Health & safety

When to get medical help

In the first month—especially the first week—small changes in feeding, alertness, color, or breathing can be the first sign that a newborn is unwell. If baby cannot be woken, is not moving, is struggling to breathe, or has blue or gray lips, tongue, or face, call 911 or your local emergency number now.

Full guide

The dated summary changes with the card you choose. The complete reference below stays available for context and safety.

What to watch right now

Newborn illness can be subtle and can worsen quickly. The American Academy of Pediatrics (AAP) advises calling promptly when a baby under 1 month starts to look or act abnormal in any way. Feeding is a particularly useful clue: notice an abrupt weak suck, feeds that suddenly cannot be finished, or a baby who must now be woken for every feed. See the AAP’s newborn illness warning signs.

A fever in a young baby needs an immediate call

For a baby 3 months or younger, a rectal temperature of 100.4°F (38°C) or higher means call the pediatrician immediately and arrange urgent in-person evaluation, even if baby otherwise seems well. The AAP’s current care-setting guide lists this fever in a baby under 3 months as a reason to go directly to an emergency department; follow the pediatrician’s local instructions, and go if you cannot reach them promptly. Do not give fever medicine before getting medical advice. A rectal reading is the most reliable for this age; feeling the forehead is not accurate. See the AAP’s detailed fever guidance for babies.

What changes next

Over the first few days: you will begin to learn baby’s usual cry, color, movement, sleepiness, and feeding effort. A sudden change from that pattern matters more than one isolated noise or twitch.
During the first week: mild yellowing can appear as bilirubin builds up, but jaundice in the first 24 hours, yellowing that spreads or deepens, or yellowing with poor feeding or difficulty waking needs medical advice. The AAP’s newborn jaundice guide explains what to notice and why follow-up after discharge matters.
Through the first month: keep the threshold for calling low. Feeding should not suddenly become weaker, breathing should remain easy, and baby should still wake or be rousable for feeds.
As baby gets older: normal patterns and fever advice change with age. Use the pediatrician’s current instructions rather than carrying newborn thresholds forward indefinitely.

Reassuring signs

Look for the whole pattern rather than relying on one sign:

Baby wakes or can be gently roused to feed and has periods of alertness.
Sucking and swallowing remain similar from feed to feed.
Breathing is mostly quiet and easy, without the skin pulling in around the ribs.
Lips and tongue keep their usual color, and baby moves both sides of the body.
Wet diapers increase during the first days and then follow baby’s usual pattern.

A reassuring sign is useful, but it does not cancel a fever or another urgent warning sign.

When to call or get help

Call the pediatrician

You are unsure whether a pattern is normal, or a mild concern keeps recurring without any prompt or emergency signs below.
You need to confirm the after-hours plan, follow-up schedule, or feeding and temperature instructions from discharge.
A common variation—such as jitteriness while crying, noisy sleep, or small spit-ups—changes or no longer fits its reassuring description.

Get prompt medical advice

Call the pediatrician now or use the after-hours line if:

Baby is under 1 month and looks or acts different: feeds poorly, cannot finish feeds, sleeps more than usual, has a weak or unusual cry, moves less, or looks pale or gray.
A rectal temperature is 100.4°F (38°C) or higher in a baby 3 months or younger: call now and arrange urgent in-person evaluation; go to an emergency department if you cannot reach the pediatrician promptly.
A rectal temperature below 96.8°F (36°C) does not rise after warming baby normally.
During the first month, there is new coughing, diarrhea, repeated vomiting, a swollen soft spot, or sweating with feeds.
Skin or eyes are becoming more yellow, or jaundice comes with poor feeding, unusual fussiness, or difficulty waking.

If you cannot reach a clinician promptly or baby is getting worse, seek in-person urgent care.

Get urgent help now

Call 911 or your local emergency number if baby:

cannot be woken, is not moving, or is very weak;
has stopped breathing, is struggling for each breath, or makes a new grunt or moan with each breath; or
has blue or gray lips, tongue, or face.

Go to an emergency department now if baby is hard to wake, becomes floppy, has a weak suck, vomits green fluid, or has trouble breathing such as ribs pulling in with each breath. The AAP describes these breathing signs in its guide to breathing trouble. Do not wait for a webpage or callback when baby appears to have a life-threatening emergency.

Usually not a worry

Brief irregular breathing: a comfortable newborn may pause for less than 10 seconds and then take several quicker breaths. Call promptly if a pause lasts longer than 10 seconds; get emergency help if breathing looks hard or color changes.
Noisy sleep: brief whimpers, groans, gurgles, and occasional twitches can happen during sleep. Call if the sound is a grunt with every breath, baby is hard to wake, or there is a suspected seizure.
Startles and trembling: a startle or trembling while crying can be normal when it stops once baby is calm or sucking. Call if it happens while calm or is getting worse.
Small milky spit-ups: these are different from forceful or green vomit. Call promptly about new forceful or repeated vomiting; green vomit needs emergency evaluation.

The AAP’s guide to normal newborn reflexes, sounds, and breathing patterns gives more examples and the warning signs that change the advice.

Useful today

Save the pediatrician’s daytime and after-hours numbers and know which emergency department the care team recommends.
Keep a working digital thermometer nearby and follow the care team’s instructions for taking a rectal temperature safely.
Note feeds and wet diapers simply enough to recognize a change; you do not need to document every normal sound or movement.
When calling, share baby’s age in days or weeks, the exact temperature and how it was taken, the last few feeds and wet diapers, and when the change began.
If something feels distinctly wrong in the first month, call. You do not need to wait for several warning signs to appear together.