Newborns may not always have a fever when sick. Some subtle signs to be aware of and to immediately report to your pediatrician include the following:
- If your baby seems yellow (jaundice). Especially if associated with excessive sleepiness, refusal to eat and/or irritability.
- If your baby refuses 2 or more feedings. This can lead to dehydration and/or hypoglycemia (low blood sugar).
- If your baby projectile vomits or has frequent vomiting in a six hour period.
- If vomit looks green (bilious) or is a coffee ground color.
- If your baby’s temperature is less than 97.8°F or greater than 100.4°F under the arm. (Follow the instruction given by your healthcare provider if these numbers vary)
If your baby has less than 4-6 wet diapers in a day in the first few days of life, less than 6 wet diapers a day after the 6th day of life, or does not have a wet diaper for more than 18 hours. This can be a sign of dehydration. Other signs of dehydration include:
- Increased heart rate and breathing
- Less frequent urination
- Dry skin
- Dry mouth and lips
- Sunken eyes
- Sunken “soft spot” on head
- Skin that does not bounce back when pinched and released
- If your baby has not had a bowel movement after 24 hours (especially if this is associated with a hard abdomen and vomiting), stool is formed and hard (sign of constipation) or is having consecutive liquid stools (diarrhea).
- If meconium is present on the 5th day of life. This could be a sign of inadequate milk transfer in breastfeeding babies.
- If blood is present in the stool or if stool is green and watery.
- If your baby is lethargic (floppy), crying excessively, and/or having jerking movements of body and/or eyes.
- If your baby’s breathing pattern has become labored (e.g. rapid breathing, shallow breathing, gasping for air, flaring nostrils, changing colors and/or making a grunting sound when breathing). If your baby turns blue or stops breathing—CALL 911.
- If the umbilical cord or circumcision site has a foul odor, swelling, pus, or excessive bleeding.
- If eye drainage develops.
- If you notice the tongue and/or cheeks have a thick white film on it that you cannot scrap off. This can be thrush, a yeast infection in the mouth that requires treatment with an anti-fungal medication prescribed by your doctor. Learn more about Thrush here...
If by the end of the first month of life your baby:
- Feeds slowly
- Does not blink when shown a bright light
- Has little amount of movement or stiffness of the arms and legs
- Has a floppy muscle tone
- The lower jaw trembles constantly, even when not crying or excited
- Does not respond to loud sounds
Remember, any time you are concerned about your baby's health and/or development, call your child's healthcare provider.
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Author : Diba Tillery RN, BSN, IBCLC, CPST