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)
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
Fetal 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: StudyHealth Tip: Prevent Tooth Decay in BabiesPointers for Easier Potty TrainingHealth Tip: Make Sure Babies Eat RightGut Microbiota May Affect Vertical Transmission of Being OverweightHealth Tip: Protect Baby from Whooping CoughMany Parents in the Dark on When Kids Should First See a DentistStroke May Not Mean Language Loss for NewbornsCause of Sudden Unexpected Infant Deaths Shifts in the U.S.Babies Face Higher SIDS Risk in Certain StatesNICU Family Integrated Care Ups Infant, Parent OutcomesBabies With Normal Head Size Might Still Have Zika-Linked Brain DamageZika Tied to Rise in U.S. Birth Defects: CDCNutrients in Child's First 1,000 Days Key for NeurodevelopmentOpioid Epidemic Also Taking Toll on BabiesHome Visit Program Can Help Prevent Toddler ObesityHealth Tip: Succeed in Toilet TrainingNeurodevelopment Not Impacted by Glucocorticoids in PreemiesToo Many Babies Still Die Needlessly of SIDS, CDC Says16 Percent of Infants Receive Complementary Foods Too Early2013 to 2015 Infant Mortality Rate Varied by State and RaceHealth Tip: Health Tip: Prepare Your Child for the DentistMost U.S. Babies Start Solid Foods Too SoonSpecial Baby Formula Doesn't Seem to Prevent Type 1 DiabetesHealth Tip: Ways to Bond With Baby
Questions and AnswersLinks
Related Topics

Child & Adolescent Development: Overview
Childhood Mental Disorders and Illnesses
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.