No one knows your baby like you do. You know their different cries, their temperament and their personality. But even with that knowledge, it can be hard to know when to call a doctor. Is it just mild discomfort or are the symptoms serious enough to worry about?

Your instinct as a caregiver is trustworthy, but it always helps to have some guidance. The experts in our neonatal intensive care unit (NICU) share their advice for when to pay extra attention, when to call for advice and when to seek care. They also provide special considerations for families of babies with medical conditions.

What are signs of mild illness or discomfort?

Sometimes babies are fussy for several hours or days. It could be colic, gas, an average cold or another minor issue. Seeing your baby feel uncomfortable is often unsettling, but these symptoms can usually be managed at home.

It’s important to know your baby’s normal baseline for behaviors, including breathing rate, eating, sleeping and crying. Changes from these norms are your first signal that your baby might not be feeling well.

The following are signs of mild childhood illness or discomfort:

• Eating slightly less than normal
• Sleeping more or less than normal
• Crying more than normal

These can all be signs of gas or a mild virus that you can manage at home. If you see these signs in your baby, monitor them closely to see if they get worse. If your baby is breathing normally, making 6 to 8 wet diapers a day and has a temperature lower than 100.4 F, they likely don’t need medical care.

When checking your baby’s temperature for a fever, keep their environment in mind. If you have a lot of layers or blankets on them, remove those layers, wait half an hour and then take their temperature. If it’s still above 100.4 F, call their doctor. As a rule of thumb, babies typically need only one more layer of clothing than adults.

When should I take my baby to the doctor or call their pediatrician?

Sometimes you may find yourself in a grey area where your baby seems to be feeling more than mild discomfort, but you don’t know if seeking care immediately is going overboard. That’s when you should phone an expert. Call your baby’s pediatrician or a pediatric nurse line if your baby experiences the following:

• Fewer than 6 wet diapers in a 24-hour period
• Temperature above 100.4 F
• Sudden and uncontrollable crying that might indicate pain
• Difficulty feeding
• Sleeping significantly more than normal
• Signs of rash, other than a diaper rash

If you can, call your baby’s pediatrician first. They will know your baby best. If it’s late, the weekend or another time when your doctor is unavailable, call our pediatric nurse line at 720-777-0123.

When to call the pediatrician for babies with medical conditions

For babies who were in the NICU or have ongoing medical conditions, it’s especially important to know their baseline for behaviors that could indicate illness. For example, many babies born prematurely or with breathing conditions have a higher breathing rate, and it seems like they’re working harder. For babies with medical conditions, that may be a typical baseline behavior. Understand what’s normal for your baby’s breathing, eating, sleeping and crying, and seek advice when they change from their normal patterns.

Every baby with a medical condition has a different set of considerations and issues to look for. Before you leave the NICU, make sure you have condition-specific instructions and warning signs for your baby, and share those with your pediatrician.

When should I take my baby to the doctor?

For some symptoms, your baby will need an in-person visit with their pediatrician as soon as possible. If your doctor is unavailable for a long period of time, it may be best to visit the emergency department. Try to see your doctor quickly if your baby:

• Is projectile vomiting
• Has bright green vomit
• Has (small amounts)
• Is working harder to breathe due to increased stuffiness, but is still eating well

In other situations, an emergency visit is necessary. Call 911 if your baby:

• Isn’t breathing
• Is working hard to breathe and grunting or making other noises while breathing
• Is pausing when breathing
• Is pale or blue in color

When should I seek care if my baby has a medical condition?

The guidelines and concerns specific to your baby’s condition will be your best guide. Outside of that, you can follow the same advice listed above with additional caution. Premature babies and those with ongoing medical conditions are more fragile, so moderate illnesses could cause more serious consequences. When in doubt, it’s better to seek care too early than to wait and see.