Recognizing Newborn Illnesses

Bringing your baby home from the hospital is a very exciting time. But having a newborn around can be stressful for lots of reasons. One of these is concern about the new baby getting sick. How will you know? It can be hard to tell when a newborn is sick. You may not know what your baby’s normal behavior is yet. This makes it difficult to tell if your baby’s behavior is not normal. Signs of serious illness in newborns can be subtle. They aren’t always easy to spot.

It is important to be aware of what signs could mean that your newborn is sick. Their immune system is not as strong after birth, so it’s harder for them to fight off infections. And once they do get an infection, it can get worse quickly. That’s why you should know what to look for.

Path to improved health

One of the main things to look for in your newborn is if they look or act in any way that seems abnormal to you. If this happens, call your baby’s doctor right away. Some of the ways they could look or act abnormal include:

• Any symptoms of illness. These include crying more often, irritability, coughing, diarrhea, or vomiting. If your newborn vomits green (bile), call the doctor right away.
• Changes in feeding. Newborns usually eat frequently. If you have to wake your newborn to eat or they can’t finish their feedings, they could be sick.
• If your newborn has a fever, especially over 100.4 F (38 C), call the doctor.
• Low body temperature. If your baby’s temperature falls below 96.8 F (36 C), call the doctor.
• Changes in how they cry. Their cry could be weak, sound strange, or be frantic without stopping.
• Weak sucking or not being able to suck for very long
• Sweating while they eat
• Sleeping more than normal (needing to be woken up to eat, for example)
• Decreased muscle tone or floppy limbs.
• Moaning or grunting noises when they breathe.
• Decreased urination (fewer wet diapers) and dry mouth (dehydration).
• Any change in color, such as pale, bluish, or gray arms and legs

It can be hard to tell if your newborn is sick. Pay attention and watch them closely for any of these signs of illness. If you have any question at all about your newborn, call their doctor.

Things to consider

While illness is not normal for a newborn, there are some conditions that are common in the first few weeks after birth. Watch your newborn for signs of any of these conditions and call their doctor if you see symptoms.

Abdominal distension. Your baby’s abdomen (stomach) should feel soft between feedings. If it feels swollen or hard, there could be a problem. It might be gas or constipation. But if they haven’t had a bowel movement for more than a day or two, or if they are vomiting, a swollen stomach could be a sign of an intestinal problem.

Blue baby. Your newborn may show mildly blue hands and feet if they are cold. They may go a little blue around the face, tongue, or lips if they are crying hard. But if they have persistent blue coloring plus breathing or feeding difficulties, it is an emergency. It could be a sign that the heart or lungs are not working correctly. Call the doctor or go to the emergency room right away.

Coughing during feeding. Your newborn may cough or sputter a bit as they learn and adjust to a feeding routine. But if they cough or gag regularly when they are trying to eat, there could be a problem in the lungs or digestive system.

Excessive crying. Newborns cry, sometimes for no reason. If your baby won’t stop crying, make sure they are fed, burped, warm, and have a clean diaper. Then try to hold them and soothe them. You can’t “spoil” a newborn with too much attention, so don’t hesitate to pick them up when they are crying. Soon you’ll get used to your newborn’s crying patterns. But if their crying sounds different, such as shrieking, or it goes on for an unusually long time, call your doctor.

Jaundice. Many healthy newborns have a yellowish tinge to their skin. This is called jaundice. It happens when a chemical called bilirubin builds up in the baby’s blood. Mild cases of jaundice are harmless. But if the buildup gets to be too much and it isn’t treated, it can cause problems. Jaundice normally appears on the face first, followed by the chest and abdomen, and finally it spreads to the arms and legs. Sometimes the whites of the eyes can become yellowish, as well. If you notice your baby developing jaundice, call the doctor.

Respiratory distress. In most cases, if your newborn is having trouble breathing, it’s because their nasal passages are blocked. This is normally easy to remedy by using saline nasal drops and a bulb syringe to suck the mucus out. But there are other signs that could mean your baby is having serious breathing problems. These include

• Fast breathing (more than 60 breaths in one minute). Remember, though, that babies breathe faster than adults.
• This is when the stomach muscles between the ribs get sucked in with each breath, making the ribs stick out.
• Flaring of the nose.
• Grunting while breathing.
• Persistent blue coloring.

Call your newborn’s doctor right away if he or she develops any of these signs of respiratory distress.

Questions to ask your doctor

• What signs should I look for that my newborn may be sick?
• How do I know what’s normal when I just brought him or her home?
• How do I know if my baby is vomiting or just spitting up?
• My baby cries all the time. Could they have colic?

Resources

National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development: What are some of the basics of infant health?

National Institutes of Health, MedlinePlus: Common Infant and Newborn Problems