The first days, weeks, and months of your baby’s life are exhilarating and exhausting. You’re just getting to know your little one – what their different cries mean, where they like to sleep – and how you respond to make everything better.
But what about when they’re not feeling well? Signs of illness in newborns and infants can certainly be scary, and it can be difficult to know exactly how to react. Do you contact the on-call doctor? Go straight to the ER? Wait and see?
We have put together some guidelines to help you decide on next steps when your baby has symptoms of an illness. Keep in mind that this list is in no way exhaustive and does not replace seeking medical advice from a doctor.
When to Seek Emergency Medical Care
Many illnesses can be treated in your doctor’s office, but there are several symptoms that should be cause to seek immediate care.
Call 911 or go to the ER right away if your newborn or infant:
- Can’t wake up or isn’t moving
- Has new-onset seizures or convulsions
- Has bluish (or gray) lips, face or tongue
- Is very weak and/or lethargic
- Has difficulty breathing or is breathing rapidly
- Has large amounts of blood in their stool
- Has fever (at any age) between 104ºF and 105ºF
- Has trouble swallowing
- Is constantly vomiting (or the vomit has become dark green)
- Has a rash on their chest, back, arms or legs that, when pressed with your finger, doesn’t fade
Newborns are especially susceptible to infections. Seek immediate care if your newborn has a temperature of 100.4ºF or higher, or you notice swelling of their fontanelle (the soft spot at the top of their head).
Evaluating your baby based on their temperature can be tricky, as not all fevers are created equal. Here is when you should seek medical care by age group:
- Newborns up to 3 months: A fever of 100.4°F or higher
- 3 to 6 months: A fever of 101°F or higher
- Over 6 months: A fever of 103°F or higher
To accurately take your baby’s temperature, your doctor may advise you use a digital rectal thermometer. New research has shown that temporal artery thermometers may also be accurate.
Remember that a fever is often a sign that the body is fighting an infection. As a general rule of thumb, if your baby is older than 6 months and has a fever lower than 102°F, medication is not necessarily needed.
Also consider how your child is feeling and acting. Their illness may not be serious if they are eating and drinking well, alert and smiling, and still interested in playing. Even if they’re not interested in eating, don’t worry too much. A decreased appetite is common with infections that cause a fever. Just make sure they’re still drinking and urinating normally.
Vomiting is different from spitting up. Spitting up (typically seen in infants less than one year old) is the easy flow of stomach contents out of the mouth. Vomiting is when the stomach contents come out forcefully – shooting out instead of just dribbling. Spitting up generally doesn’t affect an infant’s well-being, unless you notice streaks of blood in the spit up, your baby has problems gaining weight or the spitting up causes your baby to gag or choke.
One single episode of vomiting isn’t necessarily a reason to worry. However, if it continues, dehydration could become an issue.
Symptoms of dehydration include:
- Dry mouth
- Less than six wet diapers a day
- A sunken fontanelle
- Dry skin
- Few or no tears when crying
- Sunken eyes
If any of these symptoms are present along with persistent vomiting, or a fever, call your doctor. If your baby projectile vomits, contact your doctor immediately.
While it’s normal for a baby’s stool to be softer than an adult’s, if it suddenly becomes more watery or looser – and happens more often and in larger amounts – it could be diarrhea.
Just like vomiting, a big concern with diarrhea is dehydration. Be on the lookout for symptoms of dehydration and contact your doctor quickly if your baby is showing any of them. Other accompanying symptoms that should prompt you to seek medical care include a fever of 102°F or higher, belly pain, sluggishness, blood/pus in the stool or stool that’s white, black or red.
Trying determine the kind of rash, and the cause of it, can be difficult. Most rashes aren’t dangerous and will fade over time. Your doctor will help you learn to identify common diaper rash, chafing and eczema, and suggest at-home remedies for relief. See your doctor if a rash lingers for weeks or returns often or appears suddenly with other symptoms.
Seeking Pediatric Care
Comprehensive Primary Care offers personalized pediatric services at our Medical Center office in Rockville. We offer same day sick visits Monday through Friday and 24/7 on-call coverage so you can reach a doctor when you need guidance about your baby’s health.