Key takeaways: Newborn sepsis is a serious bloodstream infection. Early signs can be subtle: fever or low temperature, poor feeding, unusual sleepiness, fast breathing, or color changes. Any rectal temperature of 100.4°F or higher in a baby under 3 months needs immediate medical attention.
Sepsis is the body’s extreme response to an infection. In newborns, infections can spread quickly, and early signs may be subtle. Knowing what to watch for helps you act fast.
Types of Newborn Sepsis
- Early-onset sepsis: in the first 72 hours of life (some definitions use the first week), often from bacteria passed during birth, such as group B strep or E. coli.
- Late-onset sepsis: after the first few days, from bacteria in the environment or the community.
Who’s at Higher Risk?
- Premature or low birth weight babies.
- Babies whose birthing parent had a fever during labor, an infection of the amniotic fluid (chorioamnionitis), or prolonged rupture of membranes.
- Babies born to GBS-positive parents who didn’t receive adequate antibiotics during labor.
- Babies with IV lines or other medical devices (in the hospital).
Any baby can develop sepsis.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. My book covers common first-year illnesses and the warning signs that mean it’s time to call the doctor, explained the way I’d explain them at the bedside.
Warning Signs
Signs can be subtle and may develop quickly:
- Temperature: fever (100.4°F or higher rectally) or low temperature (below about 97.5°F).
- Feeding: poor feeding, refusing feeds, vomiting.
- Behavior: unusual sleepiness, floppiness, hard to wake, or very irritable.
- Breathing: fast breathing, grunting, pauses in breathing.
- Color: pale, gray, blue, or mottled skin.
- Other: fewer wet diapers, jaundice, a bulging soft spot, or seizures.
Diagnosis and Treatment
Doctors test blood, urine, and sometimes spinal fluid. Babies suspected of having sepsis are given IV antibiotics right away, often before results return. Treatment usually happens in the hospital.
Prevention
- GBS screening in pregnancy and antibiotics during labor when indicated.
- Hand washing by everyone who touches your baby.
- Keeping sick people away.
- Breastfeeding, which provides antibodies.
- Keeping caregivers’ vaccines up to date.
Seek medical care immediately (call 911 or go to the emergency room) if your baby: has a rectal temperature of 100.4°F or higher, a low temperature with poor feeding or sleepiness, trouble breathing, color changes, is limp or hard to wake, or has a seizure. Don’t give fever medicine first.
The Bottom Line
Newborn sepsis is serious but treatable when caught early. Trust your instincts, know the warning signs, and seek care right away.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
- Meningitis in Babies: Warning Signs
- Fever in a Newborn: Why 100.4°F Means Call Right Away
- Flu in Babies: Prevention and Warning Signs
Sources
- Puopolo KM, Benitz WE, Zaoutis TE; Committee on Fetus and Newborn; Committee on Infectious Diseases. Management of neonates born at ≥35 0/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics. 2018;142(6):e20182894.
- Pantell RH, Roberts KB, Adams WG, et al; Subcommittee on Febrile Infants. Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics. 2021;148(2):e2021052228.
- Centers for Disease Control and Prevention. About sepsis. https://www.cdc.gov/sepsis
- American College of Obstetricians and Gynecologists. Committee Opinion No. 797: Prevention of group B streptococcal early-onset disease in newborns. Obstet Gynecol. 2020;135(2):e51-e72.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
