Should I call the pediatrician? 12 concerns to look out for, mama

Determining whether or not to call the pediatrician when you have a concern about your baby can be stressful. I hear so many new mamas say things like, “I don’t want to bother them,” or “I don’t want to overreact.”

Mama, please hear me: Go ahead and “bother” them! Go ahead and overreact!

In fact, your pediatrician expects this from you. You are a new mama who is concerned about her baby, and they are the person who is there to get you through it. So if you have a worry, please don’t ever hesitate to call. Your pediatrician office should have a 24-hour on-call number so you can reach them at any time of the day or night.

Keep in mind that some concerns require more immediate assistance than calling and waiting for a call-back can yield. You don’t need permission from your pediatrician to go to an urgent care facility or emergency room—if your baby has an emergency, just go. Or call 911 who will send an ambulance and can provide treatment as they drive you to the emergency room.

I always advise expectant parents to do a little research and make a list of where the nearest urgent cares are emergency rooms are so that in the moment of an emergency, you don’t have to stress about Google-ing where to take your baby. When you are researching your options, some factors to note:

• Location
• Hours
• Insurance accepted
• Conditions treated

If you have access to a pediatric urgent care facility or emergency room (designed specifically for children), and you have time to get to it, opt for that location. But if not, or if the situation requires immediate medical attention, all emergency rooms are equipped to handle children so get to the nearest one.

Here’s an example:

When my son had croup and was having difficulty breathing, I called 911, and we went to the absolute closest hospital because time was of the essence. When that same son broke his collarbone a few years later, we drove him to a pediatric emergency room. He needed care right away, but the difference between it taking 10 minutes and 25 minutes to get to a hospital was not as critical, so I chose the pediatric facility.

Here are 11 reasons to call the pediatrician or seek emergency medical care for your baby.

1. If you just feel like something is wrong

Mama, this one goes first for a reason. You are your baby’s expert. If something just does not feel right, even if you can’t put it into words, call. It is much better to call the pediatrician and have them tell you it’s fine than to not and wish you had.

If something is worrying you, call.

2. Trouble breathing

Difficulty breathing is serious and should not be handled lightly. If you are worried about your baby’s breathing, immediate medical assistance is needed.

Signs to look out for include:

• Blue, gray or purple lips and skin
• Grunting or wheezing
• Nasal flaring (nostrils getting bigger as the child breathes)
• Retractions (belly pulls in under the ribcage or breastbone, or skin pulls in at the neck or between the ribs). You can take a look at this video of retractions to see an example.
• Croupy cough (sounds like a seal barking), especially if the child cannot catch their breath between coughs

Once again, difficulty breathing warrants immediate emergency care so get to the nearest hospital or urgent care. Better yet, call 911 since they will be able to support your child’s breathing on the way to the hospital in the ambulance.

3. Projectile vomiting

Spitting up is normal for babies, but if the vomit is projectile—travels or shoots across a distance, often in an arc—it could be a sign of pyloric stenosis, a blockage in the intestines. This is a medical emergency, so seek medical care right away.

4. Fevers

Toddlers and older kids get fevers a lot, and very often, it’s fine. But a fever in a newborn (3 months old and younger) can be a sign of an emergency. Simply put, if a tiny baby has a fever, there is a significant chance that there is a more severe infection causing it, which needs prompt attention.

The temperature for a fever is 100.4-degrees Fahrenheit (38-degrees Celsius), though some pediatricians will want to hear from you at 100-degrees Fahrenheit (37.7-degrees Celsius).

The best place to take your baby’s temperature is rectally (in their bottom). Insert the thermometer no further than the silver tip, and wait for your reading. Remember, once a rectal thermometer, always a rectal thermometer.

You can check under their armpits, but pediatricians often advise that you add a degree to your reading—if you get 98.2-degrees, it’s really 99.2.

In the absence of other symptoms, if your baby has a fever, it’s okay to call your pediatrician, but the chances are good that you are going to be on your way to urgent care or an emergency room.

5. Lethargy

If your baby is difficult or impossible to wake up, or their body feels like limp, seek medical attention right away.

6. Changes in their pees + poops

If you notice a decrease in your baby’s peeing or pooping frequency, call your child’s provider. For example, if your baby usually pees nine to 10 times a day, but today has only peed four times, call.

If your baby goes longer than 8 hours without peeing, also call.

Babies should poop at least once per day (when they are newborns). If it’s been longer, or if you notice a change in their poop, call. Signs to look out for include:

• Bloody poop
• Diarrhea
• Green frothy poop
• Hard, rabbit-pellet-like poop
• Straining or crying with pooping

7. Yellow skin or eyes

While jaundice (higher than normal levels of bilirubin) is usually diagnosed early on through blood work, do keep an eye on your infant’s coloring. If you notice that their skin or the whites of their eyes look yellow, call your baby’s provider. Often you can see this when you press down on their skin (try their nose, gently)—when you lift up, the skin looks yellow.

8. Umbilical cord concerns

Rarely, the umbilical cord stump and surrounding area can become infected, or the umbilical area can develop a hernia (when tissue or intestine bulge through the abdominal wall). Concerns to look out for include:

• The area around your baby’s belly button looks red
• Pus or drainage at the umbilical cord insertion site
• Foul-smelling umbilical cord
• Bleeding
• Bump or mass under the skin on your baby’s belly

9. Circumcision concerns

If your baby boy is circumcised, call your pediatrician if you notice any of the following:

• Blood on the diaper or gauze that is larger than a quarter
• Excessive crying or pain
• Pus or drainage
• Redness or swelling
• Decreased peeing
• If a plastic ring was placed on his penis, it’s okay if it moves off the shaft of the penis, but if it moves down the shaft towards his body, call. Also call is it is still on his penis after two weeks.

10. Injury

Any injury warrants a call, and likely a trip to urgent care or the ER. This might include:

• Falls
• Head trauma
• Cuts and bites
• Burns (including too-hot bath water)
• Bleeding
• Shaken baby syndrome (where the baby has been shaken back and forth)

11. Stiff neck or seizure

If your baby’s neck becomes very stiff, or you think they have had a seizure, seek emergency care right away. A seizure might look like:

• Stiffening limbs, sometimes accompanied by arching back
• Jerking or twitching motions in limbs (some or all)
• Eyes rolling back
• Suddenly limpness and loss of consciousness

12. Rashes

Rashes are tricky—sometimes, it is completely fine, while other times, it can be a sign of a serious illness or concern. If you notice any changes to your baby’s skin, call your pediatrician. This might include:

• Redness
• Bumps
• Itching
• Patches