Bringing your newborn home is exciting, emotional and sometimes a little overwhelming. Suddenly, every sound, movement and change in behaviour can raise a new question. Is that breathing normal? Should my baby be sleeping this much? Are they feeding enough?
Newborns do many things that may seem unusual at first. They sleep for much of the day, feed frequently and may have irregular breathing patterns while resting. However, newborn babies can also become unwell quickly, and the signs are not always obvious. Knowing which newborn warning signs require medical attention can help you respond promptly without feeling that you need to panic over every hiccup or sneeze.
For more guidance on your baby’s earliest hours, read “The First 24 Hours: What to Expect with Your Newborn.”
Is your newborn struggling to breathe?
A newborn’s breathing may occasionally speed up and slow down while they sleep. Brief pauses can also occur. However, breathing that remains fast, looks difficult or requires visible effort should never be ignored.
Seek urgent medical assistance if your baby:
- Is breathing much faster than usual
- Makes grunting, wheezing or unusual noises while breathing
- Flares their nostrils with each breath
- Pulls the skin in between or underneath ribs
- Has long pauses in breathing
- Cannot feed comfortably because they are breathless
- Develops blue, grey or unusually pale lips or skin
Breathing difficulties can worsen quickly in young babies. Our guide to the warning signs of breathing difficulties in children explains what parents should look out for in more detail.
Does your baby have a fever or feel unusually cold?
A temperature of 38 degrees Celsius or higher in a baby younger than three months requires urgent medical assessment, even when the baby appears relatively well.
Newborns with an infection do not always develop a high temperature. Some may feel unusually cold or have a temperature that is lower than expected. Shivering, cold hands and feet, mottled skin or a body that feels cold despite being dressed appropriately may also be concerning. Use a reliable digital thermometer rather than relying only on touch. Do not delay seeking medical help while waiting to see whether the temperature improves.
Has your newborn stopped feeding normally?
Feeding patterns vary, particularly during the first few days. Some babies feed eagerly, while others need a little encouragement and support as they learn to breastfeed or bottle-feed.
A sudden or noticeable change in feeding is different.
Contact your healthcare provider if your newborn:
- Refuses several feeds
- Has a weak suck
- Cannot remain awake long enough to feed
- Takes much less milk than usual
- Coughs, chokes or changes colour during feeds
- Sweats excessively during feeding
- Vomits repeatedly after feeds
Poor feeding may be one of the earliest signs that a newborn is unwell. It can also lead to dehydration, so it is important to ask for help promptly.
Is your baby unusually sleepy, floppy or difficult to wake?
Newborns sleep a great deal, but they should still wake or respond when they are hungry, uncomfortable or gently stimulated. A baby who is unusually difficult to wake, moves much less than usual or feels floppy should be assessed urgently. Other concerning changes include a weak cry, an unusually high-pitched cry or continuous crying that cannot be settled. You know your baby’s usual behaviour better than anyone else. A sudden change in alertness or responsiveness matters, even when you cannot identify another clear symptom.
Has your baby’s skin colour changed?
A newborn’s hands and feet may occasionally look slightly blue shortly after birth, particularly when they are cold. However, blue or grey colouring around the lips, tongue or face is an emergency.Very pale, blotchy or mottled skin can also indicate that a baby is unwell, especially when it occurs alongside poor feeding, breathing difficulties or unusual sleepiness.
Jaundice, which causes yellow colouring of the skin and eyes, is common in newborns. It still needs to be monitored. Seek medical advice if jaundice appears during the first day of life, becomes more noticeable, spreads down the body or occurs with poor feeding and excessive sleepiness.
Are there signs of dehydration?
Your newborn’s nappies provide useful clues about whether they are receiving enough fluid.
Possible signs of dehydration include:
- Far fewer wet nappies than usual
- No wet nappy for an extended period
- A dry mouth or dry lips
- A sunken soft spot on top of the head
- Unusual sleepiness or irritability
- Poor feeding
- Dark, concentrated urine
Vomiting, diarrhoea, fever and feeding difficulties can all increase the risk of dehydration. Newborns should be assessed promptly when these symptoms are present.
Is your baby vomiting green fluid or vomiting repeatedly?
Small amounts of milk may come back up after feeds, particularly while a newborn’s digestive system is still developing. This is often normal.
Repeated forceful vomiting, blood in the vomit or bright green vomit is not normal. Green vomit may indicate a blockage in the digestive system and requires emergency medical care. A swollen or tender abdomen, blood in the stool or persistent diarrhoea also needs prompt assessment.
Does the umbilical cord area look infected?
The umbilical cord stump gradually dries and falls off, usually within the first few weeks. A small amount of dried blood may be seen as it separates.
Contact your healthcare provider if you notice:
- Redness spreading into the surrounding skin
- Swelling or warmth around the belly button
- Pus or cloudy discharge
- A strong, unpleasant smell
- Ongoing bleeding
- Fever, poor feeding or unusual sleepiness
An infection around the umbilical cord can spread rapidly in a newborn and should not be treated at home without medical guidance.
Has your newborn had a seizure or developed an unusual rash?
Any suspected seizure in a newborn requires emergency medical attention. Signs may include repeated jerking, unusual stiffening, rhythmic twitching, staring episodes or movements that do not stop when you gently hold the affected limb.
A rash that does not fade when pressed with the side of a clear glass can also be a warning sign of a serious infection. Seek emergency help, particularly when the rash occurs with a fever, unusual sleepiness, breathing problems or poor feeding.
When should you trust your instincts?
Not every newborn illness fits neatly into a checklist. Sometimes, the most important sign is simply that your baby is behaving differently.
You are not wasting anyone’s time by asking for help. Newborn babies are vulnerable, and early assessment can make a meaningful difference. When your baby appears seriously unwell, struggles to breathe, turns blue, has a seizure or becomes unresponsive, go to the nearest emergency department or contact emergency medical services immediately.
Dr Anisa Vahed offers supportive neonatal and newborn care for babies who require medical monitoring, assessment and ongoing care. If your newborn develops a concerning symptom or suddenly seems unwell, contact the practice or learn more about available emergency consultations.
Your questions are always worth asking. When it comes to a newborn, it is better to seek guidance early than to wait and worry.