Neonatal Sepsis: Symptoms & Treatment

Instructor: Lisa Cauthen

Lisa is a Registered Nurse with a 14 years of experience and a Masters Degree in Nursing Education. She has certifications in CPN, ACLS, PALS, and NRP.

Neonatal sepsis is a serious and potentially life-threatening condition in newborn babies. Symptoms of sepsis must be easily and quickly recognized by the healthcare professional so that treatment can begin promptly. This lesson will review the symptoms and treatment of neonatal sepsis.

Neonatal Sepsis: Symptoms & Treatment

It's your third day rotating in the mother-baby unit of the hospital, and you got assigned to the newborn nursery! So far, your day has been fun. You've been seeing newborn babies, doing their assessments, and giving them their first baths and first shots! This might be your calling. As you change the diaper of Baby Girl Smith, you notice her breathing seems odd and get the feeling that something isn't right. After being checked by the charge nurse, the baby is getting several tests, and the nurses are worried she has neonatal sepsis. Why do they think this, and what are they going to do to help this baby?

Neonatal Sepsis

A neonate is an infant one month, or 28 days, of age or younger. Sepsis is a systemic, or whole body, response to an infection. So, neonatal sepsis is a condition in which a newborn baby is exhibiting a systemic response to an infection. Neonatal sepsis is a serious condition because neonates have an immature immune system and are unable to fight infections the way older infants are. Without prompt treatment, the neonate's life could be in danger.

Symptoms of Neonatal Sepsis

An infant experiencing sepsis may have several of the following symptoms or could have only one. Prompt recognition of these symptoms is crucial in providing the infant with immediate treatment and the best chance of survival.

Alteration in Temperature

A normal temperature for a neonatal infant is 96.8-100.3 degrees Fahrenheit (36-37.9 degrees Celsius). A core temperature, taken rectally in newborns, above or below the normal range is a symptom of sepsis.

Alteration in Heart Rate

A newborn's normal heart rate (HR) ranges from 100-180 beats per minute (BPM). Newborns, when crying, for example, may have an increased heart rate, even near 200 BPM. After the infant is calmed, the heart rate should return to a normal rate. A persistent heart rate above or below the normal range with no external cause is a symptom of sepsis.

Alteration in Respirations

The normal respiratory rate (RR) in an infant ranges between 30 and 60 breaths per minute when calm. Like the heart rate, a respiratory rate can fluctuate with the infant's activity, such as eating or crying. A respiratory rate that continues to be above or below the normal range is a symptom of sepsis.

In addition to the respiratory rate, the effort of the respirations should be considered. Is the baby's breathing particularly shallow, or do you see an extreme effort being put forth? An alteration in the respiratory effort is a symptom of sepsis.

Alteration in Blood Count

An infant who exhibits any of the above criteria, especially when coupled with a birth story that includes risk factors, will likely have a complete blood count (CBC) drawn and sent to a lab for evaluation. The white blood cell (WBC) count is of particular importance when considering sepsis. A WBC level that is above or below the normal range is a symptom of sepsis.

Normal WBC levels vary depending on the patient's age. A WBC level of 9,000-30,000/mcL is accepted as normal for ages newborn to one month. However, because various laboratories use different machines and calibration methods, the reference guide supplied by the laboratory performing the test should be considered when evaluating the infant's WBC level.

Other Symptoms of Sepsis

A neonate can present with other symptoms of sepsis such as decreased alertness (increased sleepiness), decreased activity, poor sucking, or seizures. A change in bowel movements, vomiting, or distended abdomen could also be symptoms of sepsis. These or other abnormal findings in a neonate should be evaluated by a medical professional to rule out sepsis and other medical conditions.

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