Sepsis In Babies: Causes, Symptoms, Treatment And Prevention

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Septicemia or sepsis in babies is the clinical name of a serious condition wherein the body displays an extreme immune response to infections. This response usually causes widespread tissue inflammation, harming body organs and adversely affecting their functioning. A severe state of sepsis leads to septic shock that causes organ failure.

More than 75,000 infants and children develop severe sepsis in the US every year (1). Therefore, early medical intervention is vital to prevent long-term complications and death. In addition, parents can significantly reduce the risk of sepsis in babies by following the immunization schedules diligently and maintaining good hygiene standards.

Keep reading as we tell you more about sepsis in babies and its causes, signs and symptoms, treatment, and possible prevention strategies.

What Is Neonatal Sepsis?

Neonatal or newborn sepsis is a blood infection that occurs during the first 90 days of an infant’s life (1). Clinically, it is identified in two categories — early-onset and late-onset sepsis.

Early-onset sepsis refers to a blood infection developed within the first few hours or days of birth. Such infections most likely pass from the mother to the baby during the pregnancy or birth. Group-B Streptococcus and E.coli are the bacteria naturally present in the birth canal and are often responsible for early-onset sepsis (2).

Late-onset sepsis occurs in babies older than a week. Such infections usually occur due to the baby’s exposure to infectious agents such as those found in the hospital and home.

Causes Of Sepsis In Babies

Microorganisms, such as bacteria, fungi, viruses, and parasites, can cause an infection, which increases the risk of sepsis in babies. Group-B streptococcus bacterial infections are the most common cause of sepsis among infants. A baby could get an infection (3):

  • Before birth, due to an infection of the amniotic fluid.
  • During birth, due to exposure to the birth canal infection.
  • After birth, due to exposure to pathogens in the hospital or at home.

Factors That Increase The Risk Of Sepsis

The following situations could increase the risk of sepsis in babies (4).

  • Premature birth, meaning the baby is born before the 37 weeks of gestation or pregnancy.
  • Amniotic sac rupture more than 18 hours before birth.
  • Strep infection during pregnancy that has infected the amniotic fluid, exposing the fetus to an infection.
  • Prolonged presence of a catheter in the blood vessel, exposing the site of insertion to infection.
  • Hospital stays for an extended time due to a medical condition.
  • Weakened immune system due to any underlying condition.

Depending on the risk factors and the baby’s health, there could be a few or multiple symptoms of sepsis.

Symptoms Of Sepsis In Babies

Sepsis symptoms could vary among babies and often depend on the cause and intensity of infection. Some of the common signs and symptoms include the following (1) (3).

  • Fast breathing and shortness of breath
  • Rapid or slow heart rate
  • Extreme pain
  • Vomiting
  • Diarrhea or decreased bowel movement
  • Fever or low body temperature
  • Blue, pale or clammy, skin, lips, or tongue
  • Cold skin, especially on hands and feet
  • Poor appetite and reduced sucking
  • Swollen tummy or other body parts
  • Drowsiness, sleeping more than usual, or disorientation

Many of these signs and symptoms could occur in other conditions as well. Therefore, consult a pediatrician to determine the exact cause.

Diagnosis Of Sepsis

A doctor will evaluate the baby’s symptoms and carry out a set of diagnostic tests called sepsis workup (3) (5).

  1. Blood culture: This test looks for the type of bacteria in the blood responsible for causing the infection. Identification of the bacteria can help set the right course of treatment.
  1. Blood test: Complete blood count (CBC) and C-reactive protein (CRP) check are advised to determine infection and its effects on the blood cells, kidney, and liver.
  1. Urine test: Urine test and culture are often conducted to determine the presence of bacteria in the urinary system.
  1. Cerebrospinal fluid test: Lumbar puncture or spinal tap test involves collecting the cerebrospinal fluid and checking for infection. It can help determine if the infection has spread to the nervous system.
  1. Imaging tests: The doctor may advise imaging tests, such as X-ray, CT scan, and MRI, to check for damage to the body’s organs and other tissues.

Treatment For Sepsis In Babies

The treatment depends on the baby’s age, health condition, and the infection’s severity. If a baby is diagnosed with sepsis, they are hospitalized, and intravenous antibiotic treatment begins immediately.

Additionally, the baby could receive intravenous fluids, special nutrition, and other medications. The baby may also need breathing support (ventilator) until their condition improves. The treatment is reviewed and updated periodically based on the baby’s response.

Possible Complications Of Sepsis

Sepsis is a serious condition warranting immediate medical assistance. Any delays in its treatment and management can worsen the condition causing septic shock, a potentially life-threatening condition.

Septic shock is a widespread infection affecting multiple organs at a time. It causes an extreme drop in blood pressure, decreased mental alertness, and wide changes in body temperature. Septic shock is most common in newborns whose immunity is still developing (6).

Long-term Effects Of Sepsis

Sepsis may cause physical and psychological changes even after recovery. These long-term effects are known as post-sepsis syndrome (7).

Some of the most commonly observed changes are the following.

Prevention Of Sepsis In Babies

Preventing infections is the only way to prevent sepsis. Parents and caregivers can observe the following precautionary measures to reduce the baby’s infection risk (1) (8).

  • Breastfeed within an hour after birth. Breast milk contains several antibodies that could significantly reduce the risk of early infections.
  • Feed a healthy, well-balanced diet containing foods from different food groups to boost the baby’s immunity and overall health.
  • Follow their routine vaccination schedule. Vaccination can help prevent infections that could ultimately curb the risk of sepsis.
  • Ensure the baby’s environment is properly cleaned. Their crib, play area, and toys are neat and frequently sanitized.
  • Follow standard hygiene practices. Wash hands before and after preparing meals. Wash the baby’s hands before they eat to prevent accidental ingestion of pathogens.
  • Promptly sterilize and treat open wounds and keep them covered with clean gauze until they fully heal. Some injuries may need to be left open; in such cases, ensure your baby is not licking the wounds.
  • Do not apply anything on the umbilical cord stump or belly button

Besides these, stay alert to any signs and symptoms of infections and consult a pediatrician without delay.

Sepsis in babies is a life-threatening medical complication that arises from an infection before, during, or after birth. Premature birth, weakened immune system, and prolonged hospital stays are common causes. Prompt treatment is essential to avert adverse complications, such as septic shock. Even after recovery, sepsis can have long-term effects, such as constant appetite loss, feeding difficulties, and increased fatigue. Preventing infection is the only way to prevent sepsis.

Key Pointers

  • Sepsis is a serious condition where an extreme immune reaction to an infection adversely affects the body’s tissues and organs.
  • It is commonly caused by Group-B streptococcus bacterial infections in infants and occurs in the first 90 days of life.
  • Premature birth, amniotic sac rupture, and extended hospital stays are some factors that increase the risk of infections.
  • Treatment in neonates includes intravenous antibiotics and respiratory and nutrition support.
  • Breastfeeding within an hour of birth, routine vaccinations, and ensuring proper hygiene practices may reduce the risk of infections and sepsis.

Frequently Asked Questions

1. Where does sepsis rash appear?

A rash (hemorrhagic rash) could appear in people with sepsis. The rashes might begin as tiny pricks on the skin and may gradually develop bigger and spread in any part of the body when left untreated (9).

2. Can sepsis go away on its own?

No. Sepsis is rare but usually a serious condition that requires quick medical intervention. If the treatment is delayed in babies or children, it may lead to severe consequences (10).

3. Can sepsis develop overnight?

Sepsis may develop in newborns within hours (within 24 hours) after birth due to several reasons, such as maternal rupture of membranes during birth or infections (11).

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Sepsis in Infants & Children; Healthy Children; AAP
2. Pediatric Sepsis: Symptoms, Diagnosis & Treatment; Yale Medicine
3. Sepsis in the Newborn; Stanford Children’s Health
4. Neonatal sepsis; Medline Plus
5. Neonatal Sepsis; NCBI
6. Septic shock; Medline Plus
7. Sepsis: Treatment and Recovery; NHS UK
8. Breastfeeding from the first hour of birth; UNICEF
9. Septicemia; Johns Hopkins Medicine.
10. Sepsis; NHS inform.
11. Sepsis and Children; Sepsis Alliance.
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Swati Patwal

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with over eight years of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children. Then she worked as a nutrition faculty and clinical nutrition coach in different... more

Dr. Anuradha Bansal

(MD)
Dr. Anuradha Bansal is a pediatrician and neonatologist working as assistant professor in the Department of Paediatrics at PIMS Jalandhar. She has done her MBBS and MD Pediatrics at GMCH, Chandigarh. Thereafter, she polished her skills as senior resident at MAMC, Delhi. She has also done IAP Fellowship in Neonatology at GMCH, Chandigarh and obtained the membership of the prestigious... more

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