Call 413.540.1234 to
schedule an appointment
CONCERN/EAP: 413.534.2625
Billing questions? Call: 413.540.1212
CRISIS: 413.733.6661

Child Development & Parenting: Infants (0-2)
Resources
Basic Information
Infant Development: How Your Baby Grows and MaturesInfant Parenting: Keeping Your Baby Healthy and HappyInfant Safety: Keeping Your Baby SafeInfant Enrichment: Stimulating Your Baby
More InformationLatest News
Health Woes Hit 1 in 7 Babies Exposed to Zika in U.S. TerritoriesTo Combat Childhood Obesity, Start at Birth … or Even BeforeBreast-Feeding Suffers in Homes With Smokers: StudyHomeless Babies Face Lasting Health RisksHealth Tip: When Small Children Play Near WaterWhy Choo-Choo is Better for Baby's Language Skills Than TrainDrinking While Breast-Feeding May Dampen Child's Brain DevelopmentAre You Car Seat Savvy?Food Allergies Less Severe in Infants: StudyMany Young Kids Not Screened for Developmental DelaysHealth Tip: Recognizing Hearing Loss in InfantsWant Good Sleep for Baby? Food May Be KeyA-C-T to Prevent Hot Car TragediesLook Before Locking: Protect Your Child From a Hot Car TragedySmart Steps for a Safe NurseryMom's Voice: The Sleep Secret for Babies in Intensive CareHealth Tip: Soothing Baby During TeethingClean Skin, Hands Critical for 'Kangaroo Care' for PreemiesAmericans' Obsession With Sugar Starts in InfancyNo Safety Concerns With DTaP Combo Vaccine for Kids: StudyFish Oil May Protect the Youngest HeartsCould Early Birth Hinder Adult Success?Health Tip: When Baby Spits UpTreatment for Teething Pain Poses Serious Health Threat: FDAFetal Growth, Maternal Anger Impact Infant RegulationInfants Know Real 'Baby Talk' When They Hear ItOpioid Crisis Means More Newborns With Hepatitis C, But Few Get TestedCCHD Newborn Screening May Detect Other DiseasesHealth Tip: Prevent Hand, Foot and Mouth DiseaseMultiple Anesthesia Exposures Affect Learning and AttentionHealth Tip: Milestones to Look for by Age 5Anesthesia Doesn't Seem to Harm Child's IQ: StudyHealth Tip: Prevent Poisoning at HomeHeath Tip; How to Introduce Your Child to PeanutsHealth Tip: When to See a Doctor for Cradle CapZika Infection After Birth May Require Long-Term Follow-UpRear-Facing Car Seats Protect Tots in Crashes From Behind: StudyBabies Given Certain Meds May Have Higher Odds for Allergies LaterHealth Tip: Which Car Seat Should Your Child Use?Baby Sitters, Relatives Often Unaware of SIDS RiskReading With Your Toddler Boosts More Than Just Language SkillsHealth Tip: Treat Diarrhea in Young BabiesNew Moms Still Wary of Exposing Infants to PeanutsHealth Tip: Use a High Chair SafelyPoison Prevention at HomeGenetic Heart Defects Rarely the Cause of SIDS, Research ShowsVaccine Exposure in First 23 Months Has No Adverse ImpactMechanical Heart Valve Approved for NewbornsMom's Immune System May Affect Baby's BrainVaccines Don't Weaken Babies' Immune Systems: Study
Questions and AnswersLinks
Related Topics

Child & Adolescent Development: Overview
Childhood Mental Disorders and Illnesses
Parenting
Child Development & Parenting: Early (3-7)
Child Development & Parenting: Middle (8-11)

Helping Preemies Avoid Unnecessary Antibiotics

HealthDay News
by By Serena Gordon
HealthDay Reporter
Updated: Oct 5th 2017

new article illustration

THURSDAY, Oct. 5, 2017 (HealthDay News) -- Researchers say they have identified three criteria that suggest an extremely premature infant has a low risk of developing sepsis, which might allow doctors to spare these babies early exposure to antibiotics.

Sepsis is an infection of the blood, and it's a serious, life-threatening condition.

But it isn't always easy to tell if these very small babies are sick due to an infection such as sepsis, or because their tiny bodies are so underdeveloped.

"These babies can die very quickly of sepsis, which makes it very difficult to choose who really needs antibiotics," said Dr. Rick Stafford, director of neonatology at Northern Westchester Hospital in Mount Kisco, N.Y. Stafford was not involved in the study.

At the same time, doctors are trying to reduce the use of unnecessary antibiotics, because when antibiotics are given to someone who doesn't need them, it increases the risk of developing bacteria that will resist those antibiotics in the future, Stafford explained.

Right now, he said, close to 90 percent of extremely premature babies may be exposed to antibiotics in the hospital.

To see what factors might help identify babies with a low risk of infection, the researchers considered ways that babies get infections in the first place. Most infections come from the mother's uterus or the vaginal canal, according to the study.

So the researchers hypothesized that babies born by cesarean section, whose moms had no signs of uterine infection and who hadn't had their water break, would be at low risk of early onset sepsis.

The investigators then looked at a large database of more than 15,000 extremely premature infants born between 22 and 28 weeks of gestation (normal-term babies are born at 39 to 40 weeks). Almost 5,800 (37 percent) of these preemies met the low-risk criteria.

The rate of sepsis was 0.5 percent in the low-risk babies and 2.5 percent in the comparison group, the study showed.

"Knowing how to use antibiotics properly is something physicians struggle with because antibiotics have their risks and their benefits. But if you're uninfected, you're only getting the risks," said study author Dr. Karen Puopolo. She's an associate professor of pediatrics at Children's Hospital of Philadelphia and chief of newborn care at Pennsylvania Hospital.

"We found a significant difference in culture-confirmed infections between the low-risk and the comparison group -- about a 70 to 80 percent lower risk," Puopolo said.

What's more, the researchers also found that the low-risk babies had a higher risk of certain long-term complications if they were on antibiotics for five or more days.

Low-risk babies given prolonged antibiotics were more likely to develop serious fungal infections, to develop a serious lung complication, and they even had a higher risk of dying compared to the comparison group.

"With all these pieces of evidence, maybe antibiotics aren't always the safest thing to do," Puopolo said.

However, both Puopolo and Stafford said it will likely take some time before there's a significant change in practice.

And both said these findings need to be confirmed in other studies.

"Antibiotic use is hard to avoid in this population," Stafford said. "But this may get everybody to be much more critical in our thinking."

Puopolo said: "Ours is not the first dataset to show what we've always believed and what we've always done isn't working as expected. In the end, there were worse health outcomes."

She suggested that if a baby is low-risk, a doctor could try withholding antibiotics.

"It's a decision you can always change two hours later," Puopolo pointed out.

The study was published online Oct. 5 in Pediatrics.

More information

Learn more about sepsis that occurs after birth from the U.S. National Library of Medicine.