Health & Safety  ·  Newborn

Newborn Red Flags: When to Call the Pediatrician

How do I know if something is actually wrong with my newborn?

Most of what newborns do is normal, even when it looks alarming. But a short list of signs means call for help right away, and these are worth knowing by heart. Start with the 911 list, then the call-your-pediatrician list.

5 min read Health & Safety Updated June 2026

Call 911 now if

  • A breathing pause longer than about 20 seconds, OR any pause - even a short one - with blue or gray color, going limp, or floppiness.
  • Blue or gray color on the lips, tongue, or face, or gasping for air.
  • Baby is not breathing or not responding: call 911 immediately and begin infant CPR now. You do not need training. Put baby on a firm flat surface, support the head and neck, and the 911 dispatcher will talk you through it step by step.
  • A seizure, or baby is limp and cannot be roused.
  • Vomit that is green or yellow-green (bile), or vomit with blood or coffee-ground specks. Go now.
  • High-pitched cry with arching, stiffening, or limpness (a sign of severe jaundice affecting the brain).
  • Any moment your gut says this is life-threatening.

Call your pediatrician right away if

  • Rectal temperature is 100.4F (38C) or higher in a baby under 3 months. This is an emergency. Call now, and if you cannot reach them, go to the ER.
  • Low temperature: rectal under about 97.7F (36.4C), or baby is cold, mottled, or hard to warm up. In a newborn this can be a sign of infection.
  • Trouble breathing: fast or labored breaths, grunting with each breath, flaring nostrils, or the skin pulling in around the ribs or collarbone. (A pause with color change, going limp, or lasting over 20 seconds is a 911 call - see above.)
  • Won't wake to feed, is hard to rouse, or is unusually limp and floppy.
  • No wet diaper in about 6 hours, or fewer wet diapers than usual, plus dark urine, dry mouth, no tears, a sunken soft spot, or unusual sleepiness. Do not wait out the full window if these are present - call now.
  • Repeated forceful or projectile vomiting, or vomiting after most feeds. (Green, yellow-green, or bloody vomit is a 911 call - see above.)
  • Refusing to feed over several feedings in a row.
  • Bulging or sunken soft spot, a stiff neck, or a high-pitched, inconsolable cry that is not their usual cry.
  • Yellow skin or eyes that is getting deeper, spreading to the belly, arms, legs, palms, or soles, or showing up with poor feeding.
  • Any yellow skin or eyes in the first 24 hours of life. Call the same day - this is never normal that early.
  • Yellow skin or eyes along with sleepiness, difficulty waking, poor feeding, or a high-pitched cry. These can be signs of severe jaundice and need same-day evaluation.
  • Any moment your gut says something is seriously wrong.

How to take a temperature the right way

  1. Step 1For babies under 3 months, use a rectal thermometer. It is the most accurate and the number your doctor needs.
  2. Step 2Put a little petroleum jelly on the tip, lay baby on their back, and gently insert about half an inch. Stop if you feel resistance.
  3. Step 3Hold steady until it beeps. A reading of 100.4F (38C) or higher means call right away, day or night. A reading under about 97.7F (36.4C) also means call right away.
  4. Step 4Do not give fever medicine to a baby under 3 months before talking to your doctor. Call first.

Usually normal, even though it looks scary

  • Hiccups, sneezing, and noisy or irregular breathing during sleep.
  • Brief pauses in breathing under 10 seconds that end on their own with normal color, then back to normal (periodic breathing). But a pause longer than about 20 seconds, or any pause with blue or gray color or going limp, is a 911 call - see the top list.
  • Spitting up small amounts after feeds while still gaining weight.
  • Crying for 1 to 3 hours total across the day, often in the evening. But a cry that is high-pitched, weak, or that you cannot console and is unlike their usual cry belongs in the call-now lists above.
  • Soft, mustard-yellow, seedy poops in breastfed babies, even several a day.
  • Crossed eyes now and then, and startling at sudden sounds.

Safe sleep, every sleep

  • Alone: baby sleeps in their own space, never sharing a bed.
  • On the back: for every nap and every night.
  • Bare crib: firm, flat mattress, fitted sheet only. No pillows, blankets, bumpers, or stuffed animals.
  • Room share without bed share for at least the first 6 months.
  • No inclined sleepers, and do not let baby sleep regularly in a car seat, swing, bouncer, or lounger. The sleep surface must be firm and flat. If baby falls asleep in a seat or swing, move them to the crib or bassinet.
  • If you swaddle, stop as soon as your baby shows any sign of trying to roll over (often around 2 to 3 months). A swaddled baby who rolls onto their stomach cannot push back up. Keep the swaddle snug at the chest but loose at the hips, and always place baby on the back, never on the side or stomach.
  • No overheating: dress in one light layer more than you are wearing, and do not overbundle.

Trust your instincts. You know your baby better than anyone, and no question is too small for your pediatrician. Calling when you are unsure is exactly what they are there for.

Quick answers

It's the middle of the night and I'm not sure it's an emergency. Should I still call?
Yes. Pediatric offices have an after-hours line and a nurse who can help you decide. For a fever of 100.4F or higher in a baby under 3 months, trouble breathing, or blue lips, don't wait. Call right away or go to the ER. If baby has a breathing pause with color change, is not breathing, or is not responding, call 911 and start infant CPR while you wait.
How can I tell if my baby is breathing too fast or just breathing normally?
Newborns normally breathe faster than adults and in an uneven rhythm, and brief pauses under 10 seconds that end with normal color are fine. Call your pediatrician for steady fast breathing that doesn't settle, grunting on each breath, nostrils flaring, or the skin sucking in around the ribs. Call 911 for a pause longer than about 20 seconds, any pause with blue or gray color or limpness, or gasping.
My baby is spitting up a lot. When is it vomiting I should worry about?
Small, easy spit-ups after feeds are common and usually fine if baby is content and gaining weight. Call your pediatrician if the vomiting is forceful or projectile, happens after most feeds, or comes with fewer wet diapers or poor feeding. Vomit that is green, yellow-green, or bloody is an emergency - go now or call 911.

Sources & further reading

  1. American Academy of Pediatrics — HealthyChildren.org

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This guide reflects current AAP and CDC guidance and is for educational purposes only. It does not constitute medical advice. ParentFlow is a wellness companion — not a substitute for your pediatrician. For any medical concern, contact your healthcare provider.