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Elena Donovan Mauer

First 48 Hours Home With Baby: Signs To Call The Doctor

You and baby just met, and suddenly she’s all yours. Those first couple days at home can be nerve-racking. How will you know if something’s wrong?

Most newborns are perfectly healthy, and your parenting instincts kick in pretty quickly, so chances are you’d know if there was a serious problem. Of course, you can call the doctor any time you’re even a little concerned. But you should definitely pick up the phone if you notice any of these issues.

Fever

No, you don’t need to check baby’s temperature if everything seems fine, says Janelle Aby, MD, medical director of the Well Baby Nursery at Lucile Packard Children’s Hospital Stanford and clinical associate professor of pediatrics at Stanford University School of Medicine. But you should if there are other symptoms (especially those below) you’re worried about, or baby’s skin feels warm or cool to the touch. For a newborn, a fever is considered 100.4 degrees Fahrenheit or higher; a temperature is too low if it’s under 97.7 degrees Fahrenheit and also warrants a call to the pediatrician.

Baby won’t eat or isn’t peeing

Newborns shouldn’t refuse to eat, says Aby, especially if two to three hours have gone by since the last feeding. Check baby’s diapers. If the number of wet ones decreases, she could be dehydrated.

Yellowish skin or eyes

If baby’s skin or eyes become increasingly yellow, he has jaundice, which means his immature kidneys aren’t breaking down red blood cells properly. In mild cases, baby’s jaundice will go away on its own with plenty of feedings, but in more severe cases, baby may need light therapy treatment at the doctor’s office or hospital.

Blood or weird-looking spit-up

Two more symptoms Aby says to look out for are green spit-up (could signal an intestinal problem) and blood pretty much anywhere (including poop, spit-up and around the belly button or circumcision area). In those cases, “baby needs to be evaluated promptly in case treatment is necessary,” she urges.

Trouble breathing

This goes without saying, but if you think baby’s not breathing okay, it’s an emergency situation, says Alanna Levine, MD, pediatrician at Orangetown Pediatric Associates and spokeswoman for the American Academy of Pediatrics. Call the doctor and head to the emergency room.

When not to worry:

Okay, we told you what’s most concerning. Now, here’s what might seem scary but isn’t necessarily a problem.

Baby hasn’t pooped.
Not pooping for a day or two can be normal if baby seems otherwise healthy and is peeing normally, Aby says. If the poop finally comes, and it looks normal (not hard or pellet-like), baby isn’t constipated.

There’s a pink-orange smudge in the diaper.
This may look like blood but it’s not. “The discoloration, which can appear in the pee-soaked area, is caused by urate crystals which are normally present in urine,” says Aby. “Usually the color disappears after the first week or so when urine flow increases.”

Or even a little blood.
“Here’s the one exception to the general rule of ‘worry if anything is bleeding,’ ” says Aby. Some baby girls have vaginal bleeding that starts three to five days after birth and continues for a few days. It’s caused by the change in hormone levels due to her birth. Blood should only be about the size of a nickel or quarter, Aby says. And while it’s not cause for concern, if it freaks you out you can still have the pediatrician confirm it’s normal bleeding.

Baby’s eyes look crossed.
Especially when baby is sleepy, you might notice her eyes’ alignment is a little off. “Newborns have relatively weak eye muscles, so babies who are less than two months old will often have moments when their eyes cross or diverge,” Aby says. Only if you still notice it happening at six months is it an issue.

Plus, more from The Bump:

What to Do When Baby Is Sick 

10 Weird (But Totally Normal) Things About Your Newborn 

How to Survive the Newborn Period