Update information

May 2026: We have reviewed the evidence on the time between prelabour rupture of membranes and birth (at term) to see if this affects the risk of early-onset neonatal infection. We have also amended the risk factors related to fever and chorioamnionitis because of safety concerns. See box 1 on risk factors for early-onset infection.

We have reviewed the evidence on switching from intravenous to oral antibiotics when treating suspected early-onset neonatal infection. New recommendations are marked as [2026]. See the section on switching to oral antibiotics for early-onset infection.

Recommendation 1.21.3 has been amended to say 'stop antibiotics' rather than 'consider stopping antibiotics' because the committee agreed it was safe for antibiotics to be stopped if the criteria in the recommendation were met.

The guideline has been restructured to remove repetition of recommendations that previously appeared in the sections on early-onset and late-onset infection and to bring it in line with NICE style.

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 1 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, trans man or non-binary person 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-onset 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

November 2025: We updated links to NICE's guideline on suspected sepsis in under 16s.

October 2023: We updated links to NICE's 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 alert on the risk of harm from inappropriate placement of pulse oximeter probes.

ISBN: 978-1-4731-9511-0