- This guideline covers the subtle ways that infection and other serious diseases can present in newborns (birth through 30 days)
Why Newborns Need to be Observed Closely
- Newborns are at increased risk for infections, especially during the first 7 days of life.
- Newborns who develop bloodstream infections (sepsis) can deteriorate rapidly.
- The symptoms of serious illness in newborns can be subtle and atypical. That is why the statement "Age under 1 month old (newborn) and starts to look or act abnormal in any way" is found in the "Call Your Doctor Now" section of at least 10 topics.
- Feeding behavior is the one universal and reliable measure of a newborn's well-being. Newborns should be vigorous eating machines. If your baby has an abrupt change in his feeding pattern or isn't feeling well, call your baby's doctor. (Exception: never a vigorous feeder, but takes adequate amounts and nothing has changed.)
- If your newborn's appearance or behavior changes and you think it's abnormal, don't hesitate to call your baby's doctor now for expert advice.
When to Call Your Doctor for Newborn Illnesses
Call 911 If…
- Your child is not moving or very weak
- Your child is unresponsive or difficult to awaken
Call Your Doctor Now (night or day) If
- Overt symptoms of any illness including vomiting (especially any bile - yellow or green), diarrhea, or cough
- Poor feeding behavior or a sudden change in feeding behavior (has to be repeatedly awakened to feed or can't stay awake for feedings)
- Poor suck or inability to sustain sucking or feeding
- Sweating during feedings
- Sleeping excessively (exception: normally you have to awaken for feeds, but your baby is easy to arouse, alert for feedings and nothing has changed)
- Change in muscle tone (decreased or floppy)
- Decreased activity or movement
- Change in color (i.e., pale, bluish or gray arms and legs)
- Fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen)
- Low temperature below 96.8° F (36.0° C) rectally
- Unusual crying, moaning, grunting
- You think your baby needs to be seen
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You have other questions or concerns
Parent Care at Home If
- Your baby is feeding and sleeping normally and you don't think your child needs to be seen
Home Care Advice for Newborns Without Signs of Illness
- Reassurance: Based on this review your baby does not have any signs of illness at this time. Nonetheless, careful observation during the early weeks of life is always the best approach.
- Call Your Doctor If: Your baby starts to look or act abnormal in any way
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
- Jeyakumar A, Nettar K. Relieving nasal obstructions in neonates. Contemp Pediatr. 2008;25(11):36-45.
- Schwartz DA, Viles PH, Lieberman SA, et al. An unusual cause of respiratory distress in a neonate. Pediatrics. 1998;101:479.
- Stafstrom CE. Neonatal seizures. Pediatr Rev. 1995;16(7):248-256.
- Varness, T, Connor E, Stafstrom, C. Why does the baby girl "quake and tremble all this day"? Contemp Pediatr. 2005; 22(5):20-28.
This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 8/1/2010
Last Revised: 9/17/2010 11:14:51 AM
Copyright 1994-2011 Barton D. Schmitt, M.D.