Life with a newborn baby would be less stressful if babies came with an instruction manual. Many new parents don't know when to take a newborn to the emergency room -- or to the doctor's office, for that matter. When you have a sick baby, every symptom appears life-threatening to inexperienced parents. A call to your doctor can handle most medical issues in newborns, but some warrant immediate investigation and a trip to the ER.
If your newborn has stopped breathing and turns blue, even if he spontaneously begins breathing again, he needs immediate medical evaluation in most cases. If your newborn was premature and went home on an apnea monitor, your doctor might not require you to go to the ER every time your child has an episode; follow your medical practitioner's instructions in this case. But if you have a normal full-term newborn who turns blue, take him to the ER. If your baby doesn't come out of this episode on his own, call 911 immediately. If your newborn is breathing more than 60 to 70 times per minute, has nasal flaring and his chest or neck appear to "suck in" during every breath, go to the ER, pediatrician Marc Gorelick, M.D., advises on the Parents website.
Changes in Consciousness or Behavior
If your newborn becomes limp, breathes more rapidly or more slowly than usual, cries incessantly -- especially if he has a high-pitched cry different from his normal cry -- won't bend his neck or arches his head back, or won't eat, go to the ER. Call 911 if your baby loses consciousness, has a bulging fontanel -- the soft spot on the top of his head -- or has seizures. Newborn seizures might not resemble seizures in older children. The child might smack her lips, roll or blink her eyes, jerk one side of body or just jerk an arm of leg.
Babies can develop serious dehydration if they have frequent diarrhea or vomiting. Call your doctor for instructions if your child starts having gastrointestinal symptoms. If she develops signs of serious dehydration, which include lethargy, decreased urination, sunken eyes, a sunken fontanel, clammy skin or skin that doesn't spring back to normal when you pinch it, go to the ER. Newborn often don't cry tears until between 1 and 3 months of age, according to pediatrician Jennifer Shu, M.D., so lack of tears doesn't indicate dehydration in a newborn like it would in an older child.
Newborns often don't run a fever and might have a lower-than-normal temperature when they're sick. If your newborn has a temperature, look first for a cause: Is she wearing too many clothes or has she been out in the heat too long? If your newborn has a fever over 100.4 F when temperature is taken rectally, call your doctor immediately. Go to the ER if she has other symptoms that indicate a serious illness, such as a stiff neck, shrill cry or other abnormal behaviors.
You know your baby best. If you feel that something is very wrong with your infant, take him to the ER, even if he doesn't have any of these symptoms.
- Parents: When Should Your Child Go to the Hospital?; Rachelle Vander Schaff
- RBaby Foundation; When to Take Your Newborn to the ER: Changes in Behavior and Appearance that are Cause for Concern; Audrey Paul, M.D., et al.
- Children's Hospital Boston: Fever in a Newborn
- Parenting.com; Why Your Baby Doesn't Cry Tears ; Jennifer Shu, M.D.