Guidance

Update information

Update information

March 2024: The updated NICE guideline on bacterial meningitis and meningococcal disease made new recommendations for newborn babies in the following areas:

  • information and support

  • lumbar puncture

  • cerebrospinal fluid investigations

  • fluid restriction

  • assessing for immunodeficiency and recurrence risk

  • preparing for hospital discharge, including identifying and managing complications

  • care after discharge

  • recurrent bacterial meningitis.

We have moved these recommendations from the meningitis guideline into this neonatal infection guideline, so that all the recommendations for newborn babies are in one place. These recommendations are marked [2024].

April 2021: We have reviewed the evidence and made new recommendations on the risk factors for infection and clinical indicators of possible infection and on intrapartum antibiotics of neonatal infection. These recommendations are marked [2021].

We have also made some changes without an evidence review:

  • what to do if a woman has been identified as having a group B streptococcal infection in relation to future pregnancies

  • when to perform a lumbar puncture for babies who are receiving antibiotics who did not have a lumbar puncture on presentation

  • early- and late-onset meningitis.

These recommendations are marked [2012, amended 2021].

Recommendations marked [2012] last had an evidence review in 2012. In some cases, minor changes have been made to the wording to bring the language and style up to date, without changing the meaning.

Minor changes since publication

December 2024: Amended recommendation 1.10.2 to clarify that babies with suspected late-onset neonatal infection or meningitis who have been admitted from home need an additional antibiotic active against listeria as per recommendation 1.14.7 in the NICE guideline on suspected sepsis.

January 2024: Various links were updated throughout to point to the newly updated NICE guideline on suspected sepsis.

October 2023: We updated links to the NICE guideline on intrapartum care, which has been updated.

October 2022: We added text to indicate that pulse oximetry may be less reliable in people with dark skin. We also added a link to the NHS patient safety alerton the risk of harm from inappropriate placement of pulse oximeter probes. See recommendation 1.8.3.

October 2021: We added a link to NICE's guidelines on babies, children and young people's experience of healthcare and on shared decision making in recommendation 1.1.1.

ISBN: 978-1-4731-5820-7