When to Call the Doctor: Baby's First Days at Home

During the first few days at home, it is normal for new parents to be concerned about their baby's health. Fever, unwillingness to eat, yellowing of the skin or eyes, odd spit-up, and difficulty breathing are all red flags that you should seek medical attention. Understanding these indicators will help you safeguard your baby's safety and address any issues as soon as possible.

Pregatips
Most infants are completely healthy, and your parental instincts kick in immediately, so you'd probably notice if there was a significant issue. Of course, you may phone the doctor if you're even somewhat worried. However, if you observe any of these difficulties, you should call your doctor immediately.



When to worry

  • Fever: According to Dr. Sampath Kumar Shettigar, Sr. Consultant- Pediatric & Neonatologist, Kinder Hospitals, Bangalore, there is no need to monitor the baby's temperature if everything seems to be normal. However, you should seek medical attention if you are concerned about any additional symptoms or if your baby's skin feels warm or chilly to the touch. A fever for a baby is defined as 100.4 degrees Fahrenheit or greater; a temperature of less than 97.7 degrees Fahrenheit is regarded as too low and should be reported to a paediatrician.
  • Baby refuses to eat or is not urinating: Newborns should eat regularly, especially if it's been two to three hours since their last meal. Monitor the baby's nappies; a decrease in wet ones can indicate dehydration.
  • Yellowish skin or eyes: Jaundice occurs when a baby's skin or eyes become yellow, indicating that their blood contains excessive amounts of bilirubin (a naturally occurring chemical that gives bile its yellowish colour). In moderate cases, the baby's jaundice may resolve on its own with enough feedings; but, in more severe cases, infants may need light therapy treatment at the doctor's office or hospital.
  • Blood or strange-looking spit-up: Experts note that green spit-up may indicate a digestive issue, and any presence of blood, whether in faeces, spit-up, or around the circumcision area, requires prompt evaluation of the baby for potential treatment.
  • Trouble breathing: This goes without saying, but if you suspect your baby is not breathing properly, for example, if they are breathing rapidly, wheezing, or retracting when trying to inhale, it is an emergency, according to Dr Sampath Kumar Shettigar. Call the doctor and go to the emergency room.
  • Breathing Irregularities (blue lips or face, and grunting or straining during breathing): Signs such as blue discolouration or grunting may suggest severe respiratory distress.
  • Lethargy or Weakness: Look for changes in alertness and activity levels; even small changes might be important.
  • Excessive crying: Crying is typical in infancy, but excessive crying may suggest pain or distress.
  • Frequent vomiting: While spit-up is normal in newborns, regular vomiting, particularly if severe, may indicate a problem. Keep note of the frequency and consistency; this will allow your doctor to make an accurate diagnosis.
  • Seizures or jerky movements: Seizures and odd jerking motions should be regarded as medical emergencies.
  • Umbilical Cord Care (Signs of Infection): Monitor the umbilical cord stump for indications of infection, such as redness, swelling, or discharge. Proper care and cleanliness are vital for avoiding issues.
  • Excessive perspiration or coldness: Unexplained sweating or coolness, particularly in the extremities, may signal a health issue.
  • Unusual rashes: While many rashes are innocuous, some may signal allergic responses or infections.
  • Eye discharge or puffiness: Keep the eye region clean and see a doctor if the symptoms continue.
  • Excessive weight loss: Weight loss in babies may be concerning and should be investigated quickly. Monitor nutrition and weight growth; any considerable loss may signal a major problem.

When not to worry?

Now that we have covered what could be alarming, here are some things that may seem concerning but are not always an issue.

  • Baby has not passed stool: Not passing stool for a day or two is acceptable if the baby seems to be healthy and urinates regularly. If the excrement eventually arrives and seems normal (not hard or pellet-like), the infant is not constipated.
  • There is a pink-orange smear in the nappy: This may appear like blood, but it is not. The discolouration, which can appear in the urine-soaked area, is caused by urate crystals which are normally present in urine. When the amount of urine that is produced rises, the colour often vanishes after about a week has passed.
  • Or even a little blood?: Here's an exception to the basic rule of "worry if anything is bleeding”. Some infant girls have vaginal bleeding that begins three to five days after delivery and lasts several days. It is caused by a shift in hormone levels after birth. Experts say blood should be approximately the size of a coin or quarter. While it is not a reason for alarm, if you are concerned, you may have your paediatrician clarify that the bleeding is normal.
  • Baby's eyes seem crossed: You may notice that your baby's eyes appear misaligned, especially during sleep. Due to their underdeveloped eye muscles, newborns under two months old often experience instances where their eyes may cross or diverge. It is only an issue if you still notice it after six months.
  • Frequent Hiccups: If your baby's hiccups persist for a longer period of time it may be a cause for concern. Consult your paediatrician as soon as possible.
  • Frequent sneezing: Sneezing may be typical for newborns when they empty their nasal passages. However, regular sneezing along with other symptoms such as fever may need a consultation.
  • Skin Peeling: Peeling skin is common in neonates, particularly during the first few weeks. This usually heals on its own, but if you see significant peeling or other skin abnormalities, see your doctor for help.
  • Startling Reflex: The startle reaction, also known as the Moro reflex, is widespread in infants and often fades by six months. It is a typical aspect of baby growth and often happens when neonates experience a strong shock.
  • Farts: Frequent gas is a typical feature of newborn digestion and is seldom a reason for worry. This is usually considered normal as long as your child seems to be comfortable and eating properly.
  • Fontanelles, or soft areas on the head: These are natural in neonates and support brain development. These typically close by the time the youngster reaches two years old.
  • Red pimples or rash: Small red pimples are common and may not need treatment. If they continue or worsen, seeing a paediatrician may assist check that there is no underlying cause.
  • Grunting while passing the stool: Grunting during bowel motions is normal as newborns learn to coordinate their muscles. This is normal as long as the stool is soft and there is no sign of soreness. Always keep track of their eating and output to guarantee their wellness.
  • Crying without tears: It is common for babies to cry without tears, particularly in the first few weeks. As their tear ducts grow, this will alter. If your infant is especially fussy and not gaining weight, see your paediatrician.
  • Cold Hands and Feet: Cold extremities in neonates are typical, especially if they are not swaddled. As long as your baby's core temperature is normal, there is typically no reason for worry. Dressing your infant comfortably might help control their body temperature.
  • Periodic Breathing: Newborns often exhibit abnormal breathing patterns, which may involve pauses. This is normal and is due to their growing respiratory system.


FAQs on First Days Home With Baby: Signs to Call the Doctor:

  1. What temperature indicates a fever in a newborn?
    A fever in a newborn is defined as a temperature of 100.4°F or greater.
  2. Is it common for a baby to not defecate every day?
    Yes, if a baby hasn't defecated in a day or two but seems healthy and is urinating regularly, there's usually no need for alarm.
Disclaimer: Kinder Hospitals, Bangalore