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When to Call Your Pediatrician When You Are Breastfeeding

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Newborns may not always have a fever when sick. Some subtle signs to be aware of and to immediately report to your pediatrician include the following:

  • If your baby seems yellow (jaundice). Especially if associated with excessive sleepiness, refusal to eat and/or irritability.
  • If your baby refuses 2 or more feedings. This can lead to dehydration and/or hypoglycemia (low blood sugar).
  • If your baby projectile vomits or has frequent vomiting in a six hour period.
  • If vomit looks green (bilious) or is a coffee ground color.
  • If your baby’s temperature is less than 97.8°F or greater than 100.4°F under the arm. (Follow the instruction given by your healthcare provider if these numbers vary)
  • If your baby has less than 4-6 wet diapers in a day in the first few days of life, less than 6 wet diapers a day after the 6th day of life, or does not have a wet diaper for more than 18 hours. This can be a sign of dehydration. Other signs of dehydration include:
    • Irritability
    • Listlessness/lethargic
    • Increased heart rate and breathing
    • Less frequent urination
    • Dry skin
    • Dry mouth and lips
    • Sunken eyes
    • Sunken “soft spot” on head
    • Skin that does not bounce back when pinched and released
  • If your baby has not had a bowel movement after 24 hours (especially if this is associated with a hard abdomen and vomiting), stool is formed and hard (sign of constipation) or is having consecutive liquid stools (diarrhea).
  • If meconium is present on the 5th day of life. This could be a sign of inadequate milk transfer in breastfeeding babies.
  • If blood is present in the stool or if stool is green and watery.
  • If your baby is lethargic (floppy), crying excessively, and/or having jerking movements of body and/or eyes.
  • If your baby’s breathing pattern has become labored (e.g. rapid breathing, shallow breathing, gasping for air, flaring nostrils, changing colors and/or making a grunting sound when breathing). If your baby turns blue or stops breathing—CALL 911.
  • If the umbilical cord or circumcision site has a foul odor, swelling, pus, or excessive bleeding. 
  • If eye drainage develops.
  • If you notice the tongue and/or cheeks have a thick white film on it that you cannot scrap off. This can be thrush, a yeast infection in the mouth that requires treatment with an anti-fungal medication prescribed by your doctor. Learn more about Thrush here...
  • If by the end of the first month of life your baby: 
    • Feeds slowly
    • Does not blink when shown a bright light
    • Has little amount of movement or stiffness of the arms and legs
    • Has a floppy muscle tone
    • The lower jaw trembles constantly, even when not crying or excited
    • Does not respond to loud sounds
Are you breastfeeding? Then be sure to contact your pediatrician if you see any of the signs listed in our article: Breastfeeding & When to Call Your Pediatrician.

Remember, any time you are concerned about your baby's health and/or development, call your child's healthcare provider.

How to Clean Your Baby's Nose With a Bulb Syringe
 
Source:
Davidson, D., London, M., Ladewig, P. (2012). Olds' Maternal-Newborn Nursing & Women's Health Across the Lifespan (9th Edition). Boston: Pearson.
 

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