Parents of babies with bacterial meningitis got inappropriate advice, says study

A "concerning" number of parents of babies with a potentially deadly form of meningitis were given inappropriate advice before going to hospital, a small new study has found.

A number of concerned parents received "inappropriate" guidance about how to care for their unwell child - including being advised to administer prune juice for fever and irritability, the research found.

Meanwhile, the parents of more than a quarter of newborn babies with bacterial meningitis received advice to stay at home after raising concerns with a health worker.

Researchers examined the care of almost 100 newborns across England after they became ill with bacterial meningitis between July 2010 and July 2013 - bacterial meningitis is rarer but more serious than viral meningitis.

The infants had an average age of just 14 days when they were diagnosed.

The study, published in the journal BMJ Open, found that 66 babies were at home when they became unwell while the others were already in hospital.

Three in 10 parents took their baby straight to hospital but 70% sought help from another health worker first, including their GP, the old NHS Direct telephone service or by contacting their community midwife.

Of these, 28% were advised to stay at home, the authors found.

Of the 66 newborn babies who were at home when they became unwell, 30% were deemed to have been given "inappropriate pre-hospital management", according to the researchers from St George's University of London.

They wrote: "Twelve infants with fever warranted further investigation according to the NICE (National Institute for Health and Care Excellence) guidelines and, in a further eight cases, there was a delay in seeking help despite the presence of worrying clinical features.

"Examples of inappropriate advice given to parents included being told that their child's fever was due to a change in milk formula, or to an umbilical hernia, or where prune juice was recommended for fever and irritability."

The authors added: "Of concern, a significant proportion had received inappropriate advice, suggesting that further training of front-line healthcare staff in recognising serious illness in children is required."

The study, funded by the Meningitis Research Foundation (MRF), also raised concerns about delays in starting antibiotics and delays in performing lumbar puncture to correctly diagnose bacterial meningitis once children were admitted to hospital.

Professor Paul Heath, senior author of the paper, said: "Our study highlighted the difficulties in diagnosing this condition as well as variations in treatment across the UK.

"It is clear that better recognition and management is essential if lives are to be saved and complications of meningitis minimised."

The study recommends a targeted campaign for education among parents and health workers.

As a result, MRF has collaborated with the study investigators and Royal College of Paediatrics and Child Health to create a teaching package aimed at healthcare professionals to promote best practice.

They have created an online tool to help medics recognise clinical features of bacterial meningitis in young infants, which is available at neonatal.meningitis.org.

Vinny Smith, chief executive of the MRF, said: "The educational package has been piloted by paediatricians and we hope that it can ultimately improve outcomes for this vulnerable age group."

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