Chapter 3.4 Prevention of neonatal infections

Many early neonatal infections can be prevented by:

  • avoiding unnecessary separation of the newborn from the mother e.g.. baby unit
  • hand-washing before delivering and handling the infant
  • good basic hygiene and cleanliness during delivery (e.g. chlorhexidine cream for all maternal vaginal examinations)
  • appropriate umbilical cord care
  • appropriate eye care

Give prophylactic antibiotics only to neonates with documented risk factors for infection:

  • Membranes ruptured > 18 h before delivery.
  • Mother had fever > 38 °C before delivery or during labour.
  • Amniotic fluid was foul-smelling or purulent.

Give IM or IV ampicillin and gentamicin for at least 2 days and reassess; continue treatment only if there are signs of sepsis (or a positive blood culture).

Many late neonatal infections are acquired in hospitals. These can be pre- vented by:

  • exclusive breast feeding
  • strict procedures for hand-washing or alcohol hand rubs for all staff and for families before and after handling infants
  • using Kangaroo mother care and avoiding use of incubators for preterm infants. If an incubator is used, do not use water for humidification (where Pseudomonas will easily colonize) and ensure that it was thoroughly cleaned with an antiseptic.
  • strict sterility for all procedures
  • clean injection practices
  • removing intravenous drips when they are no longer necessary