What to Do When Your Premature Baby is Sick

Deciding When to Call the Doctor

Image © Eric C. Snowdeal III

Deciding when to call the doctor when you think your baby is sick is always a challenge, especially when the sick baby is a premature baby you’ve recently brought home from the hospital. After all, in the NICU the doctors and nurses were only footsteps away, watching over your baby. At home, you may feel suddenly cut off from the NICU's constant medical supervision. Even a sneeze may seem scary.

Although doctors make every effort to discharge only healthy babies from the hospital, preemies do have a greater risk of illness.

If your baby seems sick, trust your instincts and visit your pediatrician. Many babies show clear signs of being sick, and knowing those signs can help you communicate more clearly when the doctor asks “What exactly is wrong with your baby?”

General Signs of Illness

Many signs of illness in babies are the same no matter what type of illness your baby has. These symptoms may be vague and hard to recognize. If they are persistent or a change from your baby's usual routine, a phone call to the pediatrician is in order. You should never hesitate to call your doctor if you are worried, especially when you are just getting used to having a preemie at home. Trust your instincts.

  • Extreme sleepiness: Newborn babies, especially preemies, sleep a lot. If your baby seems sleepier than usual, especially if he is hard to wake up for feeding times, call your pediatrician.
  • Loose stools: Breastfed babies typically have several yellow, seedy stools per day. Formula fed babies usually have 1 or more soft, tan-colored stools daily. Take your baby to the pediatrician if his stools are loose or mainly composed of liquid, as diarrhea can cause dehydration.
  • Fewer wet diapers: If your baby has fewer than 6 wet diapers in a 24-hour period, he may be dehydrated. Make sure that he is breast or bottle feeding as often as usual, and call the pediatrician. The doctor may want to check your baby for other signs of dehydration.
  • Vomiting: Many babies spit up frequently, but spitting up shouldn’t be forceful or painful. If your baby vomits more than 2 or 3 times in a day, let your doctor know.

    Signs of Serious Illness

    Although the signs of mild illness can be vague, the signs of more serious illness are usually easy to recognize. If your baby shows any of these symptoms, call the doctor immediately or take your baby to the emergency room.

    • Difficulty breathing: If your baby seems to be working very hard to breathe, is flaring his nostrils or sucking so hard that you can see his ribs when taking a breath, has a bluish tint to his lips or mouth, or is breathing faster than 60 breaths per minute, seek immediate medical attention. Call 911 or take your baby to the closest emergency room.
    • Fever: Fevers that would be routine in older children are considered serious in infants under about 3 months of age. An infant’s temperature should be between 97.8 F and 100.4 F. A temperature higher than that could be a sign of infection, and you should call your doctor immediately.
    • Feeding difficulties: If your baby won’t wake up to eat, does not want to eat, or has a reduction in the amount of breast milk or formula he normally eats, call your doctor right away.
    • Redness, streaking, inflammation: Inflammation around any opening into the body is a serious medical condition that warrants immediate treatment. Umbilical cord stumps, circumcision sites, gastrostomy tube insertion sites, tracheostomies, and any other opening into the body may become infected. If the area is warm, red, puffy, or streaky, call your doctor.


      Kaiser Permanente. “Feeding Your Premature Baby: After Your Child’s Visit.”  http://members.kaiserpermanente.org/kpweb/healthency.do?hwid=uh5099

      Kids Health. “Medical Care and Your Newborn.”  http://kidshealth.org/parent/pregnancy_newborn/medical_care/mednewborn.html

      March of Dimes. “When to Call Your Baby’s Doctor.”  http://www.marchofdimes.com/pnhec/298_1449.asp

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