There are so many joys that come with being a new parent, but for every moment of excitement, there's usually about 10 moments of worry — especially if you've never had a baby under your care before. And when your baby is under the weather, things can get pretty scary. A lot of the time it's hard to tell the difference between a normal upset stomach and real illness that should be cause for concern.
How often your baby gets sick can vary. Babies in daycare might get sick a lot more as they are exposed to more germs at a young age (hopefully building their immune system for the future). To make matters worse, babies under 6 months who get sick aren't able to talk to you and tell you what's wrong. From babyhood to preschool, the average child may get a cold seven to eight times a year, so the early indicators of sickness are good to know.
"Oftentimes when children are ill, they will exhibit behavior that is a marked deviation from their baseline. If you ever notice a very huge difference in the manner in which your baby is behaving and interacting with you, that is a telltale sign that your child should be evaluated by a doctor," Dr. Nesochi Okeke-Igbokwe, Attending Physician of Internal Medicine at NYU Langone Medical Center, says.
Knowing what signs to look for can help calm the panic so that you can decide if it's serious enough to make an appointment with the pediatrician:
Fever itself is not an illness, but rather the baby's response to an illness – most commonly an infection. Call the doctor if your infant is less than three months old and has a rectal temperature above 100.4 F, or if your baby is between 3 and 6 months and has a temperature above 101 F. Even if the temperature is lower than these general guidelines, call the doctor if your infant appears ill with such signs as a rash, irritability, poor feeding, trouble breathing, a stiff neck, persistent vomiting or diarrhea, signs of dehydration or is lethargic or difficult to arouse.
If an infant has a fever coupled with symptoms of extreme somnolence, lethargy and inarousability, that is a definite cause for concern, Dr. Nesochi says. "The constellation of symptoms including fever, neck stiffness and sensitivity to light is also concerning and may be indicative of a very serious condition such as meningitis."
Dehydration can happen if the baby is feeding poorly, has a fever, is in too warm an environment, or has persistent vomiting or diarrhea. You can recognize dehydration if your baby has a dry mouth and gums, wets the diaper less frequently, sheds no tears when crying or the fontanel (the soft spot on the top of the head) appears to sink slightly. If you think your baby is dehydrated, call the doctor.
Diarrhea is common in infants, but call the doctor if there is blood in the stool (which can appear bright red or, more serious, black), the baby has more than six watery stools a day, is not taking fluids or shows signs of dehydration.
Infants commonly "spit up" but frequent vomiting is reason for concern. Vomiting may not be serious if it happens only once or twice. However, if it happens more frequently, contains blood or is green in color, or if the baby looks dehydrated, call your doctor.
Next Up: Difficulty breathing
Originally published March 2010. Updated July 2017.
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