The first week of life is the highest-risk period for a newborn. The following warning signs in the first seven days should prompt immediate paediatric assessment rather than watchful waiting:
• Jaundice appearing within 24 hours of birth, or deepening rapidly in the first days
• Fever above 38 degrees Celsius or temperature below 36.5 degrees Celsius at any point
• Refusal to feed for more than four to six hours in a baby who was previously feeding
• Failure to pass meconium within 48 hours of birth
• Breathing rate persistently above 60 breaths per minute, grunting, or nasal flaring
• Bluish discolouration of the lips or around the mouth
• Extreme limpness, difficulty rousing, or unresponsiveness
• Any seizure or abnormal jerking movement
In my 40 years of paediatric practice at Vatsalya Children's Hospital, the families who act on these signs early consistently achieve better outcomes than those who wait.
Written by Dr Rajendra Pathak, MBBS (Motilal Nehru Medical College, Allahabad), MD Pediatrics (Maharani Laxmi Bai Medical College, Jhansi), Senior Consultant Paediatrician and Founder-Director, Vatsalya Children's Hospital, Mahavir Road, Orderly Bazar, Varanasi, Uttar Pradesh 221002.
