Management

The management of grunting depends on a number of principals:

• if there is a potentially serious reason for the grunting then the infant should be admitted to a special care baby unit and started on intravenous antibiotics after a septic screen. The particular organism feared is infection with group B streptococcus. Indicators of potential serious infection include:
  • prolonged rupture of membranes
  • known maternal infective illness
  • preterm delivery
• if grunting occurs immediately after birth, and there is a benign cause for the grunting, and there are no serious risk factors, then the baby might be observed for an hour before admission to a special care baby unit. This applies particularly in uncomplicated caesarian deliveries, where a greater amount of lung fluid must be absorbed physiologically, or in precipitous normal vaginal deliveries.

The underlying principal is:

• if in doubt, admit, perform a septic screen and start on antibiotic therapy