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A seven day old neonate is brought in for a fever of 38.5 and lethargy. The baby had a home birth, and the parents have chosen a “lotus birth,” or umbilical nonseverance. The placenta remains attached to the newborn (carried around with the baby, often in a small bag), until it separates on its own, typically in 5-15 days.
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March 16, 2022 at 10:06 pm
B) Vancomycin
Lotus birth has been associated with neonatal sepsis and endocarditis due to coagulase negative staph species, hence the recommendation to add vancomycin. Another alternative birth practice, water immersion birth, has been associated with pseudomonas (piperacillin-tazobactam) and legionella (erythromycin). A recent review of infectious diseases associated with alternative perinatal practices was published in Pediatrics https://publications.aap.org/pediatrics/article/149/2/e2021055554/184545/Risks-of-Infectious-Diseases-in-Newborns-Exposed