What it is
This is the sorting list for the moment you stand over the bassinet and think, is this serious. Three doors. Now means 911 or the emergency room. Today means you call the pediatrician's office or nurse line and someone sees or talks to the baby within hours. Next visit means it can wait for the scheduled check.
For a baby under three months, urgent care is usually the wrong door. Most urgent care clinics send a newborn on to the ER, and the ER has the tests a newborn needs.
Every practice has an after-hours line, and its nurses expect calls at 3 a.m. A call that turns out to be nothing is a good call.
What's typical
In the first two months, most families call at least once or twice. The common calls are jaundice, feeding, diapers, spit-up, cord and circumcision, and rashes.
Your own read counts. Mothers notice 'not acting like himself' before any number changes. Say that sentence to the nurse; it is a symptom they take seriously.
What's known
The AAP and the NHS use the same core red flags for babies under three months. Fever is a rectal thermometer at 100.4°F or higher. Breathing trouble is work, not noise: flaring, grunting, ribs pulling in, pauses over 20 seconds, blue color. Dehydration is diapers: none in 8 hours, a sunken soft spot, no tears, a dry mouth. Lethargy means hard to wake and limp, not a sleepy baby who wakes to feed.
What helps
- Save three numbers the day you choose a pediatrician: office, after-hours nurse line, and the nearest ER with a pediatric unit.
- Keep a rectal thermometer and petroleum jelly in the changing station.
- Before you call, have ready: temperature and time, last feed, last wet diaper, and how the baby looks right now.
- Say your worry plainly: 'I am worried it is serious.' That sentence changes how you are triaged.
When to call someone
- Now, 911: not breathing, blue or gray, limp and unresponsive, a seizure, or choking that does not clear.
- Now, ER: rectal temperature 100.4°F or higher under three months, or under 97.7°F that stays low; breathing over 60 a minute with ribs pulling in; green or bloody vomit; a bulging or sunken soft spot; no wet diaper in 8 hours; a baby who will not wake to feed; a fall onto the head with vomiting or sleepiness; a cry that is high-pitched and constant.
- Todayfewer wet diapers than expected, yellow spreading to the belly or legs, feeding less than half of usual for two feeds in a row, a cough, eye discharge, cord redness, a rash with crusting, or a baby who is just not himself.
- At your next visitspit-up in a happy baby, hiccups, baby acne, mild cradle cap, gas, sleep questions, and anything you wrote down.
Who helps
Tools: Postpartum Prep Checklist · My Birth Team · Birthworker Directory
Related
- Fever in a newborn is an emergencyBaby Basics
- Newborn breathing, congestion, and the noseBaby Basics
- Newborn jaundiceBaby Basics
- Diaper counts and what newborn poop looks likeBaby Basics
- Crying, colic, and the witching hourBaby Basics
- Postpartum warning signs: the one-page listPostpartum: Your Body
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Sources
- American Academy of Pediatrics, HealthyChildren.org — When to call the pediatrician: warning signs in newborns
- NHS — Spotting signs of serious illness in babies
- American Academy of Pediatrics — Clinical practice guideline on febrile infants 8 to 60 days old (2021)
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