Causes of sepsis in newborns and how to prevent and treat it

Neonatal sepsis is a critical and serious medical condition that affects newborns in their first days of life, posing a direct threat to their health and survival. Many parents may mistake common newborn signs, such as lethargy or refusal to feed, as minor issues. However, any delay in diagnosing sepsis can lead to severe complications, including organ failure or even death. In this article, we will discuss in detail the causes of neonatal sepsis, its early symptoms, stages of diagnosis, and effective treatment methods, whether through medications or urgent medical interventions. We will also cover how to protect your baby from developing this life-threatening condition.

1️⃣ What is the treatment for neonatal sepsis?

Treatment depends on early diagnosis of the bacteria or causative agent. The newborn usually receives strong intravenous antibiotics in the hospital, along with close monitoring of vital signs.

2️⃣ Does the baby need other medications?

In some cases, additional medications are needed to:

Stabilize blood pressure
Manage pain
Support organ function if affected by the infection

3️⃣ Can neonatal sepsis be treated with herbs?

❌ No. Herbal remedies are unsafe for newborns and do not cure sepsis. Depending on them may be very dangerous to the baby’s health.

4️⃣ Does the baby need surgery?

Generally, no. Surgery is only needed if there is a localized infection, such as an abscess, peritonitis, or kidney infection. The doctor decides based on imaging and lab results.

5️⃣ How long does treatment last?

Antibiotic treatment usually lasts 7 to 14 days.
Severe cases may require longer or more intensive therapy, depending on the doctor’s assessment.

6️⃣ Does the baby need follow-up?

✅ Yes, medical follow-up is essential to monitor:

Heart rate
Liver function
Hearing
Nervous system

7️⃣ Can neonatal sepsis be prevented?

Prevention includes:

Following recommended maternal and infant vaccinations
Careful monitoring during pregnancy and delivery
Prompt treatment of any infections in the mother or baby

8️⃣ When should you see a doctor immediately?

Seek urgent medical care if the newborn shows:

Very high or low temperature
Lethargy or poor activity
Breathing difficulties
Seizures
Persistent vomiting
Skin rash

Duration of neonatal sepsis

Typically, treatment lasts 10 to 14 days.
The doctor may extend therapy if:

The infection does not fully respond to antibiotics
There are complications such as meningitis

Can neonatal sepsis be cured completely? ✅

Yes. With proper treatment, most babies fully recover.
The disease usually leaves no permanent damage.
However, infants who had sepsis may be more vulnerable to infections later, so follow-up and completing vaccinations are crucial.

How do newborns get sepsis? ⚠️

Because the newborn’s immune system is immature, they are more prone to infection, especially in cases of:

Prematurity (preterm babies are at higher risk)
Maternal infections (e.g., urinary tract infection, fever, chorioamnionitis)
Prolonged rupture of membranes (water breaking >18 hours before delivery)
Infections acquired during delivery

Types of neonatal sepsis

Neonatal sepsis is classified by the time of onset:

1️⃣ Early-onset sepsis (within 72 hours of birth):

Usually acquired from the mother during pregnancy or delivery.
Common bacteria: Group B Streptococcus (GBS), Escherichia coli (E. coli).

2️⃣ Late-onset sepsis (after 72 hours of birth):

Usually hospital-acquired, especially in NICU babies with medical devices such as catheters or ventilators.
Can result from poor hygiene or unsterile equipment.

Why are preterm babies at higher risk? ⚠️

Immature immune system makes them less able to fight infections.
Premature rupture of membranes allows bacteria to enter early.
Maternal infections (e.g., UTI, fever during pregnancy).
Medical devices (catheters, ventilators) if not fully sterile.
Postnatal infections acquired from the hospital or home environment if hygiene is poor.

Early signs of neonatal sepsis

The challenge is that symptoms may be mild and nonspecific, resembling other conditions.
Parents should watch for:

Poor feeding
Lethargy
Unusual crying
Fever or low temperature
Rapid breathing or apnea

⚠️ Quick medical intervention is critical for survival and recovery.

Signs of Neonatal Sepsis

Sepsis in newborns may not always present with fever. Sometimes the temperature can be lower than normal. Other warning signs include:

Abnormal body temperature: Very high or unusually low.
Lethargy or reduced activity: The baby seems weak, sleepy, and less responsive.
Feeding difficulties: Poor sucking or complete refusal to feed.
Breathing problems: Rapid breathing, pauses (apnea), or noisy breathing.
Pale or bluish skin: Cyanosis or unusual discoloration.
Abnormal crying: Very weak or unusually high-pitched cry.
Vomiting or diarrhea in some cases.
Swelling or redness around the umbilical stump, which can indicate umbilical infection.

Stages of Neonatal Sepsis ⚠️

Recognizing the stages helps parents and doctors detect the condition early and intervene promptly.

1️⃣ Initial stage – Infection begins
Bacteria or microbes enter the baby’s body through blood or the umbilical cord.

Symptoms: fever or low temperature, weakness, lethargy, excessive sleep.

2️⃣ Intermediate stage – Spread of infection
The infection starts spreading in the blood and organs.

Symptoms: rapid breathing, abnormal heart rate, jaundice or pale skin, vomiting or diarrhea.

3️⃣ Advanced stage – Systemic involvement
Multiple organs become affected.

Symptoms: severe circulatory response, organ dysfunction (e.g., liver problems, seizures, or decreased consciousness).

4️⃣ Final stage – Septic shock
The most dangerous stage.

Symptoms: severe drop in blood pressure, poor circulation, complete loss of consciousness.
Requires immediate resuscitation and intensive care.

Diagnosis of Neonatal Sepsis

Early diagnosis is crucial because even a few hours’ delay can lead to serious complications. Doctors use several methods:

1️⃣ Clinical examination

Checking for lethargy, poor activity, feeding refusal, or repeated fatigue.

2️⃣ Blood tests

Complete blood count (CBC): looks for abnormal white blood cell counts.
C-reactive protein (CRP): often elevated in infections.
Procalcitonin test: more specific for bacterial infections.

3️⃣ Blood culture

The most important test to identify the exact bacteria causing the infection.

4️⃣ Cerebrospinal fluid (CSF) analysis

Performed if meningitis or brain infection is suspected.

5️⃣ Additional tests

Urine tests: to check for urinary tract infections.
X-rays or ultrasound: to detect pneumonia or hidden infection sites.

⚠️ Important: Early detection is the key to saving the baby’s life.

Can Neonatal Sepsis Be Prevented?

Yes. Preventive measures can reduce the risk:

1️⃣ Maternal care before delivery

Treat maternal infections (UTIs, fever, or other infections) before birth.
Regular pregnancy check-ups to monitor the mother and baby.

2️⃣ Safe delivery environment

Choose a hospital or clinic with good hygiene standards.
Ensure sterile instruments, especially in cesarean delivery.

3️⃣ Breastfeeding support

Mother’s milk contains antibodies that boost the baby’s immunity.

4️⃣ Postnatal hygiene

Wash hands before touching the baby or changing diapers.
Keep the umbilical stump clean and monitored for signs of infection.

5️⃣ Close monitoring

Watch for unusual symptoms such as poor feeding, lethargy, or abnormal temperature.
Seek medical care immediately if warning signs appear.

6️⃣ Vaccinations

Follow the national immunization schedule to protect the baby from harmful infections.

Treatment of Neonatal Sepsis with Medications

The mainstay of treatment is antibiotics, started immediately once sepsis is suspected.

1️⃣ Antibiotics (given intravenously before lab results are ready):

Ampicillin
Gentamicin
Cefotaxime (used in some cases based on the doctor’s assessment)

2️⃣ Antifungal therapy

Used if the infection is caused by fungi, especially in preterm or immunocompromised babies.
Example: Fluconazole

3️⃣ Supportive medications

Intravenous fluids to maintain hydration and electrolyte balance.
Blood pressure support (vasoactive drugs) if needed.
Heart stimulants or blood vessel dilators in severe cases.

⚠️ Note: Treatment must always be carried out in a hospital under strict medical supervision.

Surgical Treatment in Neonatal Sepsis

Most cases are treated with antibiotics and supportive care, but surgery may be required if there is a localized infection that cannot be treated with medicine alone.

???? Possible surgical cases include: