New moms: To call or not to call the doctor?

Posted on 27 January 2016

It’s sometimes hard to know when to call a doctor for your new baby. Here are a few guidelines to keep the panic at bay. Jacqui Commerford shares her experience of motherhood.

I’ll never forget the day we brought my first daughter home from hospital – a tiny 2,5kg bundle who was completely swamped by her car seat. I was totally in love with her and completely terrified by the fact that she was my responsibility. Two years and a further set of twins later, I still have moments of blind panic, especially when they’re sick. Babies cry for so many reasons, but as a new mother every plaintive peep is heart-rending. But knowing when you’ve got a serious problem on your hands and when to call the doctor is not always easy to judge.

According to Cape Town paediatrician Dr Jo Lund, the following are always emergencies and you should contact your doctor or head to the emergency room immediately:
1. Seizures or fits.
2. Lethargy, sleepiness, paleness (pallor), jaundiced skin (yellow in complexion – when it’s a new symptom rather than early baby jaundice).
3. A widespread (diffuse) rash, especially if it’s accompanied by a temperature and other signs of illness.
4. Blood from any orifice – bum, private parts, ears, mouth.
5. Sustained uncharacteristic screaming.
6. Sustained bleeding from a wound (beyond 10-15 minutes).
7. Poisoning; incorrect medication or excessive dose; accidental ingestion of any chemicals or other toxic substances.

But it’s the more basic symptoms that cause indecision issues. Contact your doctor if your baby is:
1. Pale, floppy, blue (cyanosis), jaundiced or has a diffuse rash (especially combined with a temperature).
2. Irritable, lethargic and passive, excessively sleepy or difficult to rouse/wake or exhibits any significant and sustained change in behaviour.
3. Not eating. Missing or feeding poorly over more than two to three consecutive feeds is a danger sign, especially when baby starts showing signs of dehydration (see below).
4. Running a temperature. In a baby under three months old, any temperature is cause for alarm. Once baby is over three months, call your doctor if they have an ongoing or recurring temperature of 38,5º C or more, and are unresponsive to paracetamol – or are lethargic even when the temp comes down, with cold shivers (rigors) or poor perfusion (cold mottled or blue skin and peripheries such as fingers and toes; arms and legs).
5. Dehydrated or has dry nappies for more than six hours.
6. Having serious trouble breathing, rapid breathing, a barking cough or their chest draws in when they take a breath.
7. Repeatedly projectile vomiting, or has been vomiting for more than 12 hours, especially if there are any signs of dehydration or the baby vomits green bile. Also if they have diarrhoea, especially if they are pooing more than twice per half hour, have severe cramps or show signs of dehydration.
8. Has swollen or red eyes, or persistently squints after the age of three months.
9. Has any swelling on or around their genitalia.