7 baby symptoms you should never ignore

It’s scary when your baby isn’t his usual self. Find out when you need to bring him to the doctor.

As a parent, you’ll know that your baby’s health symptoms are a minefield: For instance, when is a fever too high to ignore, or why is your baby crying uncontrollably suddenly?

Indeed, most of us have problems deciding if the symptoms are serious enough to need a dash to the paediatrician, or even a quick call to your doctor.

Dr Wong Chin Khoon, paediatrician and medical director at SBCC Baby and Child Clinic walks us through common baby symptoms, plus deets on how serious they can be.

1. How high should a fever be before you rush your baby down to the Paediatrician? Why is this important?

Your baby’s fever is a symptom and not a disease. It is also the body’s way to fight infection. Like all symptoms, fever may be due to illnesses that are minor or serious, or sometimes even life-threatening. Therefore, there is no clear-cut degree of fever that tells us that the baby is very sick or otherwise. However, some studies have shown a four-times higher risk of serious infection in babies who have a temperature above 40 deg C. It is also important to note that fever in itself does not cause brain damage. In general, the degree of the fever does not correlate with the seriousness of the illness. How your baby acts is what counts.

Bring your baby to the doctor if he:
* Is less than 3 months old (there is a 21 times higher likelihood of a serious infection (compared to older children).
* Has a temperature of 40 deg C and above.
* Feeds poorly and passes very little urine (can result in dehydration).
* Seems drowsy or lethargic (especially if the fever is not above 38 deg C). A fever may make children want to sleep more, but they should awaken easily and be able to interact with their parents.
* Has difficulty breathing or has breathes noisily.
* Develops a rash (such as red spots or small purple spots on the skin that may look like bruises).
* Has a soft spot on the head that bulges out or is sunken inwards.
* Is extremely irritable ― cries constantly and you cannot settle him;
* Becomes grey, pale or blue.
* Has a fit (seizure/convulsion).

Note that a high fever does not necessarily indicate a serious illness, and a low-grade fever does not necessarily mean that the illness is minor. If the fever doesn’t come down with fever medicine does not necessarily mean the illness is serious. Sometimes, babies who have had a minor illness develop a more serious infection later. If your baby seems to be getting sicker, return immediately to the doctor’s clinic, even if you have just left the clinic and even if your baby is taking medication. Even if it is a false alarm, it is better to return than to wait too long.

Note that a high fever does not necessarily indicate a serious illness, and a low-grade fever does not necessarily mean that the illness is minor.

2. My baby doesn’t seem to be responding when I call his name (when he used to). Should I be worried?

Every newborn in Singapore is offered a newborn hearing test soon after birth. The chance that the hearing loss is congenital is very low if the result is normal. Congenital hearing loss may be due to genetic inheritance, viral infection of the baby while in the womb, or trauma during the birth process. However, certain non-genetic or non-congenital conditions may impair the hearing. These include:

* Low birthweight.
* Severe neonatal jaundice, although with close monitoring by the paediatrician and the effectiveness of phototherapy, it has become uncommon these days.
* Use of a certain antibiotic that is toxic to the ear, especially during infancy.
* An ear infection, usually associated with a running nose and a cough.
* Trauma to the ear resulting in a perforated eardrum or damage to the inner ear.
* Ear wax.

You may want to test your baby’s hearing in a quiet room, as he can be easily distracted by bright, colourful objects or sudden brightness.  This can be the reason why he does not appear to respond when you call his name. If your baby is startled by a closing door or a sudden loud noise from the television, his hearing is likely to be normal. If you are still concerned, please see your paediatrician, who will test your baby’s hearing. He may recommend an additional formal hearing test if necessary.