The unfavorable effects of neonatal immunodeficiency are limited by some naturally occurring compensatory mechanisms, such as the introduction of protective and immunological components of human milk in the infant. Breast-feeding maintains the maternal-fetal immunological link after birth, may favor the transmission of immunocompetence from the mother to her infant, and is considered an important contributory factor to the neonatal immune defense system during a delicate and crucial period for immune development. Several studies have reported that breast-feeding, because of the antimicrobial activity against several viruses, bacteria, and protozoa, may reduce the incidence of infection in infants. The protection from infections may be ensured either passively by factors with antiinfective, hormonal, enzymatic, trophic, and bioactive activity present in breast milk, or through a modulator effect on the neonatal immune system exerted by cells, cytokines, and other immune agents in human milk.
Bacterial sepsis remain a major cause of mortality and morbidity in the newborn. The severe outcome of neonatal sepsis, despite the advances in perinatal and neonatal care and use of potent antibiotics, is related to the neonatal reduced immune defenses and the complex interactions between the infecting microorganism and the host responses. An early diagnosis, based on the clinical picture, the isolation of microorganisms and the positivity of inflammatory indexed, is mandatory. A timely treatment should be aimed to the elimination of pathogens with antimicrobials. Intravenous immunoglobulin and hematopoietic growth factors may be considered to improve the disturbed immune homeostases.
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