Disclosure :: This post is sponsored by Women’s & Children’s Hospital and written by Dr. Donna Fox, pediatrician.
Six Symptoms You Should Not Ignore In Your Newborn
It’s a delicate balance when you’re a new parent
You may hesitate to call the pediatrician for every little worry, but how do you know when it’s something significant or urgent? Always remember that your pediatrician is there for your family if there is any uncertainty – just a phone call away. You don’t want to overlook serious health issues.
Here are some symptoms that may be cause for concern:
Fever
If an infant under 3 months of age has a true fever – a temperature of 99.4 or higher when measured under the arm – it’s important the he or she be evaluated by a pediatrician. Doctors will perform a physical examination and listen to the details of your baby’s condition, since a fever isn’t going to tell us exactly what is wrong.
When your child has a fever, you may notice he or she needs more fluids, has an increased heart rate, has problems sleeping or may be unhappy. Some of the most common conditions associated with newborn fever include:
- Colds
- Ear infections
- Sore throats
- Pneumonia
- Flu
- Croup
The majority of the time when a newborn has a fever, it turns out to be something mild. However, some of the time, fever in a newborn can be from something life-threatening, like sepsis or meningitis. These require immediate medical attention, so you’ll want to call your pediatrician right away if your child has a fever. Remember that fever is just a clue – it tells us that something is wrong, and we need to find out what it is.
Though rare, for older babies and children up to age 5, quickly rising fevers may trigger seizures known as febrile convulsions. These are more likely to occur if someone in your family has a history of them. If your child does have an episode, their arms and legs may shake or they may become stiff and unconscious. If this happens, call 911 and let your pediatrician know. Most febrile convulsions cause no harm to the child, but it is very frightening to watch as a parent. Children who have them are more likely to have another. They are slightly more likely to be diagnosed with epilepsy later on.
Constant crying or irritability
Newborns cry. It’s one of the only ways they can communicate with the outside world – but constant crying may mean something is up. Over time, parents will be able to distinguish between different types of cries – those for hunger, those for pain, those for being upset. The expression “cry baby” was developed because babies cry a lot. It is normal for newborns to cry up to three hours a day during the first three months of life. A cry that persists, despite feeding, being held and having a clean diaper might indicate something more serious is happening. These little babies cannot tell us when something is hurting. A call to the pediatrician would be wise. Some serious health conditions can show up only as excessive crying.
Sometimes crying and being fussy happens more in the evening hours. That could be from colic. Babies who have colic often scream for long periods of time, pull up their legs and pass gas. The crying can come in waves – crying strongly, then stopping, pulling up the legs and crying strongly again, then stopping. The causes of colic are not well understood. There are medications on the market for crying babies, but no medication should ever be given to a newborn without checking with the pediatrician first. Even those labeled “all natural” can contain ingredients which are dangerous for a baby. Many drugs come from nature. Discuss with the pediatrician possibly changing your baby’s diet – varying mom’s diet if breastfeeding, or trying a different formula if bottle fed. If your pediatrician determines that your baby has colic, there are ways to try to comfort them. These include:
- Rocking them or walking around in a carrier
- Playing steady, calming sounds like white noise or the dryer
- Swaddling
- Taking the baby for a ride in the car
Vomiting or excessive spit-up
All babies spit up some. It’s a natural part of being an infant. As we grow out of infancy, there is a muscle at the top of the stomach which helps keep the food from coming back up. That muscle is not fully developed on infants, so milk will occasionally come back up. However, excessive spit-up or vomiting could require a visit with the pediatrician.
Babies will spit up more if they are over-full, if they swallow extra air with feedings or if they are moved around a lot after feedings. If there is blood in the vomit, or if your infant is not wetting diapers well or passing as much stool as usual, or if the baby is having choking episodes, you should call the pediatrician. Also, if the infant is not gaining weight well or is extra fussy during or after feedings, there may be some gastroesophageal reflux disease beyond the usual newborn issues. Frequent spitting up can be prevented by making sure your baby is positioned well for feedings, burping them during and after feedings and limiting any jarring activities after feeding.
Low energy levels or inactivity
Newborns sleep a lot, but they should still wake up every few hours to eat. When your child is awake, they should be looking around, babbling and should be startled by loud noises and things like that. Low energy means they just aren’t their normal, active self and aren’t as engaged with the world as they usually are. Infants are not very able to let us know when they are hurting or ill. An infant having less activity than usual could be the clue that lets us know they are ill.
If your baby is showing any of the following signs, see your pediatrician:
- They don’t wake up for feedings, or it is hard to wake them.
- They are lethargic or floppy when they are awake.
- They are too weak to cry or make noise, or they just look at you.
Rashes
Your infant will be checked for rashes before they leave the hospital – specifically for anything bumpy, flat, red or scaly. Many babies have rashes which can be very normal at different phases. If you notice spots that pop up, you should call your pediatrician. Your infant should see the doctor if there is any fever, if the rash looks blister-like, if it oozes or looks wet or if the baby isn’t feeding well.
Changes in stool
During the first few days following birth, a typical newborn will pass a substance called meconium, which is usually black and tarry. After a day or two, you should notice that your baby’s stool turns dark greenish yellow and has the consistency and appearance of mustard with seed-like bits in it. If your child is receiving formula, the stools may vary a lot in color, consistency and odor. If you notice that your baby has stools that are white, dark black or red, see your pediatrician. Stool these colors could be a sign of a more serious problem.
Whenever you notice something different or unexpected about how your infant looks or what your baby is doing, always feel free to call the pediatrician. Over time, you will come to feel much more familiar with the clues that these tiniest family members show us. Keep these six items in mind as signs that should always trigger that call.
Dr. Donna Fox is a pediatrician with Women’s & Children’s Hospital.
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