Neonatal Tetanus — what every parent and caregiver should know

Neonatal tetanus is a severe infection that affects newborns, usually in the first days or weeks of life. It happens when the bacterium Clostridium tetani gets into the umbilical stump, often after unclean cutting or when harmful substances are applied to the cord. The bacteria release a toxin that causes muscle stiffness and painful spasms. Without prompt care, neonatal tetanus can be life-threatening.

Signs, timing, and what to watch for

Symptoms usually start between 3 and 14 days after birth. Early signs are subtle: the baby may have trouble sucking or seem unusually irritable. Look for jaw stiffness (the baby may not open the mouth to feed), difficulty feeding, a stiff body, and spasms that can cause arching of the back. Excessive crying and fever may show up too. If you notice any of these signs, act fast — neonatal tetanus can progress quickly.

If you suspect neonatal tetanus, go to the nearest emergency department right away. Treatment often involves tetanus immune globulin to neutralize the toxin, antibiotics to clear the bacteria, wound care for the umbilical area, and medicines to control spasms. Some babies need breathing support or intensive care. The sooner treatment starts, the better the chance of recovery.

Prevention: simple steps that save lives

Prevention is straightforward and highly effective. First, maternal vaccination with a tetanus-containing vaccine during pregnancy builds antibodies that pass to the baby and protect them in the first months of life. If you're pregnant or planning pregnancy, ask your healthcare provider about tetanus vaccination as part of routine prenatal care.

Second, ensure a clean birth and cord care. A skilled birth attendant, sterile instruments to cut the cord, and clean hands reduce risk. Avoid applying traditional substances like ash, cow dung, or herbal pastes to the cord — those can introduce bacteria. Keep the stump clean and dry; if you aren’t sure what to use, ask a nurse or midwife for simple cord-care steps.

In high-income countries like Canada, neonatal tetanus is rare because of widespread vaccination and safe delivery practices. Still, it remains a risk in places with low vaccine coverage or where home births use non-sterile tools. If you travel to areas with limited health services or have recent relatives from such areas, double-check vaccination status and birth plans.

Bottom line: protect the baby before birth with maternal vaccination, make sure the delivery is clean, and seek immediate medical care if feeding problems, stiffness, or spasms appear. Quick prevention and fast treatment save lives.