Purple lips If your baby’s lips are purple, or the mucous membranes of the mouth or tongue turn blue, it is a sign that they are not getting enough oxygen, called cyanosis. This is a very appropriate time to call 120. Poor Breathing All babies gurgle or moan from time to time. If their breathing is consistently difficult and rapid, if you see them using their chest muscles excessively, or if their nose is dilated, it could be a sign of respiratory distress. This is the time to call your pediatrician right away, or consider seeing an emergency room if it is after hours. Newborn fever over 38°C If your infant is less than 2 months old and has an anal temperature over 38°C, it is important to be aware. It is unusual for a newborn to have a fever, which could be a cold or meningitis, and it is important to take a newborn’s fever seriously. A newborn with a temperature above 38°C may need to be hospitalized for a series of tests, such as a spinal tap, to assess what is causing the fever, and he/she may need antibiotics; in older children, the immune system is more developed and fever is not necessarily a serious problem. If a newborn’s skin is getting yellow, he/she may have jaundice. Not all jaundice is dangerous; some is normal and will go away on its own, but if it gets more yellow and does not go away, it can affect the brain and cause seizures and permanent damage. Most physicians will recommend increasing the frequency of feedings, allowing the baby’s stools to eliminate excess bilirubin, and giving the baby phototherapy to increase the breakdown of bilirubin. Dehydration If your baby’s diaper will not be wet you should worry about dehydration. Increase the number of diapers used by 1 diaper per day for 6 days after birth and 6 diapers per day after 6 days. Other signs of severe dehydration include dry mouth, deep sunken eyes, and lethargy, at which point the pediatrician may recommend feeding the baby electrolyte replacement solution. It is not a good idea to let the infant drink water at this time because it may cause sodium levels to drop, which in turn can lead to seizures. Dehydration and vomiting light green bile There are many reasons why babies vomit because they cough too vigorously, cry too hard, eat too much and have stomach problems, however, it is serious if they vomit green bile. It is also serious if the vomit looks like black coffee grounds. Green bile represents intestinal obstruction and needs immediate attention, and vomit that looks like coffee grounds may be a sign of internal bleeding. Vomiting after a head injury also needs to be evaluated because it can be a sign of a concussion.