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Sonja Brownlee, MD.
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Last Updated 1/2010
The information contained on this web site is not a substitute for direct examination and treatment by a physician. If any of this material is unclear or confusing, or if you have additional questions or concerns, please call the office at 778-6762.
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The Sick Newborn
Subtle Symptoms
A newborn is a baby less than 1 month old. Newborns mainly eat, sleep, cry a little, and fill their diapers a lot!. If a newborn is ill, the symptoms can be subtle. And an ill newborn can get much sicker very quickly. If a newborn is sick at all, the illness can be serious.
Call the office or the ER immediately if:
- Your baby is <1 month old and sick in any way (cough or diarrhea or looks pale).
- Your newborn's appetite or suck becomes poor or weak.
- Your newborn sleeps excessively -- for instance, past feeding times.
- Your newborn cries, as if in pain, excessively -- longer than 2 hours.
- Your newborn has a persistent very sick, weak, moaning cry.
- Your newborn develops a fever over 100.4 F (37.8 C) rectal.*
- Your newborn's temperature drops below 97.5 F (36.5 C) rectal.*
- You have other urgent questions.
*Fever
Generally, don't take your newborn's temperature unless s/he is unusually cranky or feels warm, or looks sick. If the rectal temperature is >100.4 F on two separate readings, and s/he's not overly bundled up, call the office or ER at once.
Breathing Difficulties
Normal breathing is about 20-40 breaths per minute. Breathing is most regular when baby is asleep and healthy. When awake, baby may occasionally breathe rapidly for a short period, then take a brief pause (<10 seconds) before returning to normal breathing. Increased breathing rate can occur with fever. A runny nose may also interfere with breathing. Call the office if your baby is breathing too fast at rest or when asleep or when baby cannot feed well because s/he's unable to breathe and suck at the same time, even after you've cleared his/her nose with a bulb syringe or saline drops and bulb syringe.
Diarrhea
A baby has diarrhea if s/he produces loose, very watery stools more than 6-8 times a day. Newborns can dehydrate very quickly. Don't wait for symptoms of dehydration, but call the office if stools are very loose or occur more often than after each feeding.
Vomiting
If your baby starts forcefully vomiting (shooting out several inches rather than dribbling from the mouth), call the office to make sure baby does not have an obstruction of the valve between the stomach and the small intestine (pyloric stenosis). Call the office if vomiting persists more than 12 hours or is accompanied by diarrhea or fever.
Excessive Sleepiness
It can be difficult to tell when a newborn is excessively drowsy. If your newborn starts sleeping much more than usual, it might indicate an illness, so call the office. If you are nursing and your baby sleeps more than 5 hours without a feeding in the first month, s/he may not be getting enough milk or perhaps is being affected by a medication you are taking, so call the office.
Floppiness
Newborns all seem somewhat floppy because their muscles are still developing, but if your baby feels exceptionally loose or s/he loses muscle tone, it could be a sign of a more serious problem, such as an infection. Call the office.
Jitters
Many newborns have quivery chins and shaky hands, or an arm or leg may quiver when baby is unwrapped. But if your baby's whole body seems to be shaking, it could be a sign of low blood sugar or calcium levels, or some type of seizure disorder, or an infection. Call the office.
Skin
Newborns can develop a variety of different "normal" rashes. An ill infant is more likely to look pale or mottled. If your baby has a rash, but is acting normal (feeding, sleeping, crying a little, and stooling each feeding), it is probably a "normal" rash. If you have any question, call the office.
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