The mother of a 2-day-old male has been informed that her child has sepsis. The mother is distraught and says, "I should have known that something was wrong. Why didn't I see that he was so sick?" The nurse's best reply is:

Question

1. "Newborns have immature immune function at birth, and illness is very hard to detect."
2. "Your mothering skills will improve with time. You should take the newborn class."
3. "Your baby didn't get enough active acquired immunity from you during the pregnancy."
4. "The immunity your baby gets in utero doesn't start to function until he is 4–8 weeks old."

Answer 1

1
Rationale 1: The immune system of a newborn lacks response to pyrogens, and presents a limited inflammatory response; thus the signs and symptoms of infection are often subtle and nonspecific.
Rationale 2: This response does not address the physiology of neonatal infection, and is not therapeutic, because it is blaming.
Rationale 3: The mother develops active acquired immunity, which is passed to the newborn transplacentally as passive acquired immunity. This immunity is to the illnesses and infections she has had or been immunized against.
Rationale 4: The passive acquired immunity a newborn receives from its mother is effective at birth, and lasts from 4 weeks to 8 months, depending on the specific antibody.