Most of what a newborn does in the early weeks — sneezing, hiccups, sleep twitches, even some skin peeling — is normal and not a reason to worry. But a small set of signs are different: they need urgent medical attention the same day, not a wait-and-see approach. This guide lists those signs, so you know when to act.

The signs that need urgent attention

  • Jaundice reaching the soles of the feet or whites of the eyes — some yellowing in the first week is common and often normal, but if it spreads down to the soles, or the eyes look yellow, it needs same-day medical review rather than waiting it out
  • Lethargy or floppiness — a baby who is unusually hard to wake, unresponsive to handling, or noticeably limp is different from a baby who is simply sleepy
  • Fast or laboured breathing — breathing faster than about 60 breaths a minute, grunting with each breath, the chest visibly pulling inward with each breath (chest wall retractions), nasal flaring, or a pause in breathing lasting more than 10 seconds (apnea)
  • Bluish lips or skin — a blue tinge around the mouth or on the body (not just cold hands and feet, which can be normal) is an emergency sign
  • A fever, in a baby under 2 months old — a temperature above 100.4°F (38°C) is always treated as an emergency at this age, even without other symptoms, because very young babies can deteriorate quickly from infection
  • An unusually low body temperature that doesn't improve with warming — a newborn who feels cold to the touch, or measures low on a thermometer, and doesn't warm up with skin-to-skin contact and extra layers, needs the same urgency as a fever; low temperature can be just as significant a sign of infection or illness in a very young baby
  • Green (bilious) vomit, or vomiting that continues for more than 12 hours — occasional spit-up is normal; forceful or green-tinged vomiting, or vomiting that doesn't settle, is not
  • Persistent vomiting or diarrhoea with signs of dehydration — very few wet nappies, sunken eyes, a dry mouth, or no tears when crying
  • Seizures or unusual, repetitive jerking movements — different from the normal brief startles and twitches newborns have, especially during sleep
  • Refusing to feed, feeding very poorly, or not waking up for feeds — a baby who won't latch or suck at all, or who has to be roused repeatedly and still won't feed
  • Continuous, inconsolable crying that nothing soothes — different from normal fussiness that responds, at least partly, to feeding, holding, or comfort
  • A non-fading skin rash, or a fontanelle (soft spot) that looks bulged or swollen — press a glass against a rash to check if it fades; a rash that doesn't fade, or a visibly bulging soft spot, needs urgent review
  • Bleeding, pus, redness, or a foul smell at the umbilical cord stump — this is different from the normal clear or yellowish ooze of a healing umbilical granuloma; active bleeding, pus, spreading redness of the surrounding skin, or a foul odour at the cord site are signs of a possible cord infection and need same-day medical review

Why these specific signs

Each of these can point to a problem that gets worse quickly in a newborn:

  • Jaundice that has spread further can mean a bilirubin level that needs treatment.
  • Breathing effort, colour change, and lethargy can all be signs of low oxygen or infection.
  • A fever under 2 months is treated differently than at any other age, because a young baby's immune system can't always contain an infection the way an older child's can — this is why doctors don't "wait and watch" a newborn fever the way they might with a toddler.
  • A low body temperature that doesn't correct with warming can signal the same underlying infection risk as a fever — newborns don't always mount a fever in response to illness, and a dropping temperature can be the only early clue.
  • Green (bilious) vomiting can signal a blockage that needs same-day evaluation, while vomiting or diarrhoea with dehydration signs reflects fluid loss that a tiny body tolerates poorly.
  • Seizures and feeding refusal can both be subtle early signs of infection or a neurological issue, even before a baby looks obviously unwell otherwise.
  • A cord stump that's bleeding, oozing pus, or has spreading redness or a foul smell can signal a localised infection (omphalitis) that needs prompt antibiotic treatment before it spreads further.

Newborns don't always show illness the way older children or adults do. That is why these specific signs matter more than how "unwell" a baby looks overall.

What to do

If you see any of these, don't wait for a scheduled check-up — call your paediatrician or go to the hospital the same day. It's always reasonable to get a symptom checked and be told it's nothing serious; that's a far better outcome than waiting on something that needed same-day attention.

None of this is meant to make you anxious about every sneeze or hiccup — most newborn quirks are completely normal. It's meant to help you recognise the small, specific list of signs that are genuinely different.

Frequently asked

Is some jaundice in newborns normal?

Yes — mild jaundice in the first week, usually appearing on the face and chest, is common and often resolves on its own. But jaundice spreading to the soles of the feet or the whites of the eyes, which is when it needs to be checked rather than watched.

My baby's hands and feet look bluish — is that an emergency?

Cold hands and feet with a slightly bluish tinge (acrocyanosis) is common in newborns and usually not a concern on its own. Bluish lips, tongue, or a blue tinge across the body is different and needs urgent attention.

How is this different from checking if my baby is growing well?

Signs your baby is growing well are about the normal, reassuring pattern over weeks — weight gain, feeding, activity. This list is about the few sudden signs that need same-day attention, even if everything has been going well until now.

Should I call the doctor first or go straight to the hospital?

If your paediatrician or hospital has an on-call line, calling first can help you get direction quickly. But if a sign feels urgent and you can't reach anyone promptly, go to the hospital rather than waiting for a call back.

What actually counts as a fever in a newborn, and why does age under 2 months matter so much?

A temperature above 100.4°F (38°C) is the threshold used for a newborn. Under 2 months specifically, this is always treated as an emergency needing same-day evaluation, even if your baby seems otherwise alert — at this age, a fever can be the only early sign of a serious infection, so doctors don't apply the "wait and watch" approach used for older babies and children.

My baby feels a bit cool — do I need to rush to the hospital?

Not necessarily. Cool hands and feet alone are common in newborns and usually resolve with an extra layer or skin-to-skin contact. The concern is a baby who feels persistently cold overall, or measures a low temperature on a thermometer, and doesn't warm up with these simple steps — that pattern needs same-day medical review, the same way a fever would.

My baby's breathing looks a little fast and I can see their chest moving more than usual — is that the same as laboured breathing?

A breathing rate persistently above about 60 breaths a minute, or the chest visibly pulling inward with each breath (chest wall retractions), are both signs of real breathing effort, not just quick normal breathing. Alongside grunting or flared nostrils, these point toward respiratory distress and are worth same-day medical review rather than watching further.

How much crying is too much, versus normal newborn fussiness?

Ordinary fussiness usually responds, at least partially, to feeding, holding, or other comfort measures, and tends to have identifiable patterns (like evening fussiness). Continuous, inconsolable crying that nothing soothes — especially alongside any of the other signs on this list — is different and worth getting checked.

My baby's belly button area is a little moist — is that the cord infection you mentioned?

Not necessarily. A small amount of clear or yellowish ooze from a healing umbilical granuloma is common and usually harmless. What's different, and needs same-day review, is active bleeding, pus, redness spreading into the surrounding skin, or a foul smell at the cord site — those point toward infection rather than normal healing.