Introduction
Neonatal sepsis in preterm and low birth weight newborns are linked to high death and morbidity rates. Intervention to lower the risk of sepsis is necessary in addition to treating the nosocomial infection. Breast milk is the finest source of nutrition for premature newborns. It contains bioactive substances with antibacterial, antiviral, and anti-inflammatory properties that benefit growth and development and immunity against infection. Neonatal sepsis is a disorder of the immune system's response to infections that harm organs and affects newborns within the first month of life.
What Are the Benefits of Breastfeeding?
Breastfeeding offers many benefits to the infants, such as;
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Breast milk contains ideal nutrients that are required for the baby.
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Colostrum, a yellowish fluid produced by the breasts during the initial days after birth, is rich in proteins. It is the ideal first milk that helps develop a newborn's digestive tract.
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Breast milk consists of important antibodies which help the infant to fight infections.
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Breastfeeding can promote healthy weight gain in infants.
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Breastfeeding promotes healthy growth and development in infants.
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Breastfeeding reduces the risk of infections in the middle ear, respiratory tract, gut, etc. It also reduces the risk of other diseases such as sudden infant death syndrome (SIDS), bowel disease, diabetes, childhood leukemia, etc.
How Does Breastfeeding Help Prevent Infection in Newborn Babies?
The newborn's immune system is small. It grows quickly, particularly due to exposure to gut bacteria. During and after delivery, the baby typically acquires germs from the mother's intestinal flora. One of the several defensive mechanisms in the mother's milk is large levels of secretory IgA (SIgA) antibodies made by lymphocytes that have moved from the mother's stomach to the mammary glands. Due to this, the SIgA antibodies mostly target the mother's recent and past gut flora. Therefore, breastfeeding controls the neonate's early exposure to microorganisms and reduces bacterial translocation across the gut mucosa. This could be a key factor in breastfeeding's effective protection against infant septicemia and several other illnesses.
What Are the Causes of Sepsis in a Preterm Baby?
Sepsis is a life-threatening condition that occurs when the body's reaction to the infection is extreme, resulting in injury to the tissues and organs. Sepsis occurs most commonly as a complication of bacterial infection. However, it can also occur due to viral, fungal, or other parasitic infections. Children below the age of one year are at high risk for sepsis. If the mother has any infections during pregnancy, the newborn also has more chances to develop sepsis.
Preterm babies are more likely to develop sepsis or an infection than term newborns. Preterm newborns have a higher risk of infections, which is mostly caused by:
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Immune system deficit, that is mostly caused by reduced IgG antibodies and ineffective opsonization and complement activation.
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The juvenile epithelial barrier, which was composed of the innate immune system.
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Because of the severe illnesses that accompany them, there is a greater requirement for intrusive devices such as vascular access, endotracheal tubes, feeding tubes, and urinary tract catheters.
An undeveloped immune system is the main factor that increases a newborn's susceptibility to sepsis. Polymorphonuclear neutrophils, macrophages, and T-lymphocytes cannot carry out a full inflammatory response in newborns due to their immature function. Additionally, newborns are born with little immunoglobulins and cannot create an effective immune response against pathogenic pathogens on a quantitative or qualitative level. The short period that premature babies spend in the uterus decreases immune globulins transfer to the fetus. When compared to term infants, preterm infants have a substantially higher risk of developing sepsis due to this immunoglobulin shortage.
A humoral and cellular immunity deficiency has been associated with neonatal sepsis and preterm. Premature births and low birth weight babies required longer hospital time for care, increasing the risk of sepsis contracted in the hospital. Premature newborns have underdeveloped immune systems because they do not have enough IgG antibodies. The danger of infection after birth increased to the point where it eventually developed into sepsis at the end of pregnancy when these antibodies were not passed from the mother to the fetal blood through the placenta.
What Are the Symptoms of Sepsis in Babies?
The symptoms of sepsis can vary. Following are the common symptoms a child with sepsis presents with:
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Poor feeding.
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Irritability.
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Hypothermia or low body temperature.
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Difficulty in breathing.
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Coldness in hands and feet.
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Shivering.
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Pain.
How Does Breastfeeding Help in Preventing Sepsis in Preterm Babies?
Breast milk contains proteins, lipids, carbohydrates, minerals, vitamins, enzymes, growth factors, and hormones, so it helps babies develop immunity and physiological and economic benefits. Compared to formula, preterm newborns fed mother's milk have a reduced death rate and are less prone to developing late-onset sepsis. Breast milk is the best nourishment for preterm and low birth weight newborns, which also lowers the risk of prematurity-related problems. It includes immune-system-active bioactive compounds such as immunoglobulin, anti-inflammatory, antioxidant, and microbiota that are anticipated to have an impact on lowering the prevalence of newborn sepsis. Necrotizing enterocolitis, sepsis, retinopathy, problems in brain development, metabolic syndrome, and repeated hospitalizations in premature infants are all serious risks for preterm infants.
The difficulty in giving breast milk to a premature baby is that mothers unable to supply enough for their own baby's needs should obtain donor breast milk, and mothers unable to nurse directly can express the milk. Mothers are crucial for nursing to be successful. Increased breastfeeding from mothers of preterm infants may result from interventions to enhance early postpartum lactation and training. If the mother's breast milk is unavailable, pasteurized donor milk may be given to the infants. When the infant is healthy and stable, breastfeeding can start right away. If the baby is not healthy and stable, the mother should express the milk. There are numerous studies that contradict one other regarding whether breast milk prevents infection. Numerous investigations showed that contaminated breast milk expression was the cause of late-onset sepsis in preterm infants.
Conclusion
Preterm babies are at high risk for developing sepsis due to their underdeveloped immune system. However, recent studies found that breastfeeding may prevent sepsis in preterm babies. Breast milk contains many antibodies, proteins, lipids, carbohydrates, minerals, vitamins, enzymes, growth factors, and hormones which can help preterm babies develop their immune system and hence fight infections.
