Sepsis in babies and children

What is sepsis?

Sepsis happens when your body reacts to an infection by causing damage to itself. It can cause serious problems with different body organs and limbs, and if it’s bad enough, it can lead to death.

Children get many infections when they are growing up. Most infections get better and don’t become sepsis, but any infection can become sepsis if it gets bad enough.

What are symptoms of sepsis in babies and children?

There any many different symptoms of sepsis. They are often similar to symptoms of a mild infection, for example, shivering with a fever, which makes it hard to know if your baby or child has sepsis. This is why you need to see a health professional if your child’s symptoms don’t get better or are getting worse. It’s always best to check and tell a doctor or nurse if you are worried that your child has sepsis.

Symptoms of sepsis include:

• breathing fast
• taking long pauses between breaths
• vomiting
• seizures
• bad pain without a clear reason

Depending on your child’s age, some behaviour changes you may notice include:

• being difficult to wake up
• confusion
• restlessness

Skin changes you may notice on your child include:

• cold skin
• blotchy or discoloured skin
• a rash that doesn’t fade when pressed

In babies, symptoms of sepsis include:

• having less wet nappies
• having problems feeding
• not settling

What causes sepsis?

Any infection can cause sepsis. The infection can be from bacteria, viruses (including influenza) or fungi. It is usually caused by bacteria in the blood, but the infection may have started anywhere such as pneumonia or appendicitis

If sepsis happens to very young babies in their first 2 days after birth, it is known as early onset sepsis. It usually happens if your baby catches an infection during labour or birth. Group B streptococcus (GBS) and gram-negative bacteria are common causes.

Late onset sepsis is when a baby has sepsis when they are more than 2 days old. It could be from an infection that they got during birth or while in hospital, or from somewhere else. It could be caused by many different infections.

Are there any risk factors for sepsis in babies and children?

Babies and children have a higher risk of sepsis than adults. Aboriginal and/or Torres Strait Islander children are also at increased risk of sepsis.

Risk factors for sepsis include:

• being up to one year old, but especially younger than one month old
• having other medical conditions, such as long-term medical problems, COVID-19, burns, wounds or previous sepsis
• being treated for cancer with chemotherapy
• having an intravenous (IV) drip or any medical device that partially sits inside the body and opens above the skin
• recently having a procedure or surgery
• having an immune system problem (immunodeficiency)

Extra risk factors for babies getting sepsis include:

• being born premature
• having a sibling with GBS infection
• the baby being stressed in labour
• having a long stay in hospital
• being born with birth differences (congenital anomalies)
• the child’s mother having prolonged rupture of membranes (when there is a long time between your waters breaking and your baby being born)

When should I seek medical help?

If you child has any of the symptoms listed above or has an infection that is not getting better, you should seek medical help urgently. If you are worried about your child, even if they recently saw a doctor, seek medical help. Sepsis is an emergency, and treating it early leads to better results.

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How is sepsis diagnosed?

There is no specific test to diagnose sepsis. A doctor will examine your child, take some blood tests and may refer your child for other tests such as x-rays. They may also ask you if your child has had any recent infections.

A doctor or nurse will take your child’s temperature. Children with sepsis may have a fever or a colder body temperature than normal, as well as some of the symptoms listed above.

How is sepsis treated?

There are many different things that are done to treat sepsis, including:

• giving your child antibiotics and fluids
• giving your child medicine to help their blood flow
• monitoring your child’s progress to treatment

You child will need to have an intravenous cannula (IV cannula or ‘drip’) for medicines and fluids. In some children, putting an IV cannula in can be difficult so the doctors may put in an intraosseous line (a device inserted through the skin into the bone). If your child is very sick, they may be need to be in a paediatric intensive care ward or the NICU (neonatal intensive care unit).

If your doctors think your child may have sepsis, they will start treatment straight away. The doctors do not need to wait for results to start antibiotics.

Are there complications of sepsis in babies and children?

If your child has sepsis, they are at risk of long-term problems. Your child’s liver, heart, kidneys, lungs and blood vessels may be damaged. There is a risk of losing a limb (amputation), permanent disability or even death if it’s not treated.

Sepsis may also cause long-term problems with thinking and memory. It can also cause emotional effects.

Can sepsis be prevented?

Things you can do to prevent your child from developing sepsis include:

• keeping your child up to date with vaccines
• washing your hands and your child’s hands often
• seeing a doctor if you are worried your child has an infection

Resources and support

If you think your child has an infection and is not getting better, or they are getting sicker, trust your gut feeling. Ask your doctor “Could it be sepsis?” If it’s outside of normal hours and your doctor isn’t available, visit an urgent care clinic.

Read more on sepsis in babies and children:

• Queensland Health has a helpful checklist of symptoms to look for that could mean they have sepsis.
• Queensland Health also has a website with sepsis information and support for families.
• The Australian Commission on Safety and Quality in Health Care has an information sheet for families and carers of children with sepsis. The sheet includes information about sepsis, including what to expect after your child comes home from hospital.