September is Sepsis Awareness Month, which was established in 2011 to shine a light on this critical illness. Sepsis is a life-threatening illness or complication from an infection, which causes a severe response in the body, inducing tissue damage, organ failure, and sometimes death. There are at least 1.7 million sepsis cases in the U.S. each year, according to the Centers for Disease Control and Prevention. It is commonly found in the blood, lungs, and kidneys.

What is neonatal sepsis?

Neonatal sepsis is distinct from sepsis in adults. Neonatal sepsis typically occurs in babies younger than 90 days, often affecting premature infants. Because their immune systems are underdeveloped and lack antibodies, they are vulnerable to bacterial infection. Other infants at greater risk are male, underweight at birth, have a low Apgar score, or are born to mothers who had an infectious disease during pregnancy. Neonatal sepsis is one of the leading causes of neonatal deaths in the U.S., with cases representing 18% of babies’ deaths.

Early onset vs. late onset

There are two kinds of sepsis in infants: early onset and late onset. Early onset neonatal sepsis often appears 24 to 48 hours after birth. In these cases, a baby has most likely become infected from the mother before or during birth. Group B streptococcus infection during pregnancy, preterm birth delivery, prolonged membrane rupture, lumbar punctures, E. coli infection, herpes simplex virus infection or infection of the placenta can increase the chances infants will contract early onset sepsis.

Late-onset sepsis can affect a baby anytime after delivery. It most often occurs at 1 week to 3 months of age, most often developing three days after birth. Babies are more at risk of neonatal sepsis if they have a catheter in a blood vessel for longer than three to eight days or if they are hospitalized for an extended period.

Common symptoms

Some signs of newborn sepsis are:

• Body temperature changes
• Breathing problems
• Diarrhea or decreased bowel movements
• Jaundice (yellowing of skin and eyes)
• Low blood sugar
• Reduced movements
• Reduced sucking
• Seizures
• Slow or fast heart rate
• Swollen belly area
• Vomiting

Neonatal sepsis in developing countries

Neonatal sepsis is more common in developing countries because of unsanitary conditions during pregnancy and birth or limited access to vaccinations, antibiotics and health care. Sepsis is one of the leading causes of neonatal mortality in the world, taking 30% to 50% of babies’ lives.

Prevention

In the U.S., more than 18 babies under 28 days old die from sepsis each day, and more than 75,000 babies and children develop severe sepsis each year, some of them going into septic shock. Many infants who survive sepsis are left with long-term health complications. Almost 35% of infants who had sepsis will develop a delay in their cognitive skills after they head home from the hospital. And almost half the newborns will return to the hospital at least once after surviving sepsis.

There are some ways to treat and prevent neonatal sepsis. These include:

• Delivering your infant 12 to 24 hours after your water breaks for natural birth and 4 to 6 hours for cesarean births
• Giving birth in a clean area
• Practicing good hygiene
• Preventing and treating infections during pregnancy
• Taking a preventive antibiotic treatment during pregnancy, if recommended by a health care provider

Neonatal sepsis should not be treated at home without your doctor’s guidance. If you notice any clinical signs, speak to health professionals about having your baby tested. A blood test must be conducted to confirm suspected sepsis. Antibiotic treatment will be prescribed after lab results confirm the infection.

Learn more about sepsis

Sepsis (YouTube)

Review our latest publications related to neonatal sepsis research

https://pubmed.ncbi.nlm.nih.gov/36383390/

https://pubmed.ncbi.nlm.nih.gov/32769820/

https://pubmed.ncbi.nlm.nih.gov/29052227/