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Informal English: Puncture Ladies, Egg Harbors, Mississippi Marbles, and Other Curious Words and Phrases of North America
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Life's Puncture Wounds
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Learn Why and What's Involved for Lumbar Punctures in an Infant

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Symptoms of seizures, continuous vomiting, and high fevers are a great cause of concern when it comes to any infant. When a virus has been ruled out, or there is cause to believe there is swelling or hemorrhaging in the brain the infant's pediatrician might request a specialist who will order different tests to check the child's over all health. Lumbar punctures in an infant are a means to examine the brain and spinal cord through the cerebrospinal fluid, CSF.

Meningitis, sepsis, and bacterial infections are among the reasons why a doctor will decide to perform lumbar punctures in an infant. Should the child be too sick the test might be postponed, but in cases where meningitis is a real concern the test will continue.

Sterile gloves and a sterile area, many times behind hospital drapes, are important during lumbar punctures in an infant. Other equipment that will be used include a procedure tray, which will hold the smaller tools, cerebrospinal fluid tubes, and spinal needles with stylet. Skin preparation making use of an iodine solution will be conducted by the doctor or assistant. The infant will also be given a local anesthetic in the lower back (lumbar) area.

At least one assistant will hold and restrain the child during lumbar punctures in an infant. A qualified and patient assistant is a must as the child may feel stressed and try to move and kick during the procedure.

Lumbar punctures in an infant require the child to either lie on his or her side, or to remain in a sitting position if able. An assistant is responsible for protecting the infant from stretching, or bending his or her neck too far as this can cause respiratory problems. Some infants will remain calm until the needle is inserted, while others may not feel it at all for the first part. The assistant should use techniques to calm the child as much as possible while the spinal tap is done.

Parents should be aware that the infant might feel some discomfort or headaches for a few days after the procedure. The child's health care provider will discuss what symptoms to look for, which of it is normal and which require an immediate hospital visit.

When the tests come back the child's doctor will look for such things as cloudiness in the cerebrospinal fluid, high or low pressure, glucose, protein markers, red and white blood cell counts, as well as bacteria or fungus. Cloudy cerebrospinal fluid, high pressure, low glucose, or high levels of white blood cells might be a sign of meningitis. The doctor might wish to perform more tests to be sure, but will probably give the child the appropriate dose of antibiotics.

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