Becoming a parent for the first time is amazing, but it can also be scary -- especially the first time your baby gets sick.
It can be tempting to hit the panic button for every little cough or rash. How can you tell what's serious, what's just new parent jitters, and what can wait until your baby’s next checkup?
Here are six serious symptoms in babies that you should never ignore.
1. Blue lips (cyanosis)
“If your baby’s lips are turning blue, or the mucus membranes in their mouth or tongue turn blue, this is a sign that they are not getting enough oxygen,” says Carrie Drazba, MD, a pediatrician at Rush University Medical Center in Chicago. This condition is known as cyanosis.
What should you do?
“If your baby is turning blue, calling 911 is very appropriate,” Drazba says.
2. Strained breathing
All babies grunt and groan from time to time. But if their breathing is consistently hard and fast, and you can see that they are using their chest muscles more than they should be and that their nostrils flare out, it may be a sign of respiratory distress, says Jadene Wong, MD, a clinical instructor in pediatrics at Lucille Packard Children’s Hospital at Stanford University in Palo Alto, Calif.
What should you do?
“Call your pediatrician right away, and if it is after-hours, consider a trip to the emergency room,” Wong says.
3. Fever over 100.4 F or 38 C (in newborns)
“If your infant is less than three months and has a rectal temperature greater than 100.4 F, call your pediatrician,” Drazba says. “Fever in a newborn is very non-specific. It can be anything from a cold to meningitis, and we treat a fever more seriously in newborns,” she says.
What should you do?
“Always take a newborn’s temperature rectally because other ways are not as accurate in newborns,” Drazba says.
Call your doctor if your newborn has a fever.
“A newborn may be admitted to the hospital to undergo a battery of tests, including a spinal tap for evaluation of what is causing the fever, and he or she may need antibiotics,” Drazba says. A fever is not always serious in older children with more developed immune systems.
4. Worsening jaundice (yellowing of the skin)
If your newborn is getting yellower and yellower after birth, they may have worsening jaundice.
“Not all jaundice is dangerous,” Wong says. “Some is normal and will go away on its own, but if it is increasing as opposed to going away, it may need an evaluation.”
Bilirubin is produced by the liver. “The liver in the baby is like a furnace: it takes a while to get it going, but once we get it going, it’s OK,” Wong says. “When they are born, if their liver is not up to speed, bilirubin can build up in the body and cause the skin to turn a yellowish color."
If bilirubin levels skyrocket, they can affect the brain, causing seizures and permanent damage.
What should you do?
Most doctors will recommend feeding your infant more frequently, so that the baby gets rid of excess bilirubin in their stool.
The next step is to place the baby under ultraviolet (UV) lights (phototherapy) to increase the breakdown of bilirubin. “If it goes higher, blood transfusions may be needed,” Wong says.
Wong notes that “home care or phototherapy is usually enough to bring bilirubin down to a level where the baby’s body can get rid of it on its own.”
5. Dehydration
“If your baby is not making wet diapers, we worry about dehydration,” Wong says. “We like to see one diaper for every day old up to six days of age, and then six wet diapers a day going forward.”
At the least, that means two diapers for two day-olds, three diapers for three-day-olds, and so on.
Others signs of severe dehydration may include dry mouth, sunken eyes, and lethargy.
What should you do?
Call your pediatrician for advice as soon as possible, Wong says. The doctor may recommend feeding the infant breast milk or formula. Water is actually not good to give a baby in these situations,Wong notes, because it can cause sodium levels to fall, and this can lead to seizures.
6. Throwing up bright green bile
Kids throw up. A lot. They throw up from coughing too hard, crying too hard, eating too much, and from those ubiquitous stomach bugs.
If they throw up greenish bile, however, it is serious, Wong says. Vomit that looks like dark coffee grounds can also be serious.
Green bile can indicate that the intestines are blocked, which needs immediate attention. Vomit that looks like ground coffee grounds may be a sign of internal bleeding. Vomiting after a head injury will also require evaluation because it can be a sign of a concussion or of bleeding inside the cranium.Head injuries, with or without vomiting, should be evaluated by a doctor.
What should you do?
Vomit that is greenish bile or blood-colored should be evaluated by the pediatrician immediately.
Head injuries, with our without vomiting, should be evaluated by a doctor. Call your pediatrician immediately, and follow his or her advice, Wong says.
In general, it's always better to be safe than sorry. When in doubt, always trust your gut and call your pediatrician.
