Newborn Warning Signs

Your newborn baby is going through many changes in getting used to life in the outside world. This adjustment almost always goes well. But there are certain warning signs you should watch for with newborns.

Call 911 anytime you think you may need emergency care. For example, call if:

• A baby has blue or gray lips or tongue.
• A sleepy baby cannot be woken up enough to nurse or bottle-feed.
• A baby is limp, floppy, or not moving.
• A baby has new wheezing, grunting, or whistling sounds while breathing.

Contact your doctor now or seek medical care right away if:

• A baby has a fever (see below for information about fever and children).
• A baby vomits repeatedly, especially when it is yellow or green in color.
• A baby has yellowing (jaundice) of the skin on the chest, arms, or legs, or whites of the eyes that gets worse.
• A baby is breathing fast (for example, over 60 breaths per minute) or a bluish skin coloring that doesn't go away. Newborns normally have irregular breathing, so you need to count for a full minute. There should be no pauses longer than about 10 seconds between breaths.
• A baby is not urinating (this may be hard to tell, especially with disposable diapers).
• A baby's crying or irritability does not get better with cuddling and comfort.
• A baby has poor appetite or weak sucking ability.
• A baby shows signs of sickness (such as cough, diarrhea, or pale skin color).

Every child is different. Trust your knowledge of your child and call your child's doctor if you see signs that are worrisome to you.

Use a digital thermometer to check your child's temperature. Don't use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
• Mouth (oral). Don't use a thermometer in your child's mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker's directions for correct use. Insert it gently. Label it and make sure it's not used in the mouth. It may pass on germs from the stool. If you don't feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child's fever, tell them which type you used.

Below is when to call the doctor if your child has a fever. Your child's doctor may give you different numbers. Follow their instructions.

When to contact a doctor about your child's fever

For a baby under 3 months old:

• First, ask your child's doctor how you should take the temperature.
• Rectal or forehead: 100.4°F (38°C) or higher
• Armpit: 99°F (37.2°C) or higher
• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher
• Ear (only for use over age 6 months): 102°F (38.9°C) or higher
• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age
• Temperature of 104°F (40°C) or higher in a child of any age
• A fever of ___________ as advised by the doctor