Last Updated on January 17, 2026 by Lila Sjöberg
Every cough, every weird rash, every temperature that seems slightly warm sends new parents into a spiral of “is this normal?” and “should I call someone?” I called my pediatrician so many times in the first month that the nurses knew my name. Some calls were necessary; others I could have handled at home. Here’s what I wish I’d known about when to worry and when to wait.
Key Takeaways
When in doubt, call — pediatricians expect first-time parent questions and would rather hear from you than have you worry alone. However, some symptoms in newborns always require immediate attention: fever over 100.4°F (37.7°C) under three months, difficulty breathing, or refusal to eat. Trust your instincts, but also know which signs are red flags.
The Short Answer: Call your doctor for fever in babies under three months, breathing difficulties, signs of dehydration, lethargy, persistent vomiting, or anything that seems seriously wrong to you. For milder concerns, calling during office hours for guidance is always appropriate.
Let me break down the situations that need urgent attention versus those that can wait for a regular appointment.
Call Immediately: These Can’t Wait
Fever in a baby under three months old is always an emergency. If your newborn’s rectal temperature is 100.4°F or higher (37.7°C), call your pediatrician immediately or go to the emergency room. Young babies can’t fight infections the way older children can, and fever at this age requires evaluation for serious bacterial infections.
Breathing problems need immediate attention at any age. Signs include rapid breathing (more than sixty breaths per minute in newborns), grunting sounds with each breath, flaring nostrils, ribs visibly pulling in with each breath, or blue coloring around lips or face. Don’t wait to see if it gets better — call 911 or get to an ER.
Lethargy beyond normal newborn sleepiness is concerning. If you can’t wake your baby for feeds, if they’re unusually limp or unresponsive, or if something seems significantly “off” about their alertness, seek help. You know your baby — trust that sense that something isn’t right.
Signs of dehydration warrant urgent calls too. If baby hasn’t had a wet diaper in six to eight hours, has a sunken soft spot on their head, dry mouth, or no tears when crying, they need evaluation. Dehydration can escalate quickly in infants.
Call Soon: Within Hours
Persistent vomiting — not just spit-up, but actual projectile vomiting or vomiting after most feeds — should prompt a call within a few hours. Occasional spit-up is normal; refusing to keep anything down is not.
Blood in stool or vomit needs evaluation, though small amounts aren’t always emergencies. Call your pediatrician to describe what you’re seeing — they’ll tell you whether to come in immediately or schedule an appointment.
Jaundice that’s worsening after the first week or affecting a baby who seemed to be improving warrants a call. Yellowing of the skin and eyes is common in newborns but should improve, not worsen, after the first few days.
Unusual rashes that spread quickly, are accompanied by fever, or include blisters or bruising deserve same-day attention. Most baby rashes are harmless, but some patterns indicate infection or other concerns.
Inconsolable crying that differs from normal fussiness — higher-pitched, weaker, or accompanied by other symptoms — suggests pain or illness rather than typical newborn distress.
If crying follows a predictable pattern without other symptoms, it might be colic.
Call During Office Hours: Can Wait But Worth Asking
Cold symptoms without fever — congestion, sneezing, mild cough — usually don’t need urgent evaluation in otherwise healthy babies. Call during office hours for guidance on comfort measures and signs that would warrant a visit.
Minor skin issues like cradle cap, baby acne, mild diaper rash, or dry patches can wait for your next scheduled visit or a routine call. These are common and rarely urgent.
Questions about feeding, sleep, or development don’t require after-hours calls unless you’re genuinely worried about baby’s safety. Write them down and bring them to appointments or call during business hours.
Mild fussiness or changes in sleep patterns — without other concerning symptoms — are usually normal variations. Monitor for additional symptoms and mention at your next visit.
Trust Your Instincts
Pediatricians will tell you that parent intuition matters. If something seems wrong — even if you can’t articulate exactly what — it’s okay to call. You’ve spent more time with your baby than anyone and know their baseline.
“Something seems off” is a valid reason to seek guidance. You don’t need to diagnose your baby; you just need to communicate what you’re observing. Let the medical professionals determine whether it’s concerning.
That said, also trust when things seem okay. A happy, alert, feeding baby with mild symptoms is usually fine to monitor at home. You’ll learn to read your baby and distinguish “needs a doctor” from “needs a cuddle.”
Our newborn essentials checklist includes items like thermometers and nasal aspirators that help you assess and manage mild symptoms at home.
Making the Call Productive
When you call, have information ready. Note baby’s temperature, symptoms, when they started, and what you’ve tried. Describe what’s concerning you as specifically as possible.
Take baby’s temperature before calling so you have an exact number. Our first aid essentials guide covers what to keep on hand. Rectal temperature is most accurate for babies. “Baby feels warm” isn’t as useful as “baby’s rectal temperature is 99.8. (37.5°C)”
Note the timing and progression of symptoms. Did the rash appear suddenly or gradually? Is the crying getting worse or staying the same? How long has baby gone without eating? Specific details help the medical team assess urgency.
Don’t apologize for calling. Pediatric offices expect calls from worried parents. It’s literally their job to help you determine whether symptoms need evaluation. They’d much rather answer your question than have you wonder and worry.
Emergency Room Versus Pediatrician
True emergencies — difficulty breathing, unresponsiveness, high fever in young newborns, seizures, serious injuries — warrant the ER or 911. Don’t wait to reach your pediatrician if baby is in distress.
For non-emergencies, calling your pediatrician first is usually better. They know your baby’s history and can often fit you in for same-day visits or guide you over the phone. ERs are for emergencies and might involve long waits for less urgent concerns.
After-hours, most practices have nurse lines or on-call doctors who can help you decide whether something can wait until morning or needs immediate attention. Use these resources — they exist specifically for midnight worries.
Frequently Asked Questions
Am I calling too much?
Probably not. New parents are expected to have questions, and pediatric practices are set up to handle them. If you’re calling multiple times daily with non-urgent concerns, consider keeping a list of questions for scheduled visits instead. But don’t let embarrassment stop you from calling when genuinely worried.
What if I wait and it gets worse?
If you’re debating whether to call, it’s often better to call. Most conditions don’t worsen dramatically within the time it takes to get guidance. But if you’re truly concerned about rapid deterioration, seek care immediately rather than waiting.
How do I know if it’s an emergency?
Difficulty breathing, unresponsiveness, fever over 100.4°F in babies under three months, seizures, or significant injury are emergencies. When in doubt, err on the side of caution — calling 911 or going to the ER for something that turns out to be minor is far better than waiting on something serious.
What if the doctor dismisses my concerns?
If you’re told baby is fine but your worry doesn’t ease, it’s okay to seek a second opinion or call back if symptoms change. Your observations matter, and persistent parental concern sometimes catches things that initial exams miss.
Should I take baby to the ER for a fever at night?
For babies under three months, yes — fever at this age requires evaluation regardless of time. For older babies, call the after-hours line first. Fever alone in an otherwise comfortable baby over three months can often wait for morning if the on-call provider agrees.
You’re going to make many of these judgment calls as a parent, and you won’t always be certain you chose right. That’s okay. Asking questions and seeking guidance when worried is exactly what good parents do.
Your baby is lucky to have someone paying such close attention. 🥰
Lila.
