invasive monitoring on the postnatal ward. Those at higher risk may be taken to the neonatal unit.
• Your baby may require blood tests to look for infection and usually will be treated with antibiotics, the duration of which will depend on the results of the tests.
• Sepsis doesn’t only affect newborns; infections can occur at any point in life, but newborns and young infant are among those most at risk. You should always seek medical attention if your baby develops a fever or appears unwell.