Worried Your Newborn is Sick? Here’s What to Look For

Contributing Expert: Jennifer Kusma, MD, MS

This post is part of our newborn health and wellness series. For more information from our pediatric experts, visit our Newborn Resources page

Parents of newborns often have questions about typical behaviors versus signs of sickness. Your pediatrician’s job is to help you navigate these questions. We asked Lurie Children’s pediatricians to talk about some common newborn problems and warning signs of sickness.

What’s Common in a Newborn Versus a Sign of Sickness?

In the first weeks of getting to know your newborn, you start to learn their patterns. You learn how they eat, how often they poop and pee and what different cries mean.

One of the biggest questions pediatricians get is: Is this normal? Sometimes there is a clear answer, but often, it’s a matter of knowing if it seems normal or out of character for your baby. When it comes to your baby, you know more than you think!

That said, here are some common newborn issues that may or may not be warning signs of sickness: 

Common Newborn Issues Potential Sign of Sickness

Mild cold symptoms, like runny nose or sneezing (sneezing is reflexive and helps babies clear their airways)

Lots of congestion and coughing, seeming lethargic

Hiccups or spit-up when eating

Vomit that seems excessive and forceful

Feeling warm, especially when bundled up tightly

Continuing to feel warm, when their clothing or the temperature of the room doesn’t seem to indicate they should be overly warm (see below about signs of a fever)

Constipation and going a few days without pooping

Going more than a week without pooping

Poop that is yellow, green, brown, or any combination of those

Poop that is red, white, or black (red can mean blood; black can mean old blood; white can mean their stomach enzymes aren’t working quite right)

Making grunting or snorting noises when eating or sleeping

Looking as if they can’t catch their breath; using whole body to breathe
Fussy when feeding or skipping a feeding

Refusing to feed for two or more feedings, or making less than 3 wet diapers in a day

Web-like purple veins on their skin (they may just be cold and need another layer)

Blue around mouth, lips, or nose (it means they are having trouble breathing)

Baby acne, right after birth or again around 3 months old

Sores that are red, warm to touch or seem to be causing the baby distress
Dried blood around umbilical cord (especially when it falls off) Redness around the base of the belly button or puss in the belly button; also, white or yellow tinged fluid could be a sign of infection

Signs of a Fever in a Newborn

Pediatricians take fevers in newborns seriously. A temperature of 100.4 degrees Fahrenheit or more is considered a fever. Your child is considered a newborn if they are younger than 60 days old.  

If your newborn has a fever, your pediatrician will send you to the Emergency Room. This is because it’s hard to know what’s wrong with a newborn who has a fever without running some tests. Infections can also move around a newborn’s body more quickly. Viruses usually cause fevers in newborns. But it’s important to run tests to check for bacterial infections, which should be treated with antibiotics.

The only way to know for sure if your newborn has a fever is to take their temperature. While you can use the types of thermometers that do a forehead scan, the most reliable reading is a rectal temperature.

For this, you need a metal-tipped thermometer designed for babies. Your pediatrician can talk you through taking your newborn’s temperature rectally. The American Academy of Pediatricians also has these tips.

While older babies and children have more telltale signs of a fever, such as being extra sleepy, it can be more difficult in newborns. Some signs to look for include:

  • Feeling excessively warm (especially when it’s not hot in the room)
  • Seeming “off” and not wanting to feed
  • Color that seems off, either flushed or excessively pale

Remember, it’s always better to call your pediatrician with questions or if you suspect something is out of the ordinary.

In addition to expert specialty care, Lurie Children’s offers several primary care locations around the Chicago area for your child's healthcare needs — from infancy through childhood and adolescence. Learn more about our primary care services

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