Infant Exposed to Strep

Dear Lisa,

I have a 7 day old infant. My mother came down shortly after she was born and stayed with us for 5 days. The day she left she found out she had strep throat (her throat had been bothering her during her stay). Should I be concerned that my baby was exposed to strep throat and should I bring her to a physician. She has been fine with eating, voiding and bowel movements. She is also breast fed.

“Concerned Parent”

Dear “Concerned Parent”,

Strep throat is an infectious disease caused by group A beta hemolytic streptococcus. It is commonly found in school age children and can be found in toddlers 1 to 3 years old. (1) It may occur in infants if there has been close contact with a person with strep pharyngitis, but this is rare. In my practice, I occasionally had an infant who developed Strep Pharyngitis, but they tended to be older infants (between 9 and 12 months old) who crawled on the floor, played with toys and put their hands in their mouth. I have never seen or read any journal articles about a 7 day old infant with Strep Pharyngitis (Strep Throat).

Strep is transmitted from one person to the next through exposure of respiratory secretions. Therefore there is little opportunity for an infant to become infected because of the unlikelihood that they would come into contact with respiratory secretions. Older children who engage in play resulting in close physical contact through wrestling or hugging are at risk for catching Strep throat. Older children tend to share foods and drinks, kiss on the mouth, drool, suck on toys, share toys that are soaked with respiratory secretions and sneeze and cough in each other faces. In addition children generally do not practice good hygiene skills such as covering their mouth with coughing and sneezing or washing their hands after touching their mouth or nose. These are the practices that put children at risk for catching Strep Pharyngitis.

A seven day old infant in a crib does not engage in any of these risky behaviors and therefore should not be a candidate for acquiring Strep Pharyngitis. I can understand that you are concerned because your mom did stay at your house and was diagnosed with Strep Pharyngitis shortly afterwards. It is true that infants are susceptible to infections because of their immature immune systems. In particular, infants for the first 12 weeks of life are at risk for developing serious bacterial infections such as Meningitis and Bacteremia (blood infection). (2)

Since your baby was exposed you should watch for signs of an infection in a newborn which include fever (rectal temperature of 100.4 Fahrenheit or higher), irritability, lethargy, vomiting, rash, change in her feeding pattern, redness and swelling around the umbilical cord, or odorous discharge coming out of the umbilical cord. If any of these symptoms occur you should have your baby checked by your Pediatrician. The good thing is that your baby is breastfeeding well and from your description seems to behaving normal.

One of the best ways to prevent infants from catching infections is to practice good hand washing techniques. (3) Anyone handling a baby for the first 12 weeks of life should wash their hands first. Caregivers should wash their hands before handing the baby’s formula, bottles and pacifiers. Infants can develop a Strep infection in their umbilical cord (Neonatal Omphalitis) therefore adults caring for infants should also wash their hands before cleaning or touching the umbilical cord. (2) Adults and children with an illness, especially with “the Flu” or a virus should not visit a baby under 3 months old until they are well. It is also a good idea to keep a baby away from large crowds of people for the first 4 to 6 weeks of life.

References:
(1)Herd Immunity produced by PCV7 protects infants to young to immunize. Infectious Diseases in Children. 2006. June:22.
(2) American Academy of Pediatrics. Group A Streptococcal Infections. In: Peter G, ed. 1997. Red Book: Report of the Committee on Infectious Disease. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics; 1997:483-485.
(3) Betz C, Hunsberger M, Wright S. Family-Centered Nursing Care of Children. 2nd ed. Philadelphia, PA:W.B.Saunders Company. 1994:139.

Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice About Keeping Babies Helathy