Finding into death of Baby S

Female·Sepsis in the setting of a lotus birth

A premature female neonate born at 36+5 weeks via emergency caesarean section developed sepsis and died at 2 days of age. She had been delivered with lotus birth (cord left attached to placenta) and vaginal seeding (maternal vaginal fluid applied to baby) despite obstetric counselling against these practices. Her mother's GBS status was unknown and she declined antibiotics and antenatal steroids. The infant showed early signs of sepsis at SCN admission (hypoglycaemia, hypothermia, poor perfusion, mottled appearance) but improved initially. She deteriorated on day 2 with grunting, pallor, and hypothermia; antibiotics were started promptly. Despite aggressive resuscitation and retrieval to a tertiary centre, she died from sepsis with evidence of early necrotising enterocolitis and umbilical cord inflammation. Key lessons: alternative birth practices (lotus birth, vaginal seeding) carry significant infection risk, particularly when maternal GBS status is unknown; early recognition of sepsis signs in high-risk neonates is critical; all relevant clinical information must be communicated between obstetric and paediatric teams; and clear guidelines for counselling parents about non-evidence-based practices are essential.