What’s normal newborn behavior, and when should you call the doctor?

Having a new baby is scary business for most new parents. There are so many transitions and things baby goes through, it is hard to tell what’s normal and what’s not. Here are a few of the most common problems you may experience with your newborn.

Jaundice
Jaundice is the yellowing of baby’s skin. This is very normal in the newborn period. The jaundice is actually from an increase in bilirubin. Bilirubin is the byproduct, or after effects, of the breakdown of red blood cells. We all experience a breakdown of red blood cells, but babies’ red blood cells generally break down faster than an adult and their immature liver sometimes has trouble handling it. Some elevation of bilirubin is normal, but if the levels rise too high they need to be treated promptly. If that happens, the doctor will order phototherapy, or light therapy. This will either be a blue-light blanket or an overhead light. If your baby is under phototherapy, you will more than likely get to keep baby in the room with you, but it is very important that you keep the light on baby as much as possible. Her bilirubin should start to go down around day 5.  In the meantime, make sure baby eats as much as possible.

Crying
Babies can’t talk to tell us what is wrong, so they cry. When your baby starts to cry, first make sure they are not hungry and then try to change their diaper. If the crying does not stop, you can try to wrap your baby snugly or hold and rock your baby. Your baby could have gas or a tummy ache. You may want to try to burp your baby as well. Sometimes baby cries and we don’t know why. The most important thing to remember is to not get too frustrated. If you feel you are at your wit’s end and need a break, place your baby in his or her crib and walk away. Do not leave your baby, but you can walk to another room and catch your breath. Never shake or hit your baby to try and stop the crying. If your baby is inconsolable, or his cry changes to a high-pitched scream, call your pediatrician.

Noisy breathing
Babies do not breathe through their mouth – they breathe through their nose. Think about the wet environment baby lives in for 9 months. Those fluids do not just go away immediately, and some newborns may still have fluid in their nose. Babies will sneeze to rid their airway of this fluid. Sometimes they can also have swelling in their nose. If you hear your baby making noises during breathing, look at the baby’s chest to ensure they are not breathing too hard or working hard to breathe. Make sure their color is nice and pink around the nose and mouth. If you notice any change to their work of breathing or color, call your pediatrician immediately.

Acrocyanosis
This is the medical term for bluish coloring of the hands and feet. Baby’s circulation is not fully developed at birth. It takes some time for all of the blood vessels to open up and circulate blood effectively throughout the body. It is normal for the hands and feet to be a bluish color for 24-48 hours after birth. If it persists for longer than this or if you notice blue around the mouth or nose, let your pediatrician know immediately.

If you are ever unsure whether baby’s symptoms or behavior is normal, it’s always best to check with your pediatrician.

Renee Colquitt, CRNP, NNP-BC Director of Perinatal Services at Madison Hospital