Sepsis In Babies: Causes, Symptoms, Diagnosis And Treatment

Sepsis, also known as septicemia, is a life-threatening condition wherein the body exhibits extreme immune response to infections. The immune system compounds spread through the bloodstream, triggering widespread tissue inflammation. Septic shock is a severe state of sepsis causing organ failure. Every year, more than 75,000 infants and children develop severe sepsis in the US (1).

Early medical intervention is vital to prevent long-term complications. Parents can significantly reduce the risk of sepsis in babies by avoiding infections through immunizations and following good hygiene standards.

This post tells you about sepsis in babies, its causes, signs and symptoms, treatment, and possible prevention.

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.

2. 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.

3. Urine test: Urine test and culture are often conducted to determine the presence of bacteria in the urinary system.

4. 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.

5. 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.

• Poor or constant lack of appetite
• Extremely picky eating leading to feeding difficulties
• Frequent wakefulness and trouble falling asleep
• Increased irritability and fussiness
• Easily tired or fatigued
• Weakened immunity causing frequent episodes of illness

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.

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

Sepsis is a life-threatening condition that can usually be prevented by avoiding infections. If an infection does occur, focus on its early resolution to avoid adverse complications and sepsis. Immediate medical assistance is the only way to ensure the baby survives and recovers with minimum long-term effects.

References: