A Parent's Guide to the NICU

Infection

What kinds of infections are common in babies?

Babies can get many kinds of infections. Generalized infection or infection of the blood stream is referred to as sepsis; infection of the lungs, pneumonia; infection of the fluid that surrounds the brain, meningitis; infection of the urine, urinary tract infection or UTI. Babies can also get localized infections under the skin called abscesses or infections of the skin.

Infections in babies can be caused by bacteria (most common), viruses, or fungi. Infections can start before birth, near the time of birth, or while the baby is in the nursery.

Why do premature babies get infections so easily?

Babies have an inexperienced immune system. They have not had time to build up their own antibodies to fight infection. Preemie babies get fewer antibodies from their mothers since most antibodies go across the placenta to the baby in the last few months of pregnancy.

Preemie babies often have intravenous catheters. These may serve as routes of entry for bacteria.

Preemie babies frequently are given antibiotics for infections. These kill the bacteria most likely to cause infection, but enable other less common germs to grow more easily.

How does a baby with an infection act?

Signs of infection are not specific; babies may act the same no matter what is wrong with them. These may include any or all of the following:

• less active or less alert
• more apnea
• new or increased respiratory problems
• difficulty keeping his/her body temperature normal
• poor tolerance to feedings
• poor skin color
• problems with low blood pressure
• seizures (meningitis only)

How will my baby's doctors know if there is an infection?

Your baby's doctor may:

• Obtain fluid samples from one or more body sites (blood, urine, spinal fluid) to send to the laboratory for culture. The laboratory will see if bacteria grow from this fluid.
• Measure the number of white blood cells in your baby's blood. With infection there may be too many, too few, or more than usual number of young white blood cells.

How is an infection treated?

Bacterial infections are treated with drugs called antibiotics. There are several different antibiotics. Your baby may be on more than one at a time because no single antibiotic controls all infections. Your baby's doctor will select the ones to control the germs that are most likely causing your baby's infection. Different drugs are used when the infection is caused by a virus or a fungus.

Will there be permanent problems from infection?

Most of the time the baby's infection responds rapidly to antibiotics. Usually there are no permanent problems from infection. Permanent problems are most likely if the baby has meningitis, or if there has been severe low blood pressure for a long period of time.

Can infections be prevented?

The best way you can help prevent infections in your baby is to make sure you and people taking care of your baby always wash their hands or use alcohol gel.