Newborn babies can get infections easily because their defenses against infections are not well developed. The more premature a baby is, the more likely she is to get an infection.
Many newborns are tested and treated for infection, because:
Most newborn infections are caused by bacteria. Bacteria normally live in the birth canal, and the baby is exposed to them during birth. The baby may swallow or breathe in the fluid in the birth canal and then the bacteria may get into the baby's lungs and bloodstream.
A baby may be sick at the time of birth or get sick during the first week after birth. You may not notice the first symptoms, but as the bacteria multiply the baby can get quite sick very fast. If an infection is found and treated early, the baby will do very well. If the baby is not treated until later, the baby may get very sick and need intensive care to recover.
Sometimes newborns catch a viral infection. Viruses cause colds, flu, and some diseases such as herpes and chickenpox. A virus may travel from the placenta into a baby's bloodstream before birth. Or the baby may be exposed to a virus in the birth canal during delivery. Sometimes a newborn catches a virus after birth by being exposed to someone with a viral infection.
When a baby first develops an infection, the baby might:
Many healthy newborns have these symptoms at times. However, if a baby keeps having these symptoms, she needs to be checked.
As the infection gets worse, a baby might:
Some newborns may have an infection in only one part of their body. In these cases you might see:
If your baby has 1 or 2 signs of infection, he is often tested for infection and antibiotics are given even before the results of the tests come back. The results are usually back in 48 to 72 hours.
Certain lab tests will show if a baby has an infection and where it is located:
If a baby does have an infection, bacteria usually grow in a culture within 2 to 3 days. If the test is negative (no bacteria grew) and the baby's symptoms go away quickly, or if some other cause is found for the symptoms, the baby probably does not have an infection and the antibiotics will probably be stopped.
Spinal taps are safe for babies. The baby is curled on her side for the test. To make sure that she is breathing OK during the test, the baby is attached to a monitor. A nurse watches the baby during the spinal tap. A hollow needle is put into the space in the baby's back below the spinal cord and a small amount of spinal fluid is taken. The fluid is then tested for infection. Most babies do not like to be held in this position and will cry during the test, but a spinal tap is no more painful than drawing blood. It takes 5 to 10 minutes to do a spinal tap.
If a baby is having problems, the doctor may start antibiotics and wait to do the spinal tap until the baby is better able to handle the test.
Parents are asked for their written or verbal consent before the spinal tap is done. Some parents worry that putting a needle so close to the spinal cord will cause the baby to be paralyzed. However, there is almost no risk of paralysis because the needle is put into the space below the end of the spinal cord.
If a baby has signs of infection, she is taken to the special care nursery (SCN) for evaluation and treatment. The baby is placed on a warming bed. She is attached to a monitor that continuously measures heart rate and breathing. If the baby has trouble breathing, she may also be attached to a pulse oximeter that records the amount of oxygen in her skin.
Suspected bacterial infections are treated with antibiotics. An IV is put into one of the baby's veins. The IV delivers the right amount of antibiotic to the baby's bloodstream. Antibiotics are not well absorbed from a baby's stomach.
If the lab tests are positive for a bacterial infection or the baby's symptoms strongly suggest infection, the baby will get IV antibiotics for 7 to 14 days.
Antibiotics do not treat a viral infection. Most babies will be able to fight the infection without medicine. There are some antiviral medicines that can be used for specific viral infections, such as herpes and chickenpox.
If the baby is breathing too fast to eat, he is given fluids through the IV so he won't get dehydrated. If he is too sleepy to eat, he may be given IV fluids or he may be fed by dripping milk through a tube that passes through his mouth and into the stomach. If the baby needs extra oxygen, he is given extra oxygen.
Some babies are not very sick and the only treatment they need is antibiotics. These babies are able to breast-feed or bottle-feed.
Nearly all newborns who have infections recover completely and do not suffer long-term problems.
Babies who have meningitis are at risk for hearing loss. They need to have their hearing checked several times during their first year. They can also develop learning or other developmental problems later on. The baby’s healthcare provider will check carefully for these problems.