Sepsis & GBS – The hidden killer of newborns

I wasn’t sure which category to place this under, Its especially fitting for home birth mums as it outlines important signs that could be very easy to miss. But its relevant to anyone who is about to have a child, especially as most hospitals will discharge you within 6 hours of birth if everything appears to have gone well.

I hadn’t heard of sepsis until I had my second son in March this year, I knew I was GBS Positive and that this could be potentially passed onto my son during the birth process but I thought that in my case the chance of this happening would be low, especially as once I was in labour I was going to be monitored throughout due to attempting a VBAC, and I was also going to be on IV antibiotics to minimise the chance of passing the GBS to my son.

My VBAC failed before I had taken 2 hours of IV Antibiotics (You need a 4 hour dose for maximum protection), I ruptured and my gorgeous boy was born via emergency section under general anaesthetic.

I assumed that as I hadn’t delivered vaginally the chances of my baby boy getting any infection in regards to the GBS was pretty much zero. In fact to this day I am unsure if his sepsis infection was caused by the GBS infection or by the birth trauma of rupture and the emergency section.

Either way Sepsis can affect any newborn and GBS can cause Sepsis, so for the purpose of this post it is irrelevant. The picture below is my gorgeous boy the day after his birth receiving his antibiotics. I don’t think I ever really appreciated antibiotics until they were working their magic and saving the life of my son. (Sorry crunchy mums but no amount of garlic is going to fix GBS/Sepsis)

Considering that I ruptured I was extremely lucky my boy wasn’t in the NICU, I was able to have him with me as soon as I came out of the general anaesthesia. He was born at 8.34am and I eventually held him for the first time just before lunch.

All seemed well, he was feeding well (or at least I thought so as he was always on my boobs, but that’s another story) and we were getting lots of snuggles and skin to skin. Because of my GBS status the midwives were monitoring him every couple of hours, he also had bloods taken as a precaution (hospitals are great for this) I can’t remember the exact time but it must have been around 2am, one of the midwives was examining him and woke me up to ask how long he had been ‘grunting’. I say grunting but it was a small high pitch gruntish noise he made with every other breath. It wasn’t noticable unless you were listening for it, and he had done it from the moment I held him for the first time, as he seemed so well and was feeding well I hadn’t even considered that it could be a sign of anything amiss. She then counted his resps which were high and went off to speak to the consultant. He was then put on watch with resps being done every hour.

At around 6am I was woken up to the sound of my boy being wheeled away from me by a team of doctors. I asked them what was happening. They explained that his bloods had come back with significant infection markers (139) and they needed to take him for a lumber puncture to rule out meningitis and get an IV in for immediate antibiotics. I wasn’t allowed to go with him. The NICU unit was directly below the ward I was on and this is where all of his bloods, IV line and his lumber puncture were done. Needless to say I was distraught. I had to wait over 24 hours to find out if my gorgeous boy had meningitis or not. Those were the scariest 24 hours of my life. Thankfully we were in the right place and he was already on a high dose of antibiotics, if the lumbar had come back positive he was already being treated and damage would be minimal. Thankfully he only had the sepsis infection to fight.

I was very lucky, I was on a small ward with a great team of midwifes, my boy only ever left my side to go down to NICU 6 times a day for his antibiotics and bloods. It took 8 days but eventually his infection markers were back below 10 and he was given the all clear and was able to have his IV line removed.

I can not thank the midwife enough for spotting the early signs of sepsis, god only knows what would have happened if I had been at home or it hadn’t been picked up on. He showed no other signs of distress just fast resps and his weird grunty noise. I have included some information below to raise awareness of this. That way if you are a new mum and you have been discharged you will at least know what to look for. I had been clueless. Home birth mums too, this really is relevant and something you need to be aware of. Without antibiotics Neonatal Sepsis is fatal!

What is Neonatal Sepsis?

Sepsis can affect anyone at any time but it does tend to strike more often people at the extremes of life, the very old and the very young. As a result, children, particularly premature babies and infants, can be more susceptible to developing sepsis.

Sometimes called blood poisoning, sepsis is the body’s often deadly response to infection or injury. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.

Once sepsis sets in, if left untreated, it can progress to septic shock and death. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, and organ dysfunction (don’t work properly) and/or amputations.

In the United States, more than 42,000 children develop severe sepsis each year. Approximately 4,400 of them die – this is more than those who die of pediatric cancers. Sepsis in the developing world is even more serious, causing many more deaths.

In developing countries, many more children develop sepsis and many more die. Sepsis can occur from unsanitary conditions at birth, maternal infections that are passed on to the newborns, or preventable infections that may be more prevalent in countries with limited vaccinations and medical care.

As with an adult, a child can develop sepsis as the result of any type of infection.

Neonatal Sepsis

When a child develops sepsis within a few months of birth (up to 90 days), it is called neonatal sepsis. If the sepsis develops within 24 hours of birth, it is called early onset and the baby was infected during the delivery. Sepsis that develops after delivery is called late-onset neonatal sepsis.

The risk of early-onset neonatal sepsis is increased if:

  • The mother has group B streptococcus infection while pregnant;
  • The baby is premature; or
  • The mother’s membranes rupture (water breaks) more than 24 hours before the baby is delivered.

Babies can develop sepsis after birth if they become infected by bacteria, a virus, or a fungus (rare). Certain situations increase the risk of a baby getting sick. They include:

  • Being in the hospital for treatment and
  • Being exposed to people who have contagious infections.

The most common infections that can cause sepsis in babies include:

  • Respiratory synctytial virus (RSV)
  • Cytomegalovirus (CMV)
  • E. Coli
  • Candida
  • Herpes simplex virus
  • Listeria monocytogenes

Very young babies and those who have medical problems may not be able to receive childhood vaccines at the recommended times. This makes the children vulnerable to catching the diseases. Many of these childhood diseases can lead to severe complications, such as sepsis. The most common ones are:

  • Rubella (German measles)
  • Varicella (chicken pox)
  • Haemophilus influenzae type b (Hib)

What Are the Symptoms of Sepsis in Children?

According to MedLine Plus, part of the U.S. National Library of Medicine, signs and symptoms of neonatal sepsis are:

  • Body temperature changes
  • Breathing problems
  • Diarrhea
  • Low blood sugar
  • Reduced movements
  • Reduced sucking
  • Seizures
  • Slow heart rate
  • Swollen belly
  • Vomiting
  • Yellow skin and whites of the eyes (jaundice)

In general, signs of sepsis in children include:

  • High fever (above 100.4 degrees)
  • General illness or a previous injury, such as a scrape or cut
  • Shortness of breath
  • Very rapid heart beat
  • Drop in or no urine output

If in doubt call your doctor immediately!!!

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