INFECTIONS IN NEWBORN BABIES
A good immunity is required to fight infections. Newborn babies have immature immune systems, particularly so if they are born premature. Therefore, they acquire infections much more easily than adults. Some of these infections are minor and occur on the skin, mouth, eyes or genitals. Minor infections are easily treatable and usually require only a local application. At times the infection may get into the bloodstream or internal organs of the baby. These are serious infections and they can either cause death or permanent damage to internal organs, if not treated on time. Doctors refer to these serious infections as “sepsis”. We have tried to answer some Frequently Asked Questions (FAQ’s) by mothers- related to sepsis in newborn babies.
1. What can I do to prevent infections in my baby?
The most important thing that you can do is to exclusively breast-feed your baby for the first six months of life. Mother’s milk does not contain any disease causing germs. It has a high amount of proteins and white blood cells that fight against diseases. It allows your baby’s gut to get colonised by friendly germs that fight against disease-causing germs.
Secondly, you and all your family members must always handle your baby with clean hands. Remember to wash your hands thoroughly with soap and water after returning home from outside; after a visit to the toilet; after handling soiled nappies; after touching footwear; before and after eating food and after touching unclean objects at home. Remind your family members to also do the same.
Do not use a pacifier. They often fall on the floor and there is a tendency to put them back immediately to the baby’s mouth to prevent him/her from crying.
If a family member or visitor has a fever or skin infection or a pus discharge or a common cold or a lung infection, it is best to tell such a person to stay away from the baby until the infection subsides.
2. But what if I myself have an infection?
If you have an infection, you must consult a child specialist. Asking the mother to stay away from her baby is not always a good idea because it affects breast-feeding and mother-infant bonding. Hence, your doctor will advise you on a case-by-case basis. There are only a few rare situations where it is essential for an infected mother to stay away from her baby.
3. Should I use a hand sanitiser or wash my hands with a medicated soap each and every time I touch my baby? My mother-in-law says that I’m becoming paranoid about it!
If your baby is a good weight, full-term, otherwise healthy, breast-fed baby, and you do not have any infections, your mother-in-law is probably right (which does not necessarily mean that she is right all the time!). You do not need to use a hand sanitiser or wash your hands each and every time you touch such a baby at home- that would be going overboard. As long as you and all your family members follow the common sense advice given in response to question #1, your baby will be fine. Remember that your hands must be clean when you feed your baby.
On the other hand, if you yourself have an infection or your baby is premature or has a low birth weight, it is prudent to be extra-cautious.
4. How do I know that my baby is at risk of developing a serious infection?
If your baby was born premature or with a low birth weight, s/he is at risk of developing serious infections. Your doctor would have told you whether your baby was born premature or with a low birth weight. If the actual date of delivery was more than three weeks before your due date of delivery, it is called a premature delivery. A birth weight of less than 2.5 kg is called low-birth-weight.
If you are bottle-feeding your baby without adequate cleaning and sterilisation, there is a risk of serious infections.
5. How will I know that my baby has developed a serious infection?
If your baby shows one or more of the following signs, you should visit a child specialist or the Emergency Department of a hospital:
6. So what should I do if my baby shows one of the above signs?
Show your baby to a child specialist if you can reach him/her quickly or visit the Emergency Department of a hospital as soon as possible. A delay may be dangerous.
7. But some of the signs mentioned are so common. Often I find it difficult to wake up my baby and sometimes she brings out milk a few times a day. Do you expect me to rush to a doctor everytime?
What is important is if there is a change from an established routine. Within a few weeks of caring for her baby, every mother learns what is her baby’s routine and what is out of the ordinary. This is part of a mother’s instinct! So if your baby normally regurgitates milk three or four times a day and is otherwise a happy healthy baby, it does not signify a serious infection. If your breast-fed baby normally passes 8 to 10 stools per day, it is okay. But if s/he normally passes only one stool a day and all of a sudden starts passing 8 to 10 stools along with some vomiting, then you must visit a doctor.
8. What is my child specialist likely to do after I reach him/her?
Your child specialist will first thoroughly examine your baby. Remember, not every baby who has one of the signs listed under question # 5 will have a serious infection. It requires experience to judge whether a baby is likely to have a serious infection or can be sent home. If your doctor is reasonably sure that your baby has a serious infection, s/he will insert a device called a cannula into one of the veins of your baby and will start giving antibiotic injections through the cannula. S/he will also send some blood tests. In most cases, your doctor will insert a fine needle into the lower spine of your baby and send the spinal fluid for tests to exclude the possibility of a brain infection. S/he may perform a chest x-ray or urine examination too.
Prof Sourabh Dutta and
Newborn Unit,
Department of Pediatrics,
PGIMER