Tommy's PregnancyHub

Protecting your premature baby from infection

Premature babies have less developed immune systems and are more susceptible to infection, but there are ways to reduce the risk.

All newborn babies are at risk of infection because their immune systems are not yet mature. Babies can pick up infections during labour and childbirth or after the birth. Infections in babies less than 72 hours after birth are called early onset infections. Infections picked up after this time are called late onset infections.   

Why are babies in the baby unit more likely to get an infection?

Babies in the baby (neonatal) unit, especially premature babies, have a higher risk of infection. This is because their immune systems are less developed and they’re more likely to need invasive tests and treatments, such as blood tests and breathing tubes.  

How are infections in premature babies treated?

If your baby has an infection, treatment will depend on what is causing it. 

Bacterial infections are treated with antibiotics, while fungal infections are treated with anti-fungal medicines. Viral infections may be treated with good nutrition or medicines.

Your baby may be moved to a private area or room if they have an infection that could pass to the other babies in the unit, such as the flu. 

What are the signs of infection?

Tell your healthcare team if you notice any possible signs of infection in your baby. These include: 

  • floppiness, listlessness or irritability – or if they just don’t seem 'right'
  • poor feeding
  • a temperature of below 36°C or over 38°C 
  • rapid breathing, recession (if baby is sucking in their chest with each breath) or apnoea (if baby pauses their breathing for a variable amount of time)
  • an abnormally fast or slow heart rate 
  • sickness (vomiting) or runny poo (diarrhoea)
  • spots, a rash or yellowing of the skin (jaundice)
  • weeping, oozing or a foul smell from a wound or opening in the skin.

Sometimes, a baby’s immune system can over-react to an infection, causing a life-threatening condition called sepsis. The signs of sepsis can be hard to spot in babies but may include: 

  • pale, blue or blotchy skin
  • breathing problems
  • a weak or high-pitched cry, which is different from usual
  • sleepiness or not responding as they usually do.

The healthcare team will keep a close eye on your baby so that any symptoms of infection or sepsis are picked up quickly. Sepsis is treated with antibiotics and sometimes breathing support.  

How can infections be prevented in the baby unit?

The healthcare team will give you information on how to reduce the risk of passing on an infection to the babies in the baby unit. 

Everyone must wash their hands before going into the unit. All parents and visitors must clean their hands when they arrive and again if they move around the unit. Parents should avoid wearing rings, watches or bracelets. You should also wash your hands before and after touching your baby.

Anyone who has an infectious illness will usually be asked to keep away from the baby unit until they’re better. If you have an infection, some baby units may let you see your baby if you follow guidelines to protect your baby, for example by wearing a face mask. Siblings should also avoid coming to the unit if they are unwell. 

Bliss have some information about helping your baby avoid infections.

NICE (2012) Neonatal infection (early onset): antibiotics for prevention and treatment. Clinical guideline 149. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/cg149

Macdonald S, Johnson G (2017) Maye’s Midwifery 15th edition. Elsevier, London.

EFCNI, Helder O et al. (2018) European Standards of Care for Newborn Health: Hand hygiene. European Foundation for the Care of Newborn Infants. https://newborn-health-standards.org/hand_hygiene/

NHS. Sepsis: symptoms. https://www.nhs.uk/conditions/sepsis/ (Page last reviewed: 18/7/2019. Next review due: 18/7/2022.)

Pammi M (2020) Premature newborn care. BMJ Best Practice. https://bestpractice.bmj.com/topics/en-gb/671/pdf/671/Premature%20newborn%20care.pdf

EFCNI, Helder O et al. (2018) European Standards of Care for Newborn Health: Hand hygiene. European Foundation for the Care of Newborn Infants. https://newborn-health-standards.org/hand_hygiene/