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Your baby may have been acting up – or maybe s/he was just born – and you are told that one of the blood tests being performed is a “CRP.” You want to know what that is, and what it means for your baby. “CRP” stands for C-reactive protein, a substance produced by the liver when the body is experiencing some sort of stress. Originally used in adults to track treatment response to deep-seated infection, neonatologists have adopted it as a marker to help diagnose infection. The measured amount increases when the body is experiencing stress or inflammation, and is low (< 2 mg/dl) under normal conditions. Premature neonates can be “stressed” for lots of reasons; infection is one of the most likely, most easily treated reasons, and is most dangerous if missed. However, infection is not the ONLY reason why a CRP may be elevated! The stress of birth, alone, causes an elevation in CRP, as does other stressful events such as blood draws or pain. And a culture of body fluid that is supposed to be sterile – typically urine, blood and spinal fluid – remains the “gold standard” for diagnosing infection. In neonates, however, cultures are frequently falsely negative for a number of reasons, including the antibiotics that a mother may get prior to birth. (

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