Sepsis in babies and children

baby with sepsis

Sepsis is a rare but serious complication of an infection, which can lead to multiple organ failure and, in some cases, death. Anyone can get sepsis, but children under the age of five are an at-risk group – and knowing exactly what to do when sepsis strikes can mean the difference between life and death.

The UK Sepsis Trust estimates that around 37,000 deaths each year are associated with the condition, but around 10,000 could be avoided. If your child is unwell with a bug or infection, watch them closely and if your child has any of the symptoms listed below or are sicker than you would expect, seek medical advice urgently. Sepsis is treatable if it is identified and treated quickly, and in most cases leads to a full recovery with no lasting problems.

We spoke to Dr Ed Gaynor, a paediatrician with 10 years' experience, and clinical fellow for the National Medical Director for the NHS in England: "Sepsis is a life-threatening condition that results from a body’s reaction to an infection in which the body attacks its own organs and tissues.

“An infection is caused by microorganisms or 'germs' (usually bacteria) invading the body, and can be limited to a particular body region (e.g. a skin infection) or can be more widespread in the bloodstream (often called septicaemia or 'blood poisoning').

“Sepsis is a medical emergency, as it can lead to shock, multi-organ failure, and death. However, if caught early, the outlook is good for the vast majority of patients, but it is vital not to delay seeking medical attention.”

Sepsis symptoms in children under five

“It's really important for both doctors and parents to ask, 'Could this be sepsis?' Not all infections will develop into sepsis, and those that do may develop very quickly.”

Keep a close eye on your child when they are poorly, and if they have any of these symptoms, go to A&E immediately or call 999:

  • Looks mottled, bluish or pale
  • Is very lethargic or difficult to wake
  • Feels abnormally cold to touch
  • Is breathing very fast
  • Has a rash that does not fade when you press it
  • Has a fit or convulsion

If a child shows any of the following signs and is getting worse or sicker than you would expect, seek medical advice urgently from NHS 111:

Temperature

  • Temperature over 38ºC in babies under three months
  • Temperature over 39ºC in babies aged three to six months
  • Any high temperature in a child who cannot be encouraged to show interest in anything
  • Low temperatures (below 36ºC, check three times in a ten minute period)

Breathing

  • Finding it much harder to breathe than normal – looks like hard work
  • Making 'grunting' noises with every breath
  • Can't say more than a few words at once (for older children who normally talk)
  • Breathing that obviously 'pauses'

Toilet/nappies

  • Not had a wee or wet nappy for 12 hours

Eating and drinking

  • New baby under 12 months old with no interest in feeding
  • Not drinking for more than eight hours (when awake)
  • Bile-stained (green), bloody, or black vomit

Activity and body

  • Soft spot on a baby's head is bulging
  • Eyes look 'sunken'
  • Child cannot be encouraged to show interest in anything
  • Baby is floppy
  • Weak, 'whining' or continuous crying in a younger child
  • Older child who's confused
  • Not responding or very irritable
  • Stiff neck, especially when trying to look up or down
baby with sepsis

Dr Gaynor said: “I’m a strong believer that parents should trust their instincts – if you’re worried, you often know what is normal for your child or loved one. If you’re uncertain, this is where 111 or seeing your GP is really helpful and will guide you in whether you should ‘Watch and Wait'.”

For more information visit www.nhs.uk/conditions/sepsis or www.sepsistrust.org.

What Mumsnetters say about sepsis

''My newborn DS developed it after having surgery on the second day of his life. Thankfully, it was very mild and he was already on antibiotics as a precaution, so there were no ill effects and it was classed as 'resolved' within a few days.''

''Knowledge is power. All you can do is be vigilant.''

''DS had it but was lucky in that he had a non-blanching rash early on. It appeared while we were out of the house and within 15 minutes of being at A&E, the 24 hour antibiotic was in (via a 30 minute IV). The hospital acted very quickly.''

''I'm a paediatric nurse and I'm surprised at the number of people who think there must be a rash for them to seek medical help, when a rash is actually a very late sign.''

''I nearly lost one of my children from it. He was just over a year old and became ill overnight – it seemed just like a normal winter infection. In the morning he was worse, had a tiny odd rash but it didn't seem like an emergency. My husband took the morning off to take him to the doctors and I was expecting a call saying it was a normal childhood illness and that we were being silly. Instead, I was told to get to A&E straight away. It took him a couple of hours to go completely downhill and the rash to cover him. Luckily, a doctor put him on broad-spectrum antibiotics while they were running tests.''