When to Call Your Baby's Pediatrician

Knowing when to call your baby's pediatrician is important for your baby's health and your peace of mind. As a parent, you may be uncertain about how to spot and address your baby's potential signs of health problems. Three symptoms and expressions of medical issues we are going to outline and discuss are: fevers, behavioral changes, and breathing problems.

Baby Fevers

Fevers result when the body temperature is higher than normal and usually means there is an abnormal process occurring in the body. For a baby, the system that controls their body temperature is not well developed.

A fever is not an illness by itself. It is a symptom that something is not right within the body. A fever does not tell you what is causing it or even that a disease is present. It may be a bacterial infection, a viral infection, or an allergic reaction.

Fevers have other symptoms besides an above average body temperature. Because babies can't always express how they feel, it's important to watch out for the following signs:

• Flushed face

• Hot and dry skin

• Low output of urine or dark urine

• No interest in eating

• Constipation or diarrhea

• Vomiting

• Headache

• Aching all over

• Nausea

• Overheating

Measuring your baby's temperature should always be done using a digital thermometer and never with a mercury thermometer.

Using a rectal thermometer is recommended by the American Academy of Pediatrics for babies and toddlers up to 3 years old for simple and quick results. Do not use oral thermometers rectally as these can cause injury.

Using a temporal artery (forehead) thermometer is a newer method of measurement that is also quite accurate. This method causes less discomfort than a rectal thermometer. It measures the temperature of the blood flowing through the temporal artery (on the forehead.)

Use the right tool for the right method! Oral, temporal artery (forehead), and rectal thermometers have different shapes and should not be substituted for the others. Rectal thermometers have a security bulb designed specifically for safely taking rectal temperatures.

Please note: If your baby's temperature is 100.4°F (38°C) or above, you need to call your baby's pediatrician.

Behavioral Changes

It's normal for a baby's activity, appetite, and cries to vary from day to day, even hour to hour. A distinct change in any of these areas may signal illness.

Listlessness and lethargy are behavioral changes to look out for. Your baby may be lethargic or listless if:

• they appear to have little or no energy
• they are drowsy or sluggish
• they sleep longer than usual or are hard to wake for feedings
• when awake, they are not alert or attentive to sounds and visual cues
• sometimes, this can develop slowly and a parent may not notice the gradual change

Increased and persistent crying or irritability are behavioral changes to watch out for especially when paired with other symptoms of illness. Because babies can only communicate by crying, it is important to know the differences between cries for normal needs and cries due to pain or illness.

• A baby who becomes highly fretful, fussy, or cries for long periods may be ill.
• Jitteriness and trembling are symptoms that may also point to potential illness.
• A baby may be irritable if they are hurting and in pain.
• To eliminate the possibility of a physical cause, it is important to check your baby for problems, such as pinched up clothing or a diaper pin that is poking out.

Contact your baby's pediatrician if your baby is lethargic and listless, crying for longer than usual, or has other signs of illness.

Breathing Problems

Babies breathe much differently than older children and adults. Here is what you need to know about normal and healthy breathing for babies:

• Babies breathe much faster than older children and adults.

• A baby's normal breathing rate is about 40 to 60 times per minute.

• Their breathing rate may slow to 30 to 40 times per minute when sleeping.

• A baby may breathe fast several times, then have a brief rest for less than 10 seconds, then breathe again. This periodic breathing is completely normal and healthy for babies.

• When babies breathe, they normally use their diaphragm (the muscle below the lungs)

Changes in a baby's breathing rate, pattern, and methods/use of parts to breathe can be problematic and require medical attention. Signs of respiratory problems include:

• Rapid and irregular breathing - Rapid breathing is more than 60 breaths per minute. A baby who is overheated or upset and crying may breathe rapidly, but the rate should slow when the baby is no longer too hot or crying. Continuously rapid breathing is a sign of a problem. Breathing that stops longer than 20 seconds, called apnea, can be a serious problem.

• Apnea refers to breathing that stops longer than 20 seconds and can be a serious problem.

• Flaring nostrils - a baby who is having trouble taking in enough air will have nostrils that widen with each inhaled breath.

• Retracting is when the baby is pulling the chest in at the ribs, below the breastbone, or above the collarbones.

• Grunting, moaning, or sighing when exhaling are sounds made when a baby is trying to keep air in their lungs to build up oxygen levels.

• Changes in color - a baby that is not getting enough oxygen may begin to turn blue, which is known as cyanosis. This is often seen in babies with heart defects and respiratory problems.

• Coughing - Sometimes a baby may cough or choke may when they eat too quickly. Persistent coughing or choking may indicate a breathing or digestion problem.