Those first few weeks of life are a magical time as you and your baby bond and get to know each other, but they can also be a precarious time for your infant. Doctors usually schedule a baby check-up the first week or so after birth because they want to ensure that your newborn’s weight is going up and that no health problems have arisen that weren’t obvious at birth.
Your newborn’s immune system is still immature. Infections and other problems can set in quickly. “Trust your intuition,” says pediatrician Jennifer Shu, M.D., author of Heading Home With Your Newborn: From Birth To Reality, published by the American Academy of Pediatrics. “If your baby’s symptoms are making you concerned or nervous, it’s better to call the doctor than to delay. If it’s an emergency, your doctor’s office can let you know if you should call 911.”
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Here, symptoms in your newborn and older baby that you should never ignore:
1. Fever—anything over 100.4 in a baby under three months old. “Most fevers are not serious, especially in an older child, but newborn babies can become very sick very fast, so if there is a fever, we want to jump on it and check the baby out,” says Dr. Shu. (In older children, a fever of 105 that does not drop after your child takes fever medication is considered an emergency.)
2. Poor feeding. If your baby is sleeping through feedings, not consuming much at the breast or bottle, or isn’t wetting or dirtying her diapers very much during the day, your baby may not be getting enough to eat and there could be a physical problem. Call the doctor.
3. Listlessness or lethargy. Your baby seems sleepy, uninterested in nursing or the bottle, stares off into space, or is difficult to awaken from a nap. These symptoms could signal an infection or other problem. Call the doctor right away.
4. Grayish or bluish skin color— especially if your baby also has other symptoms such as lethargy, or trouble breathing or eating, or is unusually fussy. “These could all be signs of a potential heart problem in an infant,” says Dr. Shu. “Some heart problems take a week to declare themselves, so even if your baby is born with a heart problem, you may not be able to tell until about a week later.”
5. Shrill or inconsolable crying. Of course, infant colic can cause inconsolable crying, but if your baby is less than one month old or more than four months old, and if the crying is happening all day long not just at specific hours of the day, it’s probably not colic and you should call the doctor. “Babies may cry inconsolably if they are in severe pain,” says Dr. Shu. “It’s important to rule out any serious problems.”
6. Vomiting—any vomiting at all in a baby under one month old requires a call to the doctor. Persistent vomiting, especially if your baby is also lethargic and her lips look chapped or dry may signal that your baby is becoming dehydrated. Call the doctor.
7. Difficulty breathing. If your baby is wheezing, can’t “catch his breath,” or his chest is rising high with each breath (sign of labored breathing), your baby should see a doctor right away. Labored breathing could signal pneumonia or other infection, asthma, a heart malfunction, or other serious problem. Call the doctor or 911.
8. Yellow skin and/or whites of the eyes. These are signs of jaundice, an excessive amount of bilirubin (a yellow pigment produced by the liver) in the blood. When seen in newborns, jaundice often clears up without treatment within a week or two, however, in rare cases, severe jaundice may lead to brain damage in infants, so it should always be checked out as soon as possible.
9. Bleeding—call the doctor if you notice blood in your baby’s vomit, poop, or urine, or if your baby’s belly button or (in boys) circumcised penis area is bleeding. Your baby may have an infection or other problem.
10. Spasms—or convulsions or involuntary jerking motions are all signs of a seizure in your baby. “Call 911,” says Dr. Shu. “In older children who have a history of seizures—especially seizures caused by a fever—often you can call the doctor, but if your baby has a seizure, call 911.”
11. Changes in the soft spot on your baby’s head that make it look either hard and bulging (pressure on the brain) or sunken (sign of dehydration). Call the doctor.
For more information about how to “read” your infant’s symptoms, log onto AAP’s website, www.healthychildren.org, and type “symptom checker” in the search box.
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Laura Flynn McCarthy is a New Hampshire-based writer who specializes in health and parenting topics.