When a newborn develops a serious infection in the first days or weeks of life, it can affect far more than immediate health. Neonatal infections are among the most significant risk factors for long-term neurological complications, including cerebral palsy. For families navigating a birth injury diagnosis or seeking to understand what happened during or after delivery, recognizing the role of infection is an essential part of making sense of a complicated medical picture.

This page explains what neonatal infection is, how it can affect brain development, and what steps can be taken to reduce risk and support recovery.

What Is Neonatal Infection?

Neonatal infection refers to serious bacterial, viral, or fungal infections that occur in the first 28 days of life. These infections can include:

Sepsis (bloodstream infection)
Meningitis (infection of the membranes surrounding the brain and spinal cord)
Pneumonia (lung infection)
Encephalitis (inflammation of the brain tissue itself)

Some infections begin before birth, when a mother has an infection that reaches the baby through the placenta or amniotic fluid. Others develop during delivery or in the days afterward, especially in babies who require intensive care or medical interventions.

While most newborns do not develop infections, those who do face increased risk for complications that may not appear until months or even years later.

Why Neonatal Infection Matters in Birth Injury Cases

Infection in the newborn period can cause direct injury to the developing brain. The inflammation triggered by infection releases substances that damage fragile brain tissue, disrupt blood flow, and increase vulnerability to oxygen deprivation. White matter, the part of the brain responsible for communication between different brain regions, is especially susceptible to this kind of injury.

Research has shown that neonatal infection is a well-established risk factor for cerebral palsy, particularly when combined with prematurity, low birth weight, or birth complications. Understanding this connection helps families and clinicians identify causes, anticipate developmental challenges, and plan appropriate early intervention.

Types of Neonatal Infection and How They Cause Harm

Infections During Pregnancy and Labor

Chorioamnionitis is one of the most common and significant maternal infections linked to cerebral palsy. It occurs when bacteria infect the placenta and amniotic fluid, often during prolonged labor or after the water breaks. Signs may include maternal fever, rapid heart rate, and foul-smelling amniotic fluid.

Other maternal infections that increase risk include:

Urinary tract infections
Bloodstream infections
Genital tract infections, including Group B Streptococcus (GBS)

Even when treated, these infections can trigger an inflammatory response in the baby that begins before or during birth.

Infections After Birth

Newborns, particularly those born preterm or requiring NICU care, may develop infections in the days or weeks following delivery. Postnatal infections are often caused by:

Bacteria from the environment or medical equipment
Organisms introduced during necessary procedures like intubation or central line placement
Viruses such as herpes simplex or cytomegalovirus

Sepsis and meningitis are the most serious postnatal infections. Even with prompt treatment, these conditions can cause lasting brain injury, especially in premature infants whose immune systems and brain structures are still developing.

How Infection Injures the Brain

Infection harms the brain through several mechanisms:

Uncontrolled inflammation releases toxic chemicals that destroy or weaken developing neurons and myelin
Blood vessel damage disrupts oxygen and nutrient delivery
Swelling increases pressure inside the skull
Infection-related stress can lead to seizures, low blood pressure, or secondary oxygen deprivation

These effects are most damaging in the first weeks of life, when the brain is growing rapidly and extremely sensitive to disruption.

How Common Is Neonatal Infection

Neonatal infection occurs in approximately 1 to 4 out of every 1,000 live births in the United States and other developed countries. Rates are significantly higher among:

Preterm infants
Low birth weight babies
Infants born after prolonged rupture of membranes
Babies requiring intensive medical support

Chorioamnionitis, one of the most common maternal infections, is estimated to contribute to 12% of cerebral palsy cases in full-term infants and 28% in preterm infants. The risk of cerebral palsy is roughly doubled in preterm babies exposed to infection and may be as much as four times higher in term infants.

Maternal infection during pregnancy has been associated with up to a ninefold increase in the risk of spastic quadriplegia, one of the most severe forms of cerebral palsy.

Signs and Symptoms of Neonatal Infection

Newborns with infection may show subtle or rapidly progressing symptoms, including:

Lethargy or reduced activity
Poor feeding or refusal to eat
Irritability or high-pitched crying
Temperature instability (fever or abnormally low body temperature)
Rapid or labored breathing
Pale or mottled skin
Bulging fontanelle (soft spot on the head)
Seizures

Because newborns cannot communicate discomfort and their symptoms can be vague, clinicians rely heavily on lab tests, blood cultures, and imaging to confirm infection.

Long-Term Outcomes and Risks

Children who experienced neonatal infection, particularly those with sepsis or meningitis, face elevated risk for:

Cerebral palsy, especially spastic types
Intellectual and developmental disabilities
Sensorineural hearing loss
Vision impairment
Seizure disorders
Learning and behavioral challenges

A large study of more than 1,200 children with cerebral palsy in Canada found that those with a history of neonatal infection were more than twice as likely to have white matter injury visible on brain imaging. They were also more likely to need significant adaptive equipment and support.

Interestingly, the impact of infection appears to be greatest in full-term infants and in those without other major risk factors like prematurity or birth asphyxia. This suggests that infection alone, even in otherwise healthy babies, can be enough to cause serious and lasting harm.

Treatment and Medical Management

Immediate Care

When neonatal infection is suspected, treatment begins immediately, often before test results are available. Standard care includes:

Broad-spectrum intravenous antibiotics
Supportive care for breathing, blood pressure, and fluid balance
Monitoring for seizures and neurological changes
Blood cultures and lab work to identify the specific organism
Imaging studies such as cranial ultrasound or MRI if brain involvement is suspected

In cases of meningitis or encephalitis, treatment may be prolonged and require specialized antibiotics or antiviral medications.

Preventing Further Injury

Once infection is controlled, the focus shifts to minimizing secondary brain injury. This includes:

Managing fever and inflammation
Ensuring adequate oxygen delivery
Controlling seizures
Nutritional support to promote healing
Close monitoring for developmental delays

Babies who survive severe infection often require follow-up with neonatology, neurology, and developmental specialists.

Prevention Strategies

Many, though not all, neonatal infections can be prevented with appropriate medical care before, during, and after birth.

Before and During Pregnancy

Routine screening for urinary tract infections and sexually transmitted infections
Vaccination, including flu and whooping cough vaccines
Monitoring and treating signs of infection promptly

During Labor and Delivery

Screening for Group B Streptococcus (GBS) and administering antibiotics during labor when indicated
Recognizing and treating chorioamnionitis with intrapartum antibiotics
Minimizing prolonged rupture of membranes when safe
Maintaining sterile technique during deliveries and procedures

After Birth

Strict infection control practices in the NICU
Hand hygiene and gown protocols for caregivers and visitors
Judicious use of invasive devices like breathing tubes and IV lines
Early recognition and treatment of postnatal sepsis

These strategies are part of standard care at hospitals across New York and the United States, including leading centers such as Mount Sinai, NYU Langone, Columbia University Irving Medical Center, and Albany Medical Center.

What Families Should Know

If your baby developed an infection during the newborn period, it does not necessarily mean that something was done wrong. Newborns, especially those born early or with medical complications, are vulnerable to infection despite excellent care.

However, if warning signs were missed, appropriate antibiotics were delayed, or infection control protocols were not followed, those lapses may have contributed to a worse outcome.

Families should ask questions and request medical records if they have concerns. Key questions include:

Was my baby screened for infection risk factors?
Were maternal infections identified and treated during pregnancy or labor?
Was antibiotic therapy started promptly when infection was suspected?
What follow-up care and developmental monitoring is recommended?

At nybirthinjury.com, we provide trusted information to help families understand complex medical situations and connect with qualified professionals who can offer guidance and support.

The Importance of Long-Term Follow-Up

Not all effects of neonatal infection are immediately visible. Some children appear to recover fully in the NICU, only to show developmental delays or motor impairments months or years later.

For this reason, long-term neurodevelopmental follow-up is strongly recommended for any infant who experienced:

Confirmed sepsis or meningitis
Maternal chorioamnionitis with clinical signs in the baby
Prolonged antibiotic treatment in the NICU
Abnormal neurological findings or imaging during the newborn period

Regular assessments by a pediatrician, developmental specialist, or pediatric neurologist can help identify problems early, when intervention is most effective.

Research and Ongoing Questions

While neonatal infection is a well-recognized risk factor for cerebral palsy and other disabilities, researchers are still working to understand:

Why some infected infants develop brain injury while others do not
Whether anti-inflammatory treatments can reduce damage
How to better predict which babies are at highest risk
The most effective strategies for universal prevention

Recent studies suggest that infection may play a larger role in cerebral palsy than previously thought, especially in term infants without other obvious risk factors. This highlights the need for continued vigilance, better screening tools, and earlier therapeutic interventions.

Parents of children affected by neonatal infection are encouraged to stay informed, advocate for comprehensive care, and seek out early intervention services that can improve outcomes.

Moving Forward

Neonatal infection is a serious medical condition with the potential to change a child’s developmental trajectory. Understanding how infection happens, what it can cause, and how it is managed empowers families to ask the right questions and access the right resources.

Whether you are seeking answers after a difficult NICU stay or trying to make sense of a cerebral palsy diagnosis, knowing the facts about infection and brain injury is an important step in understanding your child’s health and planning for their future.

Neonatal Infection