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Infection screening for newborn babies

Congratulations on the birth of your baby

You have been given this leaflet because there is concern that your baby is at risk of developing or is showing early signs of a potentially serious infection. If anything is unclear or you would like more information, please don’t hesitate to ask us.

What kinds of infection are we looking for?

Infections are seen more often in newborn babies because their immune system is not fully developed so they can become very sick if not treated early. Serious types of infection in newborn babies include pneumonia (chest infection), septicaemia (blood infection, which can lead to sepsis) and meningitis (infection in the fluid around the brain and spinal cord).

What does an ‘Infection Screen’ involve?

Most babies will have:

  • Regular checks of heart rate, breathing rate and temperature
  • Insertion of a cannula (‘IV line’) in the back of the hand or foot
  • Initial blood tests (taken from the cannula)
    • full blood count (‘FBC’ – to check number of white cells, usually raised if an infection is present)
    • C-reactive protein (‘CRP’ – usually raised if an infection is present). This is repeated after 18 – 24 hours (usually from a heel prick)
    • blood culture (to look for septicaemia – this is usually the last result to come back and takes at least 36 hours)
  • Antibiotic blood levels (if your baby needs more than 2 days of antibiotics)

Some babies may just need a blood culture and regular checks for 24 hours.

Depending on the results, some babies will also need:

  • Chest x-ray – to look for pneumonia
  • Lumbar puncture – to look for meningitis. This is done by inserting a thin needle into the baby’s lower back (similar to having an epidural) to collect a sample of spinal fluid

We will talk to you about where the tests will be done and if you would like to be present.

Why are intravenous antibiotics being given?

Babies can become very sick if not treated early, and we don’t want your baby to become unwell whilst waiting for the results. So even if your baby seems well, we don’t wait for the test results before starting antibiotics. They are given into the cannula (‘intravenously’) because they work more quickly and effectively that way. Most babies are given two different antibiotics which may be changed if test suggest this is needed.

Where will your baby be looked after?

Usually, your baby can stay with you on the post-natal ward and you can care for them as normal. Extra care just needs to be taken to avoid dislodging the cannula when handling your baby.  Occasionally, your baby may need to be admitted to the Neonatal Unit to be monitored more closely and to help with problems such as difficulties with feeding or breathing.

When can your baby go home?

Your baby will be discharged when they are well and they have completed the course of antibiotics. For most babies this will be after about two days, but if your baby is still unwell or the tests suggest a serious infection a longer course of antibiotics may be needed.

What should you look out for after going home?

  • abnormal behaviour (inconsolable crying, lethargy or floppiness)
  • difficulties with feeding, discomfort after feeds, or vomiting
  • abnormal temperature (lower than 36.5°C or higher than 38.0°C)
  • rapid breathing
  • change in skin colour