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When to Seek Medical Attention

Immunization schedule

When to go to the nearest emergency room

If your baby


  • Has difficulty breathing
  • If the skin is blue
  • Has dry mouth, dry tongue and has not passed any urine (pee) in 24 hours
  • Has a fever and will not wake up for feeding
  • Vomits (throws up) a large amount at several feedings in a row
  • Has watery, greenish mucousy bowel movements (poo) more than 12 times It is important to know when to seek medical attention.in 24 hours (6 times for formula fed babies)
 
If you, the mother

  • Have so much bleeding that you need to change your pad every hour or more
  • Pass golf ball size clots
  • Have trouble breathing or chest pain
  • Have a severe headache and/or blurred vision
  • Have severe pain in your abdomen, back or legs

 
When to contact the appropriate care provider within 24 hours

If your baby

  • Does not feed at least 6 times in 24 hours (breast or bottle feeding) or feeds more often than 12 times in 24 hours
  • Does not pass urine (pee) several times in 24 hours
  • Skin turns yellow (or whites of baby's eyes turn yellow)
  • Is hard to wake up and will not stay awake for feedings
  • Feels very hot or you think has a fever
  • Has a very red umbilical cord or it has an odour, discharge or bleeding
  • Has had a circumcision and there is bleeding and/or greenish or bad smelling discharge from his penis or he has not passed urine in 6-8 hours after the circumcision
  • Will not stop crying

If you, the mother

  • Have chills or a temperature over 38"C (100.4"F) and feel like you have the flu
  • Have a bad, foul smelling odour to your vaginal discharge
  • Have very sore sitches or your c-section incision is painful, leaking, red or opening up
  • Feel dizzy, faint or short of breath
  • Have sore cracked or bleeding nipples or a tender reddened area on the breast
  • Feel depressed longer than 1-2 weeks or if you feel that you may harm yourself, the baby or others
  • Do not have a bowel movement (poo) in 7 days
  • Have leg cramps or reddened areas up the back of your legs

Important baby problems to watch for

Dehydration

It is important to watch your baby for signs of dehydration. Breast fed babies can feed up to 12 times in 24 hours. Bottle fed babies usually feed 6-7 times in 24 hours. Frequent effective feeding helps make sure that your baby is well hydrated (has enough fluid). Watch the number of pees and bowel movements (poos) your baby has in a 24-hour period. A decrease in the number of pees in a 24-hour period, dry lips and a dry mouth are all signs of dehydration and you should feed your baby more frequently. Call your baby's care provider if your baby continues to have signs of dehydration.

Signs of dehydration in your baby

  • A decrease in the number of pees in a 24-hour period
  • Dry lips and dry mouth
  • Lethargy
How do I know my baby is feeding well?

  • Up to 5 days of age
    • number of wet/dirty diapers should be the same as the baby's age in days
  • 6 days of age and older
    • baby should have 2-3 stools (poos) per day
    • at least 6 heavy wet diapers in 24 hours

Jaundice

Jaundice is common in newborns and refers to the yellow colour of the skin and the whites of the eyes. The yellow colour of the skin is caused by the excess build up of the bilirubin in the blood. Bilirubin is produced by the normal breakdown of red blood cells. Bilirubin is broken down in the liver and then removed from the body in the baby's stool (poo) and urine (pee). A newborn's immature liver may break down bilirubin slowly; this may lead to jaundice.

At NYGH, a blood test will be recommended 24-48 hours after birth to check for jaundice. All babies should be examined for jaundice in the first few days after birth. When a baby shows signs and symptoms of jaundice, the doctor or midwife will recommend a blood test to check the baby's bilirubin level. The doctor will recommend treatment for jaundice based on the bilirubin level in the baby's blood, the age of the baby and the presence of other medical conditions.

Signs of jaundice in your baby


  • Yellow skin
  • White of the eyes turn yellow
  • Baby does not wake to feed, is not feeding well or refuses to feed
  • Contact your health care provider if you notice any of these signs!

Causes of jaundice in babies

  • Are born early (less than 38 weeks)
  • Are bruised during birth
  • Have a sibling who was treated for jaundice
  • Have a family history of a condition called G6PD
  • Have a different blood type than their mother

Phototherapy is a treatment that shines a special light onto your baby's skin. This light helps break down the bilirubin, making it easier for the liver to process it so that it can be passed through the baby's urine (pee) and stool (poo).

Treatment of jaundice

If the bilirubin level in the blood is mild, you will be encouraged to continue to provide frequent feedings of breast milk or extra feedings with formula if necessary. Frequent feedings will help the baby get enough fluid so more bilirubin may be passed through the baby's urine (pee) and stool (poo).

If the bilirubin level in the blood is moderate to high, your baby may need to be admitted to the Child and Teen Unit or the Neonatal Intensive Care Unit (NICU) where the recommended treatment is phototherapy and/or intravenous therapy. Phototherapy is a treatment that shines a special light onto your baby's skin. This light helps break down the bilirubin, making it easier for the liver to process it so that it can be passed through the baby's urine (pee) and stool (poo). When a baby receives phototherapy, the bilirubin levels is routinely monitored to determine the effectiveness of the treatment. For most babies receiving treatment, phototherapy may be stopped for short periods of time to allow the baby to be fed. Phototherapy treatment is typically required for 2 to 5 days. Babies with very high bilirubin levels will have multiple intensive phototherapy and may require a blood transfusion.

You may obtain a copy of your baby's bilirubin results from their health care provider.

Treatment of jaundice in babies

  • Mild jaundice — more frequent feeding
  • Moderate jaundice — phototherapy
  • Severe jaundice —  multiple intensive phototherapy and maybe a blood transfusion

 
FAQs

Is jaundice harmful to my baby?
For most babies, jaundice does not cause long-term problems. In rare cases, extremely high levels of bilirubin that are not treated promptly may cause hearing loss or brain damage.

Can my baby get jaundice again?
After your baby is treated for jaundice and discharged home, it is unlikely that they will need to be treated for jaundice again. It is important to take your baby to their follow-up appointments.

What follow-up care does my baby need?
If your baby has/had jaundice, you should make a follow-up appointment with your care provider. Your baby may require follow-up bilirubin blood testing. Check your baby every day for signs of jaundice and call your care provider if you have any concerns.

Get more information on jaundice on the Caring for Kids website developed by the Canadian Paediatric Society.
 
Immunization schedule

Immunizations are one of the most successful public health strategies in our lifetime and the Canadian Paediatric Society recommends immunizations on a regular schedule for all babies and children. Speak to your family doctor for details.
 


You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.