Recognize Illness

Suspect your baby is sick? Learn the telltale signs that mean it's time to call the doctor.

Wed, 22 Aug 2012|

-Hi, you're watching Parents TV. I'm Liz Zack, the Executive Editor of Before babies can talk, it can be hard to tell if they're sick. Joining us today is Dr. JJ Levenstein, who's going to help us figure what to look for. Thanks so much for joining us today. -Thank you, Liz. -When your baby is too young to say my tummy hurts it's hard to tell when they're not feeling well. But, there are some telltale signs that parents know when it's time to call a doctor. So, let's talk about some of this. The first is excessive irritability. Babies cry, so how do you know what's too much? -I think babies cry especially in the infancy period most of the day when they're hungry, cold, for any of their basic needs, but when a baby cries excessively 24/7 can't be consoled. No matter what with a dry diaper, with feeding, with cuddling. Something is making the baby uncomfortable and that's a sign of stress, and so that's something that should be paid attention to. -So, crying is still normal. -Yes. -It's just when it becomes successive and all the time you should start to worry. -Twenty four seven crying especially with behaviors like arching or grimacing it certainly indicate that a baby maybe uncomfortable it's a reason to call your doctor. -Great. Not eating can also be another warning sign. What's normal? -Well, a baby's brain for example grows about 200 percent the first year of life-- -Wow. -That drives a tremendous appetite. So, babies are feeding machines and when they stop feeding or they decrease their feeding dramatically something is again up. It maybe something as simple as thrush in the mouth-- -Right. -It maybe something as complex as a metabolic disease, but when they shutdown and stop eating that's a sign to be concerned. -Right. What about talking about eating, what about when babies eat a lot, but still lose weight? -That is definitely a red flag. Generally, breast milk or formula will have enough caloric amplitude to cause a baby to gain weight, and if a baby is gobbling up feeds and yet losing weight and that's a sign that something is probably amiss and should again be brought to-- -Talk to your doctor. -Doctor's attention-- -Right. -Exactly. -A change in wet diapers that also can mean that there is something up right? -Yes. Babies are peeing and pooping machines. There's no doubt about it much like they're eating. So, the more they eat the more they create down below. -Right. -But, if diaper production dramatically drops off especially with urination that could be a sign of dehydration or insufficient fluid intake. On the other hand, if a baby is sick for example with vomiting and diarrhea and they are accessibly urinating during that time that doesn't make sense. The body should be retaining those fluids, so when that happens that's also one of the things to-- -Look out for. -Look out for, exactly. -The one exception now is that babies can poop once every couple of days and that's fine-- -Sure, sure. Even as infrequently as a week especially in breastfeed babies. -Right. -They are so efficient in their absorption of breast milk that they may produce only one stool every seven or eight days, and as long as it's soft, and it's not hard and [unk] like, we don't consider that constipation. -They're fine, they're not uncomfortable. -Not at all. -Okay. Jaundice isn't a problem at first, but when should you start to worry about it? -I think of deep jaundice where a baby looks like a little pumpkin from head to toe persist for longer than a week or if it's accompanied by some restlessness, unwillingness to feed, a baby who is hard to awaken. Those are certainly worrying signs. Also, for long jaundice over a month can be associated with something as simple as breastfeeding and not dangerous, but can in rare instances also point to infection or to liver disease as a problem. -Now, you mention looking like a pumpkin. Can you describe what jaundice looks like a little bit? -If you would imagine the flesh tones or the peachy tones on a peach that is the color that a baby would normally have in the first few days following birth, however, there's a deeper color almost a yellow true, almost glow in the dark color that a baby may have from head to toe and usually with associated signs of some restlessness or irritability when it points to illness or infection. -Okay. Another warning sign is inactivity. Baby sleep, they sleep a lot-- -Yes, they do. -So, how can you tell the difference between what's normal and what is something to bring to your doctor's attention? -In the early new born period, babies sleep anywhere from 16 to 20 hours, we pray for that sleep-- -Right. -Also the good days. -Yes, and in their wake times they are active, they are moving all their extremities, they have some baseline level of movement, however, if a baby just lays their drape like a dish towel over your arm, has a weak cry, it doesn't lift their head up, doesn't have some spontaneous vigor to their muscle movement those are signs that a baby again maybe either infected or have a metabolic condition that's causing them to be weak or [unk]. There's a whole long list of things that could have be associated with that. -Gotcha. Babies can't talk, but they still can communicate and they can still also act like they're in pain. What should you look for when you suspect that? -Well, getting back to the 24/7 crying-- -Right. -With irritability, inability to console. Facial grimacing can occur even as early as the newborn period and so, little babies who have a [unk]. It's there all the time arching off the breast, arching off of a bottle just really, really not happy, no moments of contentment. Those are absolute red flags that your baby is asking you for help. -And as a mom you'll be able to tell-- -Absolutely-- -What's normal for your baby.-- -Generally those moms- -I think mom is the key. -Yes, generally those moms will march into our office with babies, like, they say take my baby something is wrong. -Right, right. What else about how they look? Anything else in terms of skin coloring? -I think even paleness or we call it pallor is certainly a sign that something maybe amiss. Most babies are very red, very pink in the first six to eight weeks of life because we donate so many blood cells over the placenta.- -Right. -However, the first few weeks of life if suddenly they become pale, if they are sweaty, if they are clammy. Those are signs that they may have heart disease or maybe anemic. -Right. -At two months of age there's a natural pallor, a natural anemia that occurs that's called physiologic and then pinkness returns by four months, but if a baby continues to be pale. -That's when you should be worried. -Yes. -Last question-- -Sure. -Throwing up. Babies spit up all the time. When is throwing up and when is it too much? -Well, all babies, I would say, well, categorically 90 percent of babies will have some element of reflux and reflux means that food from the stomach comes back up to the esophagus to varying levels and spitting up small amounts, but gaining weight and thriving and being happy between feeds-- -That's the key.-- -It's a sign of a normal baby with reflux. One who has symptomatic reflux or is throwing up across the room projectile vomiting feed after feed after feed. That could be a worrying signs if there is irritability or lack of weight gain, or a lot of respiratory disease attach with throwing up. Those are signs of worry. -Thank you so much for joining us. It has been wonderful to have you here. I know I'm relieved as a mom. Thanks for joining us and thanks for watching Parents TV. Your source for the best information for your growing family. -Thank you for watching Parents TV. Our families, our lives.