Canadian researchers warned of “potentially fatal adverse neonatal outcome of underwater birth” following the case of a baby girl who developed sepsis eight days after being born underwater in a hot tub.
“This frightening case highlights the importance of safe clean birth,” he said.
“The risks associated with standing water, particularly that which is repeatedly heated and cooled, certainly include bacteria breeding in the water and therefore we increase the risk of infection whenever we enter the water.
“But within the NHS, water births are offered in pools that are filled specifically for each birth and are specially temperature controlled. Provided they are carried out in that environment then water births continue to be a safe and popular means of delivery.”
Sepsis, also known as blood poisoning, is a reaction to an infection in which the body attacks its own organs and tissues.
The case reported in the Canadian Medical Association Journal (CMAJ), involves a baby girl who was delivered at full term and was healthy at birth.
But she was admitted to hospital eight days later with high fever, poor feeding and fussiness. She was then moved to the intensive care unit (ICU) because of multi-organ failure.
Tests indicated she was infected with the Legionella bacterium and was suffering from sepsis.
She was started on antibiotics to treat the infection and began to improve. After five weeks on a ventilator in the ICU, she was discharged with close follow-up of her condition.
“Our case serves to highlight a severe and potentially fatal adverse neonatal outcome of underwater birth, especially when prefilled heated pools are used,” wrote Dr. Michelle Barton, from the department of paediatrics, at London Health Sciences Centre and Western University, in Ontario, Canada.
The hot tub in question had been filled three days prior to the baby’s birth and the researchers state that standing water can lead to increased concentrations of bacteria such as Legionella in the water as it thrives in temperatures between 20°C and 42°C.
Recommendations on water births in the United Kingdom caution that pools with jets or recirculating pumps should not be used because of increased risk of contamination, and tanks should not be pre-filled.
Spotting sepsis in children under five.
Source: NHS Choices.
Go straight to A&E or call 999 if your child has any of these symptoms:
- looks mottled, bluish or pale
- is very lethargic or difficult to wake
- feels abnormally cold to touch
- is breathing very fast
- has a rash that does not fade when you press it
- has a fit or convulsion.
If your child has any of the symptoms listed below, seek medical advice urgently from NHS 111.
- over 38C in babies under three months
- over 39C in babies aged three to six months
- any high temperature in a child who cannot be encouraged to show interest in anything
- below 36C – check three times in a 10-minute period.
- finding it much harder to breathe than normal – looks like hard work
- making “grunting” noises with every breath
- can’t say more than a few words at once (for older children who normally talk)
- breathing that obviously “pauses”.
- not had a wee or wet nappy for 12 hours.
Eating And Drinking:
- new baby under one month old with no interest in feeding
- not drinking for more than eight hours (when awake)
- bile-stained (green), bloody or black vomit/sick.
Activity And Body:
- soft spot on a baby’s head is bulging
- eyes look “sunken”
- child cannot be encouraged to show interest in anything
- baby is floppy
- weak, “whining” or continuous crying in a younger child
- older child who’s confused
- not responding or very irritable
- stiff neck, especially when trying to look up and down.
For more information on sepsis, visit www.sepsistrust.org.