How to spot for signs of sepsis in children

Sick child and mother

I was approached recently to raise awareness on the topic of sepsis by a colleague whose cousin had survived, thanks to spotting it early and being provided with quick treatment.

I asked a few people about whether they knew what sepsis was, and it was surprising to note that six out of the ten whom I spoke with were unclear or unsure about what sepsis is and therefore would not be able to spot early signs of sepsis in their children. It is fundamental that you know what sepsis is and how to treat it quickly because it can become fatal very quickly. Sepsis can occur in adults too, but I will be focussing on spotting the signs of sepsis in children.

“25,000 children are affected by sepsis every year in the UK.” Sepistrust.org

So, what is sepsis?


When you have a viral/bacterial infection or injury, the immune system kicks into action and starts fighting back, by rustling up cells to fix the infected/damaged area. Generally, the symptoms are manageable, and your child’s immune system will help them recover fully within a few days.

Sometimes, for some unknown reason, the immune system can overreact, releasing chemicals into the bloodstream to fight the infection, but then also turning on its own organs and tissues. This overreaction by the immune system is called sepsis (or blood poisoning). Sepsis can cause inflammation, blood clots, low blood pressure, trouble breathing and organ failure. And, if not treated quickly enough, sepsis can be fatal and life-threatening. Otherwise, if spotted early, you can treat sepsis with antibiotics.

“Sepsis is the body’s overwhelming and potentially life-threatening response to an infection.” Sepsis.org

Who is at risk of developing sepsis?

Sepsis, although rare, can develop in both children and adults. It can be most common, however, in those with a weakened immune system and:

  • Newborns and infants under three months of age. Their immature immune systems cannot fight off large infections, and so sepsis can occur.
  • Children who are also not vaccinated for Streptococcus pneumonia (also known as pneumococcus) and Haemophilus influenzae.
  • Children with chronic medical conditions
  • Children with HIV, cancer or other conditions that weaken the immune system “Sepsis is the leading cause of death in children worldwide. 3 million children die every year.” sepsis.org

Newborns are affected by sepsis when bacteria enter the blood. Common culprits tend to be group B Strep, E. Coli, Listeria monocytogenes, Neisseria meningitis, Streptococcus pneumoniae, Hemophilus influenzae type B and salmonella.

Premature babies who have also spent time in the NICU, are also at most risk of sepsis because of their underdeveloped immune systems. They may be exposed to bacteria through long-term intravenous lines, catheters or tubes, and breathing tubes attached to a ventilator. If you feel that medical negligence has occurred, which has led to your child contracting sepsis, then you should contact a solicitor and ask for legal advice.

How to spot for signs of sepsis in children

Infections can be passed down from mother to baby

Sometimes the risk of infection can occur during pregnancy, which can raise a newborn’s risk of infection, i.e when:

  • The pregnant mother has an infection/fever during labour
  • There is an infection of the uterus or placenta
  • The mother’s amniotic sac ruptures before 37 weeks
  • The mother’s amniotic sac ruptures 18+ hours before delivery
  • Up to 30% of pregnant women carry group B strep, which can be passed to baby during delivery. Ask your doctor to be tested for group B strep during pregnancy. It is a simple swab and if it is present, you will be treated with IV antibiotics during labour to prevent transmission.

How to spot for signs of sepsis in children

There isn’t a specific sign and some symptoms can present themselves in different ways. Sepsis can initially look like flu, a chest infection or gastroenteritis. So, if your child is unwell with either fever or a low temperature, then call 999 and ask whether it could be sepsis.

Here are some signs to look out for. She or he may:

  • Feel very lethargic or difficult to wake
  • Have a ‘fit’ or convulsion
  • Have a bulging soft spot
  • Be breathing abnormally fast
  • Pause for breath for more than 10 seconds (apnea)
  • Have a rash that does not fade when you press it
  • Feel unusually cold to touch
  • Be unable or unwilling to make eye contact
  • Be inconsolable or irritable
  • Look bluish or pale
  • Look jaundiced (yellowish skin and/or eyes)
  • Not be feeding
  • Look confused
  • Be repeatedly vomiting
  • Have not passed urine in the last 12 hours
  • Have an existing infection (like pneumonia) with symptoms getting worse.

If you notice any of these symptoms, call your child’s doctor IMMEDIATELY. They may require emergency medical attention.

What does septic shock look like?

Sepsis can become severe when at least one of the following symptoms occur, as this may indicate that your child’s organs are failing:

  • Abnormal heart beat
  • Change in mental status
  • Difficulty breathing
  • Abdominal pain
  • Not passing urine
  • Decreased platelets
  • Very low blood pressure that doesn’t respond to typical treatment

How is sepsis diagnosed in children?

If your child’s doctor suspects sepsis or wants to rule out severe infection, he or she may order the following for diagnosis:

Urine tests

Your child’s doctor can look for bacteria in the urine that could indicate sepsis

Blood tests

Your child’s doctor can look for infection, abnormal liver or kidney function and low oxygen levels, which may show sepsis has occurred

Lumbar puncture

Your child’s doctor may need to examine a sample of your child’s spinal fluid and check for infection (including meningitis)

X-rays

X-rays can show pneumonia and other conditions which indicate sepsis.

If your doctor suspects that sepsis has occurred, even before the results come back, s/he may start your child on a course of antibiotics straight away. If the results show that your child has sepsis, s/he will need to be treated in hospital with antibiotics and IV fluids, as well as be provided blood pressure medication and equipment to help them breath. It is vital that this treatment be given as early as possible to prevent any organ damage or disability.

Ways to prevent sepsis occurring in your child

You are not able to prevent all cases of sepsis, but you can protect your child from infections that may lead to sepsis, by:

  • Making sure that your child is fully vaccinated, especially for Streptococcus pneumoniae and Haemophilus influenzae
  • If you’re pregnant, make sure you are tested for Group B strep between Week 35 and 37 and follow up on the results to ensure if you need antibiotics during labour. If you experience premature labour, ensure you ask your doctor about receiving antibiotics. If you know that you are group B strep positive, then head straight to the hospital after labour symptoms start or your water breaks
  • Make sure you and your child wash hands frequently to help prevent infection. Don’t allow sick visitors near young babies and children
  • If your child needs medical devices like long-term IV lines and catheters, make sure you follow the doctor’s directions for cleaning and accessing the device

It is important to note that many children who do survive sepsis are left with life-changing effects, both mentally and physically. Some children are left with a change in their cognitive skills or they experience post traumatic stress. And, in some cases, treatment of sepsis can result in some organs not working correctly, and/or your child may have to have limbs amputated.

This is why it is vitally important that if you are concerned and you believe that your child is experiencing any of the symptoms above, that you call 999 immediately and say that you are concerned about sepsis. The earlier you act, the more chance you have of your child surviving sepsis without disability or death.

Keep pushing your doctor!

How to spot for signs of sepsis in children

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How to spot for signs of sepsis in children Leyla Preston (544 Posts)

Leyla Preston is the owner and Editor of Motherhood Diaries global magazine for parents. Leyla is a busy mother of two even busier boys; Aron, 5, and Aidan, 4. When Leyla isn’t feeding, managing a gazillion tasks or cleaning the infinite mess at home, she is busy working on this magazine and a new cooking channel coming very soon – no rest for the wicked! You can follow Leyla on Twitter (@M_Diaries) or join the busy Motherhood Diaries Facebook group where all mums get together and share stories and solutions with one another: https://www.facebook.com//groups/motherhooddiaries/

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