Newborn meningitis

Meningitis (men-in-jy-tis) is an infection of the membranes (thin layers of tissue) around the brain and spinal cord. These are known as the meninges (men-in-jees). They help protect your baby’s brain against injury and infection.

Meningitis can be caused by infection with viruses, bacteria, or other germs such as fungi. Most serious meningitis infections are caused by bacteria.

Meningitis is rare in newborn babies, but it can be very serious and needs urgent treatment.

What causes meningitis in newborns?

A newborn baby’s immune system is not fully developed, so they are more likely to get infections. The immune systems of babies born prematurely are less developed than babies born at full term, so they are more vulnerable.

Meningitis in newborn babies may be either ‘early onset’ or ‘late onset’. Early onset means it happens in the first three days after birth. Late onset means the infection starts after at least three days, and is most likely to develop within 28 days after birth.

Early onset meningitis is usually caused by bacteria that the baby picks up from the mother during birth. Bacteria that are living harmlessly on the mother can sometimes cause serious infections in a newborn baby. Rarely, early onset meningitis is caused by bacteria that have infected the mother from food she has eaten.

Late onset meningitis is usually caused by bacteria from the environment around the baby. This type of meningitis is more likely to happen in premature babies, and most likely in babies who are in intensive care.

Bacteria can get into places where your baby is attached to equipment such as tubes into their veins, or ventilation tubes which help support their breathing, although this is rare.

The bacteria can get into the baby’s blood and travel to the meninges around their brains. The meninges can then become inflamed and cause damage to the brain.

Which babies are most likely to get meningitis?

Meningitis is rare, but a baby has a higher risk of getting meningitis if:

• They are born prematurely.
• They have a low birth weight (under 1500g).
• Their mother had a type of bacteria called Group B Strep (GBS) living in and around the birth canal at the time of birth.
• The membranes around the baby ruptured more than 18 hours before they were born, if they were born prematurely.
• Their mother had a high temperature during the birth.
• There was an infection of the placenta or fluid around the baby before birth.

Please talk to your care team if you have any questions about these risks.

It can be difficult to see if a newborn baby has meningitis. They may just seem unwell, with common symptoms of illness. If you are on a neonatal unit, your care team will be checking for signs of serious conditions like meningitis.

Signs of meningitis in newborn babies may include:

• Being drowsy, or restless.
• Being 'floppy' - feeling limp in your arms.
• Being sleepy, not active, or not responding to you.
• Having a high or low temperature.
• Breathing difficulties - breathing too fast, or having periods where they stop breathing, called apnoea (ap-nee-ya).
• Not feeding well.
• Having a rash - red, blotchy skin or patches of red spots.
• Having seizures (fits).
• Jaundice - yellow skin and yellow colour in the white area of the eyes.
• The soft spot on baby's heads (fontanelle) bulging out.

Please talk to your care team if you have any questions about these symptoms.

A common way of checking if your baby might have meningitis is by using the 'glass test'. If your baby has a rash (red blotchy skin) or patches of red spots, you can press a clear drinking glass against their skin.

If the rash of spots do not fade when you press the glass against their skin, this may be a sign of meningitis, or another serious medical condition which needs to be checked.

Meningitis Now have a useful guide on how to use the glass test.

What should I do if my baby is at home and I think they have meningitis?

If you think your newborn baby may be ill, talk to your care team as soon as possible. If you are at home, you can ring NHS 111 or call your GP for advice if you are not sure.

If you are worried that your baby is seriously ill, take them to the nearest Accident and Emergency department or call 999. If your baby has meningitis, they need urgent medical treatment.

What tests might my baby have to check for meningitis?

In the hospital, doctors will examine your baby and ask you about their symptoms.

Your baby may need some tests, including:

• Blood tests - to check your baby's health and look for signs of infection.
• A lumbar puncture (LP) - where the doctor or nurse uses a small needle to check the fluid around your baby's lower back. This is the main test that helps the care team to be sure if your baby has meningitis.

Please talk to your care team if you have any questions about these tests.

If your baby has bacterial meningitis, they will need treatment in hospital. If they are seriously unwell, they may need to be cared for in a neonatal high dependency unit (HDU) or a neonatal intensive care unit (NICU).

Your baby will need treatment with antibiotics immediately. Antibiotics are medicines that kill bacteria. The antibiotics will be given through a small tube into one of your baby's veins. This helps them to work quickly.

The doctors will look at the results of your baby's tests to help them decide which is the best antibiotic to use. Depending on which bacteria are causing the infection, your baby may need antibiotics for more than one week.

Are there any short-term or long-term effects?

With quick treatment, many babies make a full recovery after having bacterial meningitis.

Some babies get complications while they have meningitis, because of the way the infection can damage the brain. For example, they may get a build-up of fluid in the brain which will need to be removed.

If your baby has any complications, the doctors and nurses will explain what is happening, and the treatment they will need.

Some babies are left with long-term problems after having meningitis. This is more common in babies born prematurely. Serious long-term problems may include:

• Epilepsy - having seizures (or fits).
• Learning difficulties.
• Cerebral palsy - a physical condition that affects movement, posture, and coordination.
• Problems with hearing an eyesight.
• Speech and language problems.
• Problems with behaviour.

These problems may not be obvious immediately, so it is important that your baby has regular reviews of their development, particularly in the first two years, to see how they are progressing.

Sadly, although meningitis is rare, some babies who get it may die.

Having a baby who is unwell with meningitis in intensive care or special care can be a challenging and stressful experience. We have some information about how you might be feeling and the different types of support available.

If you are not sure about any part of your baby's illness, treatment or care, the staff looking after your baby will help in any way they can. It is ok to ask again if you need information repeated or made clearer. The team will understand and want to support you.

We have included some links below to charities and organisations that provide information and support around meningitis. Our website also has other links to charities and organisations to a range of medical conditions and disabilities.

Group B Strep Support – they work to stop group B strep (GBS) infection in babies. They provide support and information to families about GBS.

Meningitis Research Foundation – for information and support with meningitis at any age, including babies.

Meningitis Now – also for information and support with meningitis at any age, including babies.

If you need someone to talk to, you can also contact us via email on [email protected] or arrange a video call with one of our volunteers.