Your Baby in the NICU: Understanding Infection

All babies are at risk for infection. This is because a baby’s immune system (the body’s defense against disease) needs time to develop. While it’s developing, your baby is more likely to get sick from germs than older children and adults are. A preemie’s immune system is less mature than a term baby’s. This puts preemies at higher risk of an infection. Certain health problems also raise your baby’s risk for infection.

Types of infection

Infection occurs when germs enter the body. These are the most common types of infections in a newborn:

• Localized infection. This is an infection in 1 part of the body.

• Systemic infection. This is an infection that spreads to the organs of the body through the blood.

• Meningitis. This is an infection of the fluid around the brain or spinal cord.

How did my baby get an infection?

Here are some ways a newborn baby may get an infection:

• Before birth, amniotic membranes can break open (rupture). This allows germs to travel up the mother’s vagina and into the uterus, infecting the baby.

• Before birth, germs can pass through the placenta from the mother to the baby.

• During birth, germs may pass from the mother to the baby.

• After birth, germs from the environment can enter the baby’s body. This may be more likely to happen if there’s a break in the baby’s skin. Or it may happen if a tube is inserted into the body.

How is an infection treated?

A healthcare provider gives an antibiotic medicine through an IV (intravenous line) to treat infection. The length of time your baby will need medicine varies. This depends on the type of infection they have. The neonatal intensive care unit (NICU) staff will tell you more about the medicine and any possible side effects. The healthcare team will take special care to keep germs from spreading to other babies in the NICU during treatment.

If your baby doesn’t have an infection but is at increased risk for one, a provider may give your baby antibiotics. This is to help prevent infection.

What are possible long-term effects?

How your baby recovers depends on many factors. These include where the infection is, how bad it is, and what type of germ caused it. Talk to your baby's provider about how long it will take for your baby to recover. Ask about any follow-up that may be needed.

As you bond with your baby

Your role as parent right now is to bond with and support your baby. The NICU staff will watch your baby for the below signs of infection. But make sure to tell the NICU staff right away if you see any of these signs:

• Less activity

• Breathing problems that get worse

• Breathing that stops (apnea)

• Redness or fluid leaking from the bellybutton or other area

Help prevent infection with handwashing

Wash hands often to help prevent infection.

Most germs are spread on hands. Handwashing is the best way to prevent germs from spreading. Use the following steps. (Healthcare providers may ask you to follow a different procedure while your baby is in the NICU.)

• Remove any rings, bracelets, or watches you are wearing. It can be hard to clean under these. (You may want to stop wearing jewelry to the NICU.)

• Use clean, running water and plenty of soap to work up a good lather.

• Clean your whole hand. This includes under your nails, between your fingers, and up your wrists. Don’t just wipe. Rub well.

• Keep washing for at least 10 to 15 seconds. You may be surprised how long this takes. So, be sure to count.

• Rinse. Let the water run down your fingertips, not up your wrists.

Follow instructions from NICU staff

If you have a preemie in the NICU, the staff may ask you to follow additional safety steps. This is to help keep infection from spreading to your baby. The NICU staff will tell you more.