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Having a newborn can be scary! No joke. I don’t know what’s scarier – being pregnant and worrying about all the things that could go wrong OR worrying about all the things your baby can catch after he’s born. Maybe it’s just me. Maybe I just know too much since I’m in the medical field. But, no. I’ve interacted with lots of newborn moms over the past few years, and they all have the same concerns. So, how do you keep your baby safe? What are serious vs not-so-serious illnesses to expect or avoid? When should you really worry? Here, I’ll share with you some common medical concerns in the newborn period. I definitely won’t cover everything here – just the things that we see most often. Hopefully, I can keep you on guard, but also provide a little reassurance as you’re taking care of your little one.

The Serious

First, I’ll talk about some of the serious illnesses in the newborn period. These are things that can be life-threatening if they aren’t addressed early enough.

Fever

One big concern, that can be a sign of a serious infection in a newborn, is fever. Any temperature Of 100.4 F or above buys your baby a hospital stay. It can sometimes be the only sign of things like meningitis, bacteria in the blood, or a urinary tract infection. So, your baby’s fever requires a full work up. This includes blood and urine tests, and a spinal tap. A newborn with a fever also gets automatic IV antibiotics, and at least 48 hours of monitoring in the hospital.

Low temperatures may also be a sign of infection. So watch for consistent temperatures less than 97.7 F in your newborn, along with changes in behavior or feeding.

Group B Strep (GBS)

If your Group B strep test was positive during pregnancy it’s important that you get antibiotics before a vaginal delivery. If you don’t, your baby is at risk of getting a serious infection within the first week. Group B strep is a bacteria that can live in the vaginal area. It doesn’t cause any problems for us as women. But, it can get into your baby’s blood and cause a really serious infection. To prevent Group B Strep infection in your baby, be sure to keep your prenatal appointments and don’t skip your GBS testing. If your GBS is positive, don’t wait until the last minute to get to the hospital when you’re in labor. You’ll need antibiotics on board at least 4 hours before your baby is born to be safe.

Breathing concerns

Illnesses such as the Flu, Bronchiolitis, and Whooping Cough (pertussis) can be dangerous for newborns. These illnesses can cause shortness of breath, problems breathing, and lack of oxygen in young babies. Older kids and adults can usually tolerate these illnesses OK, but babies just can’t. So, keep your baby away from anyone with even a mild cough, congestion, and especially a fever.

Vaccine-preventable illnesses

Pregnant women are advised to get Tdap (tetanus, diptheria, and whooping cough) and Flu vaccines to protect themselves and their unborn baby. Your baby will get some protection while in the womb. He’ll get the rest of the protection once he’s old enough to receive the vaccines himself. Anyone taking care of your baby should get a Tdap booster before the baby’s born. This helps to prevent the spread of whooping cough to your baby.

Other illnesses such as rotavirus, measles, chicken pox, meningitis, and bacteria in the blood can be prevented through vaccines. Unfortunately, these vaccines can’t be given until your baby is at least 6 weeks old, so he’s vulnerable until then. Be sure to vaccinate your baby on schedule. Also, keep him protected from those who are unvaccinated, have traveled, or have cold symptoms, a fever or rash.

SIDS

Sudden Infant Death Syndrome affects way more babies than necessary every year. Follow safe sleep recommendations to keep your baby safe. Place your baby to sleep on his back, on a firm flat surface, with nothing around (no toys, bumper, blanket, etc.). Be sure those caring for your baby do the same!

Jaundice

Jaundice is the yellowing of the skin that you can see at any age, but especially in newborn babies. It’s caused by a substance called bilirubin in the blood, which can cause brain damage at high enough levels. The most common reason for jaundice in a newborn is simply poor feeding. Prevent this by feeding your baby on demand (at least every 2-3 hours) until he’s waking up on his own reliably for feedings. If you’re breastfeeding and your baby isn’t having the urine output expected within the first few days, I recommend supplementing with formula.

Jaundice can also be caused by liver disease or incompatibility between mom and baby’s blood types. These are less common reasons, and usually require treatment in the hospital if severe. Close follow-up with your pediatrician can help to pick up jaundice early. It’s important to catch jaundice early so it can be treated before it gets out of hand.

Weight

At birth, babies have a lot of “water” weight, and lots of built up “poop” (meconium) in their intestines. They lose some of this extra weight in the first week. This weight loss is OK and expected, as long as it isn’t more than 10% of their birth weight. After that loss, babies should get to their birth weight by the time they’re 2 weeks old. Too much weight loss or poor weight gain can be dangerous for young babies since they need fat for their little brains to develop.

If you’re breastfeeding, you’ll produce colostrum in the first few days, which should be enough for your baby. But, sometimes the true milk can take too long to come in, or your baby may have issues feeding at the breast. If your baby is losing too much weight, isn’t urinating enough, or is having issues with jaundice, please don’t feel bad about supplementing with formula.

Along the same lines, I recommend against forcing your baby to “sleep through the night” too early. His tummy is too tiny and can’t hold very much at one time. He needs to feed often to “refill”. Wake your newborn for feedings every 2-3 hours, at least until he’s back at his birth weight. Once he’s gaining weight well, it’s usually OK to allow him to sleep a little longer. But don’t force it if he’s hungry.

The not-so-serious

Colds

Babies – especially those with older siblings – can catch colds. It’s important to watch your newborn closely if he comes down with the sniffles. This can be an early sign of some of the breathing problems I mentioned earlier. Watch closely for fevers and breathing difficulty. Have your newborn checked out by your Pediatrician if he has any signs of a cold – just in case.

Colic/Gas

Many babies are fussy and gassy, without a clear reason behind it. Some formula-fed babies are sensitive to cow’s milk proteins. Some breastfed babies are sensitive to the foods their moms eat (though there isn’t a lot of research to support this). A lot of babies are just fussy at certain times of the day – just because. There are over-the-counter treatments such as infant gas drops, gripe water, or probiotics that can be helpful in these cases. Changing formula can also be helpful for some babies. Always discuss any medications and formula changes with your Pediatrician, to get guidance on your baby’s specific situation.

Gastroesophageal reflux disease (GERD)

Most babies spit up. But when the spitting up becomes excessive, causes your baby to lose weight or not gain well, and makes him fussy, then it’s a problem. Things you can try at home include burping your baby well, keeping him upright after feedings, and offering smaller, more frequent feedings. There’s also prescription medication that can be given for babies with a lot of discomfort from their reflux. “Happy Spitters”, who just spit up, and are still comfortable and gaining weight well, do not usually need to be treated.

Baby acne

There are a ton of normal newborn rashes that can appear within the first month. These rashes are usually not a problem, and will go away on their own. Always have rashes checked out by your Pediatrician, though, because there are some that can be a sign of a serious underlying infection.

Diaper rash

Your baby will have lots of dirty diapers in the newborn period. It can be hard to keep up with changing him as often as you need to, especially if he pooped and is sleeping comfortably! Believe me, I know! Diaper rash can happen when the skin gets irritated by your baby’s urine or poop. The best treatment is usually a barrier cream, with frequent diaper changes. Vaseline has always worked the best for me when my kids had diaper rashes. If your baby has a rash that’s causing skin breakdown, or doesn’t seem to be improving, it’s helpful to have your Pediatrician take a look.

Cradle cap

Young babies may develop a dry, flaky scalp. It’s unclear why this happens to some babies and not others. If your baby has cradle cap, baby oil, coconut oil, or olive oil usually work well for it. Massage the oil into the scalp and use a soft brush to gently brush it away. Don’t brush too hard. And don’t try to force it all off at one time.

Flat head

Babies who follow the safe sleep practices are consistently placed on their backs to sleep. Of course, this can cause flattening of the back of their heads – a condition called plagiocephaly. Many babies also have a preferred “side” that they hold their heads. This can lead to flattening on that side. Prevent this by starting tummy time as early as you can (once the umbilical cord and circumcision have healed). As long as your baby is awake and supervised, give him some time on his belly. This will give the back of his head a break and forces him to work on his neck and head strength.

That’s it for now! Again, this list definitely doesn’t cover all of the medical concerns in the newborn period. But I tried to cover the issues that I see most commonly in my practice. If you have anything to add or have any questions about anything I’ve discussed above, please feel free to leave a comment below!

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