Danger signs in newborns

If your baby is under 3 months and has a temperature of 38.0 °C or more, see a doctor right away. Do this day or night, even if your baby seems well.

A young baby’s defenses are still weak. An infection can spread fast, to the blood, the urine or the lining of the brain. A baby with a serious infection can still look well at first. That is why doctors go by your baby’s age and the fever, even when your baby looks well.

A fever you measured at home counts, even if your baby has no fever when you reach the hospital. Tell the doctor the number and the time you measured it.

A temperature that is too low, below 36 °C, is also a warning sign in a newborn. It needs a doctor the same way.

Use a digital thermometer. Never use an old glass thermometer with mercury. A hand on the forehead is not enough.

In a baby under 3 months, a reading in the bottom is the most accurate.

1. Clean the tip with soap and water or alcohol, then rinse.
2. Put a little petroleum jelly on the tip.
3. Lay your baby on the back and hold the legs up toward the chest. Or lay your baby belly down across your lap.
4. Turn the thermometer on. Slide the tip gently into the bottom, about 1 cm. Stop if you feel resistance.
5. Hold it still until it beeps, then read the number.

Under the arm is easier but can read a little lower. If an underarm reading is 38 °C or more, treat it as a fever. If the reading is normal but your baby feels hot or seems unwell, check again in the bottom or call your doctor.

Do not check the temperature right after a bath or when your baby is wrapped in many layers.

Do not give paracetamol or any fever medicine to a baby under 3 months before a doctor sees them. Paracetamol is not used under 2 months unless a doctor prescribes it. It can also hide the fever for a few hours and delay the right care.

Do not cool your baby with cold water or wet towels. Remove extra layers and go.

The doctor examines your baby and asks about the birth and the pregnancy. In a baby under 1 month, the team usually does tests even if the baby looks well. They test the urine and the blood. They often test the fluid around the spinal cord too, with a thin needle in the lower back. This test is safe and it is the only way to rule out meningitis.

Many young babies start antibiotics by a drip while the results come in. They usually stay in hospital for a day or two. This is standard care at this age. It does not mean the doctors expect the worst. Most babies go home well.

Between 1 and 3 months, the doctor may do fewer tests if your baby looks well and the first results are normal. The doctor will explain the plan and decide with you.

Other signs need care right away too. Go to the emergency room or call the Red Cross on 140 if your baby:

• breathes with difficulty: very fast breathing, grunting, the nostrils flaring, or the skin pulling in under the ribs
• changes color: blue, grey or very pale lips, face or body, or blotchy, marbled skin
• refuses to feed: skips several feeds in a row, or is too weak or sleepy to suck
• is floppy or hard to wake: limp, does not react to you, or has a weak, moaning cry
• vomits green: green or yellow-green vomit can mean a blocked bowel
• has a seizure: stiffening, jerking or staring spells that do not stop when you touch your baby
• has a bulging soft spot on the top of the head when calm and upright
• has a rash of small purple or red spots that do not fade when you press a glass on them
• has small blisters on the skin or in the mouth
• has no wet diaper for 8 hours or more

For any of these signs, go to the nearest emergency room with a pediatric team. If your baby is not breathing well, is blue or does not respond, call the Red Cross on 140.

Bring your baby’s health booklet if you have it. Note the time of the last feed, the last wet diaper and any temperature you measured.

If something feels wrong to you, even without a clear sign, call your doctor.