Meningitis is a condition that causes inflammation in the meninges, which protect the brain and spinal cord. Meningitis is most often caused by a virus or bacteria.

Meningitis is an uncommon but potentially dangerous infection. Babies under 2 months of age are at greater risk of getting meningitis, according to the American Academy of Pediatrics (AAP).

Experts are not sure why some babies get meningitis, but they believe it could be related to their immature immune systems.

Meningitis can have lasting effects on babies and can be fatal in some cases. However, prompt medical treatment can significantly reduce the risk of serious complications.

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Symptoms of meningitis in babies can include extreme sleepiness, refusal to feed, and fever or chills.

The symptoms of meningitis in babies may not be alarming at first. Some babies may simply appear irritable or tired.

Meningitis can become serious quickly, so it is essential to be aware of its symptoms and to seek medical care immediately if meningitis is suspected.

The most common symptoms of meningitis in babies include:

  • Bulging fontanel (the soft spot on top of the head). This may be due to increased pressure or fluid in the brain.
  • Fever. A high temperature is a red flag for an infection, but some babies, especially those under 3 months of age, may not have a fever.
  • Cold hands and feet with a warm torso.
  • Chills. This may include shivering or chills, with or without a fever.
  • A stiff neck. Babies may hold their bodies in a stiff position and may hold their head tilted back.
  • Irritability and crying, especially when picked up. This could be due to a sore or stiff neck or muscle and body aches.
  • Rapid breathing.
  • Vomiting persistently.
  • Refusing to feed.
  • Extreme sleepiness. A person may have difficulty with or be unable to wake the baby.
  • Red or dark rash or marks on the body. If a baby has a fever, appears ill, and develops a rash, seek medical care right away.

Babies that have any symptoms that could be meningitis should get emergency medical care. Prompt and aggressive treatment helps ensure a better outcome.

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Image credit: Stephen Kelly, 2019

The most common causes of meningitis in babies are bacteria and viruses. Bacterial meningitis is typically more dangerous than viral meningitis, though both require prompt medical care.

Several different viruses can cause viral meningitis. They include:

  • Non-polio enteroviruses. These are the most common cause of viral meningitis in the United States. They are often spread through contact with an infected person's stool, saliva, or secretions from the eyes and nose. Infection with these viruses is common, but most people only develop a mild illness.
  • Influenza. Influenza or the flu can be especially serious in babies, as it may lead to meningitis. It is spread through coughing, sneezing, and close contact with an infected person.
  • Herpes simplex viruses (HSV). These viruses cause cold sores and genital herpes. According to the World Health Organization (WHO), more than 65 percent of the world's population has HSV, and many do not know it. A person can spread HSV to a baby through kissing, even when they have no symptoms. Newborns can contract HSV from their mothers during birth.
  • Varicella-zoster virus. This virus causes chickenpox and shingles. It is highly contagious and commonly spreads through breathing, talking, or contact with an infected person's blisters.
  • Measles and mumps. These diseases are extremely contagious and are spread through talking, coughing, sneezing, and sharing items, such as cups. Measles and mumps are less common since vaccines were introduced but are still very serious in babies.
  • West Nile virus or other viruses spread by mosquitoes.

Most of these viruses will not cause meningitis in a healthy person. However, babies are at a higher risk of meningitis and other complications, so protecting them from these illnesses is vital.

Causes of bacterial meningitis

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If certain bacteria are present during pregnancy, labor, or childbirth, they may infect the baby.

Bacterial meningitis can be caused by several different types of bacteria. The most common types that infect babies include:

  • Group B streptococcus, known as group B strep. This is passed from mother to newborn during labor and childbirth if the mother is infected and not treated.
  • Escherichia coli (E. coli), which is also spread from mother to baby during labor and birth and by eating contaminated food.
  • Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), which are commonly spread through coughing and sneezing.
  • Listeria monocytogenes, which is spread through contaminated food. A fetus can be infected with listeria during pregnancy if the mother consumes food contaminated with the bacteria.
  • Neisseria meningitidis, which is spread through saliva.

Bacterial meningitis is treated with antibiotics that are typically given intravenously in the hospital through an IV.

According to the AAP, most babies who receive prompt antibiotic treatment will recover completely. However, about 20 percent may be left with lifelong effects, including hearing problems, learning disabilities, seizures, and paralysis.

Viral meningitis does not respond to antibiotics. It is usually not as serious as bacterial meningitis (except for HSV in newborns), and many babies will recover completely without complications.

However, both types of meningitis require prompt medical attention. Babies may need extra hydration with IV fluids, pain relief, monitoring, and rest in order to make a full recovery.

Meningitis can be spread easily from person to person. Although it cannot be prevented completely, some precautions can significantly reduce the risk of a baby getting it.

Vaccines are key

Babies should receive vaccines as outlined by the Centers for Disease Control and Prevention (CDC) or as recommended by a doctor.

Although vaccines do not prevent all cases of meningitis, they help protect against several types of serious bacterial and viral meningitis. This greatly reduces the risk of a baby getting the disease.

Hib (Haemophilus influenzae type b) vaccine

Before the Hib vaccine was available, this bacteria was the leading cause of bacterial meningitis. Today, infection with Hib has become much less common due to the vaccine.

Hib vaccine is given at 2, 4, and 6 months of age, and again between 12 and 15 months of age. Hib vaccine is given either alone or in a combination vaccine.

Pneumococcal vaccine

Pneumococcus bacteria can cause meningitis and other serious infections, such as pneumonia. The pneumococcal vaccine is typically given at 2, 4, and 6 months of age, followed by a final dose between 12 and 15 months of age.

Children with certain health conditions may get an additional dose between 2 and 5 years of age.

Meningococcal vaccine

The most common type of meningococcal vaccine is known as the meningococcal conjugate vaccine (MCV4). This vaccine is usually not given to babies, but to children 11 years of age and older.

MMR vaccine

The MMR vaccine protects against measles, mumps, and rubella. Before this vaccine became available, mumps was a common cause of viral meningitis, especially in babies and children. Measles can also cause meningitis.

The MMR vaccine is given at 12 to 15 months of age and again at 4 through 6 years of age.

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Practicing good hygiene when preparing bottles for milk may help to prevent meningitis in babies.

Newborns have not yet received all their vaccines, and their immune systems have not developed fully. Therefore, it is often advised to avoid people and places that may expose a baby to higher amounts of germs. Help protect babies from meningitis and other illnesses with these tips:

  • People who have cold sores or who are prone to cold sores should avoid kissing babies.
  • Keep babies away from people who are sick or who are coughing, sneezing, or not feeling well.
  • Keep the baby away from large crowds of people whenever possible.
  • Wash hands before preparing food or bottles for a baby.
  • Ask others to wash their hands before holding the baby and to avoid touching the baby's face.
  • Pregnant women should get a group B strep test between 35 and 37 weeks of pregnancy. Mothers who test positive for group B strep should receive antibiotics during labor to prevent spreading the infection to the baby.
  • Keep babies indoors during prime mosquito activity. This is usually from dusk until dawn. If the baby must be outside, use long sleeves, long pants, and ask a pediatrician about safe mosquito repellants.

Also, do not expose babies to cigarette smoke, which may increase the risk of getting viral or bacterial illnesses, such as meningitis.

Meningitis symptoms can come on quickly and rapidly become serious in babies. For this reason, babies should be given emergency medical care if any symptoms of meningitis appear, or if the baby's behavior is unusual.

Extreme fussiness without obvious cause, a fever, excessive sleepiness, or a rash should be checked by a doctor immediately.

Although meningitis can be serious, most babies will recover from viral or bacterial meningitis with proper medical care.