When to Call a Doctor If Your Premature Baby Is Sick

Deciding on whether to call your doctor when your baby is sick is always a challenge. For mothers returning home with a premature baby, the anxiety can make the decision seem all the more overwhelming. Every scream, every cry can seem terrifying.

Although doctors make every effort to discharge preemies when they are healthy and fully stable, illness can occur once a baby is at home. While you may tell yourself that "all babies get sick" and that there is nothing to worry about, the fact your baby was born premature can't help but cause distress.

What do you do?

Recognizing the General Signs of Illness

The signs of illness in babies are often the same no matter what type of illness your baby has. Some symptoms may be vague and hard to recognize; others may be obvious or persistent.

These symptoms include general signs of illness. Among the potential concerns: 

• Extreme sleepiness is something outsiders often dismiss in babies, but you know better. While newborn babies do sleep a lot (especially preemies), you as the mother know if your baby is sleepier than usual or has difficulty waking up at feeding times. Don’t let others tell you "it’s what babies do" if you feel something is not right.
• Loose stools are always a concern as they can signal dehydration in a newborn. Under normal conditions, breastfed babies will have several yellow, seedy stools while ​formula-fed babies will have one or more soft, tan-colored stools. Take your baby to the pediatrician if the stools are loose or mainly composed of liquid. These are never considered normal.
• Fewer wet diapers may not seem like a problem, but it can be another sign of dehydration. If your baby has fewer than six wet diapers per day and you are feeding normally, give your pediatrician a call.
• Vomiting is not the same thing as spitting up. When your baby regurgitates, it should never be forceful or painful. If your baby vomits or seems in pain after regurgitating, let your doctor know as soon as possible.

Recognizing the Signs of Serious Illness

Although the symptoms of baby illnesses can often be vague (such as crying or lethargy), the signs of serious illness are usually easy to spot. If your baby shows signs any of these, call your doctor immediately or go the nearest emergency room:

• Difficulty breathing should signal alarms to get help. If your baby is working hard to breathe, is flaring nostrils, or is inhaling so hard that you can see the ribs, it’s time to call 911. This is especially true if there is a bluish tint to the lips or mouth (cyanosis) or respiration is faster than 60 breaths per minute.
• Fever considered normal in older children is serious in infants under three months of age. Ideally, your baby’s temperature should be between 97.8^o F and 100.4^o F. A temperature higher than that could be a sign of infection. Treatment should never be delayed.
• Feeding difficulties or changes in eating habit are generally not about "fussiness" in newborns. If your baby won’t wake up to eat, does not want to eat, or is feeding far less than normal, call your doctor right away.
• Redness, streaking, and inflammation around any opening of the body is a serious medical condition requiring immediate care. This includes inflamed umbilical cord stumps, circumcision wounds, gastrostomy tube insertion sites, and tracheostomies. If the area is warm, red, puffy, or streaky, call your doctor now.