Neonatal sepsis leads to 8,000 newborn deaths in RP – WHO

Of the total 30,000 deaths of Filipino children less than one month old every year, nearly 8,000 is caused by neonatal sepsis, a serious blood bacterial infection.

These estimates were compiled for all countries, including the Philippines, by an expert body led by World Health Organization.

“Newborns are very susceptible to infection because of their underdeveloped immune system,” said Dr. Howard Sobel, medical officer of the WHO Philippines’ country office. “For that very reason, global standards in hospital infection control should be strictly enforced starting at birth.”

These standards begin with safe cord cutting, initiation of exclusive breastfeeding within the hour after birth and rooming in with mothers.

“The cord should be cut with a sterile blade and kept clean and dry,” Sobel said. “The three cleans — clean hands, clean perineal area and clean umbilical area should be practiced.”

He added that apart from maintaining clean hospital environment, birthing women, birth attendants and others handling the baby should observe strict personal hygiene, particularly hand-washing, at all times.

Internal exams of the mother during labor and delivery should be minimized and conducted by trained birth attendants, with clean hands, covered by sterile gloves.

Likewise, handling of the baby and invasive interventions such as setting up of intravenous lines should be conducted only when and where there is a proven need. All equipment that comes in contact with intact skin must be washed thoroughly.

However, instruments contacting mucous membranes or non-intact skin should be sterilized, boiled or chemically disinfected and those penetrating the skin should be sterilized.

“Initiation of breastfeeding in the first hour of birth also a recommended preventive measure,” Sobel said. “Newborns should be placed on the mother’s bare abdomen or chest immediately upon birth.”

He shared that the “family bacteria” on a mother’s body is the “friendly bacteria.” Immediate skin-to-skin contact of the baby facilitates these bacteria to grow in and on the baby and prevents unfriendly bacteria from growing.

“The first milk that comes out of a mother’s breast, called colostrum, serves as the baby’s first immunization,” Sobel said. “It has high concentrations of nutrients and antibodies that a newborn needs to develop properly and resist infection.”

Colostrum contains a large number of immunoglobulin that helps protect the mucuous membranes in the throat, lungs and intestines of the infant from germs. Leukocytes are also present to protect against harmful viruses. Colostrum also facilitates growth of beneficial bacteria that line the digestive tract to ward off infection.

Breastfeeding and rooming-in can dramatically reduce the number of neonatal sepsis cases.

In a well-cited comparative study by Dr. Natividad Clavano on the mode of feeding and its effect on infant mortality and morbidity, data showed that more than 95 percent of deaths caused by neonatal sepsis were prevented because of breastfeeding and rooming-in.

“Also significant in the study was the 89-percent reduction of infants who showed signs of sepsis,” Sobel said. “In another study, those that received animal milk or formula only were 18 times more likely to get neonatal sepsis than those getting breast milk.”

Rooming-in of the newborn with the mother allows continuous and exclusive breastfeeding.

Sobel added that good prenatal care can also prevent neonatal sepsis as well as many other conditions that can endanger the newborn.

Mothers should be immunized against tetanus. All types of infections should be diagnosed early and treated vigorously in pregnant mothers.