How to Spot Early Signs of Newborn Infection and When to See a Doctor

The first few weeks after birth are critical for every baby. A newborn’s immune system is still developing, so infections can progress much more quickly than in older children. Often, the early signs are subtle and easy to miss. Serious conditions like sepsis and pneumonia continue to be major causes of newborn illness, but the good news is that many complications can be prevented or treated when parents recognize warning signs early.

As a neonatal expert at Inamdar Hospital, I always tell parents: if something about your baby feels ‘not right,’ it is safer to call a doctor than to wait, shares Dr Ashwin Borade, Pediatrician, Inamdar Hospital, Pune.

Newborn infections behave differently from infections in older children. Babies in the first 28 days of life may not develop typical symptoms, such as high fever or severe coughing. Instead, they show changes in feeding, behavior, breathing, and body temperature. These changes may seem vague, but they are often the first clues that something is wrong and should never be ignored.

How To Identify Infections in Newborns?

According to Dr Borade, “One of the earliest warning signs is a change in feeding or behavior. If your newborn is too sleepy to wake for feeds, gets tired after a few sucks, or suddenly feeds much less than usual, it may signal an underlying infection.”

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Other symptoms of infection in a baby are:

• A baby who was active earlier but becomes unusually quiet, floppy, or less responsive also needs medical attention.
• Continuous high-pitched crying or crying that cannot be soothed is another red flag.
• In newborns, poor feeding or a sudden change in behavior can be as important as a fever.
• Body temperature is another critical indicator. A fever of 38°C (100.4°F) or higher should be taken seriously.

However, a low temperature below 36°C (96.8°F) can be just as concerning. Babies with low body temperature may feel cold to the touch, especially on the hands and feet. Both high and low temperatures in a newborn require prompt medical assessment, even if no other symptoms are present.

How Breathing Indicates Infection In Newborns?

Breathing patterns offer important clues as well.

“Seek help immediately if your baby is breathing very fast (more than 60 breaths per minute), has grunting sounds, flaring nostrils, or if the chest pulls in between or under the ribs while breathing,” shares Dr Borade.

These signs indicate the lungs or heart may be under stress, which happens in conditions like pneumonia or sepsis in children. Any episode of long pauses in breathing, or a baby turning blue, grey, or very pale around the lips and face, is an emergency.

Signs of Infection On The Skin

Parents should also monitor the skin, umbilical cord area, and signs of jaundice.

• Redness, swelling, pus, or a foul smell around the umbilical cord stump are classic signs of infection and should never be ignored.
• Blisters or pus-filled spots on the skin, mottled or clammy skin, or jaundice that appears within the first 24 hours or becomes deeper over time are reasons to see a doctor.

“If jaundice is accompanied by poor feeding or excessive sleepiness, medical care is needed urgently,” suggests Dr Borade.

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Digestive Troubles and Infection

The digestive system can also signal trouble.

• If your baby is repeatedly vomiting, especially green or bile-stained, it is a major warning sign.
• A swollen or tense tummy, very watery stools with poor feeding, or blood in the stool require immediate medical attention.
• Lack of urine for more than six hours in a baby who normally urinates regularly is another danger sign.

When To See A Doctor

“Parents should call or visit their pediatrician the same day if their baby has a mild fever but feeds adequately; has a mild cold but breathes comfortably; or seems slightly more sleepy or fussy but wakes up with effort,” says Dr Borade.

However, a visit to the emergency department is essential if the baby refuses two consecutive feeds, is extremely difficult to wake, has laboured breathing, has abnormal body temperature along with poor feeding, develops convulsions, or looks blue or extremely pale. Any sick-looking baby under 28 days old should be treated as an emergency until evaluated by a doctor.

Final Word

While not all infections can be prevented, parents can lower the risk with simple precautions. Wash or sanitise hands before touching the baby or cord, limit visitors, avoid kissing the baby’s face, and breastfeed if possible. Keep the umbilical stump clean and dry, and avoid applying powders or home remedies. Ensure timely vaccinations for both mother and baby.

Ultimately, you know your baby best. Trust your instincts. If something feels wrong, reach out to a doctor early. In newborn infections, even a few hours can make a big difference, and early action is always the safer choice.