Hesperian Health Guides

Health Problems of New Babies

In this chapter:

Diseases that take days or weeks to kill adults can kill a baby in a few hours.

A healthy baby breathes easily, without struggle. He should breastfeed every 2 to 4 hours and wake up on his own when he is hungry or wet. His skin should be clear, or have only a little redness or a small rash that clears in a few days. A baby who does not do these things could be in trouble and should get help fast.


Infection in a newborn baby can be very dangerous and requires treatment with antibiotics right away. Depending on how far you are from a health center and what medicines you have, you should either get help immediately or give treatment yourself – even if only on the way to get help.

Danger signs
  • Fast breathing: more than 60 breaths a minute while sleeping or resting.
  • Struggling to get air: chest sucking in, grunting, nose flaring open from the effort, while sleeping or resting.
NWTND Newb Page 12-1.png
chest sucking in
nose flaring
  • Fever, over 37.5º C, or low temperature, less than 35.5º C.
  • Severe rash with many pimples or blisters. (Small rashes are normal.)
  • Not feeding.
  • Rarely waking, or seeming to not respond to you.
  • Seizures: loss of consciousness and jerking movements.

Any of these signs means the baby needs treatment.


If you suspect an infection but it is not severe, give ampicillin or amoxicillin, but for a severe infection, inject ampicillin and gentamicin right away and get medical help. The exact amounts of medicine depend on the age and weight of the baby.

The baby should start to get better within 2 days. If he is not improving by then, different antibiotics are needed to save his life.

Antibiotics in tablets can be crushed and mixed with breastmilk and fed to a baby, but some antibiotics must be injected. These go in the long muscle on the side of the thigh. See Medicines, Tests, and Treatments (in development) for how to safely give injections.

NWTND Newb Page 13-1.png

If the mother had a fever during labor, be extra watchful of danger signs in the baby. Likewise, a baby who passed stool inside the womb can sometimes breathe in this stool at birth. (The waters would have had chunks of brown or looked greenish from stool. Or the baby's skin might have been stained a bit yellow at birth.) This can cause infection of the lungs in the first few days, so be ready to quickly treat the baby at the first sign of infection.


a man holding a crying baby while speaking to a woman.
Let me take care of the baby while you rest.

Some babies cry more than others. A baby who cries a lot is probably OK if her other health signs are normal. Check if she breathes normally when she is not crying.

Near-constant crying, which often gets worse at night, is called colic. It should get better by about 3 months. This is usually harder on the family than on the baby. Be kind to new mothers. Make sure they get the rest and help they need.

If the baby cries for much of the day and also does not eat, has a fever, or has trouble breathing, this could be a sign of infection.


NWTND Newb Page 14-1.png

Vomiting is when the baby’s body uses force to vomit, not when the milk is just spilling out. Vomiting may not be a problem but see a health worker right away if a baby has any of these danger signs.

Danger signs
  • Vomits over and over, or cannot keep anything in his stomach
  • Vomits blood
  • Has signs of dehydration

It is not dangerous when babies burp up milk. Sometimes there is a lot and it can come from the mouth or nose. As long as the baby nurses often and gains weight, burping or spitting up is not harmful. Try holding him upright after he eats.

illustration of the below: burping the baby.
Hold the baby over your shoulder or knee and gently pat his back to burp him after he eats. This will help bring up air he swallowed while feeding.

Dehydration (not enough fluid in the body)

Babies easily become dehydrated, and in babies dehydration is especially dangerous.

  • Diarrhea
  • Vomiting
  • Breastfeeding less than every 2 to 4 hours
  • Eating or drinking anything that is not breast
    milk (like formula, porridge, or water)
  • Hot weather
  • Urinating less, or dark, strong-smelling urine
  • Dry mouth and tongue
  • Dull-looking eyes or skin

Severe dehydration can cause sunken eyes, a sunken soft spot on the top of the head, weight loss, and unresponsiveness.

NWTND Newb Page 15-1.png

At the first sign of dehydration, or if the baby has diarrhea or has been vomiting, nurse more often, for as long as the baby will drink. Wake the baby up to drink at least every 2 hours. You can also give rehydration drink, a simple recipe of water with a little salt and sugar. Give rehydration drink after you breastfeed. Very rarely, a mother nurses often enough but does not produce enough milk.

If a dehydrated baby does not start to improve in a few hours, get medical help to get fluid in the baby.


Newborns get rashes, blotches, and differences of skin color that are mostly harmless and go away on their own. A rash on the baby’s bottom is caused by the skin staying wet with urine or feces. Clean the area more often. Change diapers and wet clothes as soon as they get wet or soiled. For an older baby and on a warm day, you can leave his bottom bare to heal. Zinc oxide cream can help. If it does not heal in a few days, it may be a yeast infection. Use nystatin cream.

Measles, chickenpox, and rubella are viruses that can cause a rash that spreads to different parts of the body. Usually a fever comes first, then the rash. Some illness from mosquitoes, like dengue and chikungunya, can cause a rash on the body.


Yellow skin or eyes is called jaundice. For a dark-skinned baby, check the eyes. Normally, the baby’s yellow color goes away in a few days with enough breastfeeding. Wake her every two hours to nurse. Sunlight also helps. If it is warm enough, take off the baby's clothes, cover her eyes, and have her in the sun for 5 minutes once or twice a day. (Too long will burn the baby's skin.)

Rarely, a baby can have severe jaundice, which is dangerous. Get help for any of these signs.

Danger signs
  • The jaundice starts right away – in the first 24 hours of life.
  • Jaundice starts later, but covers the whole body.
  • The jaundiced baby is very sleepy, or cannot be woken to eat.

The eyes

illustration of the above: a goopy eye.

The tiny holes that allow tears and oil to moisten the eye can get stopped up and then the eyes get goopy. Wipe them clean with a warm, wet cloth. Use a different cloth on each eye. This way if there is an infection in one eye, it will not spread to the other.

Many women have chlamydia or gonorrhea and do not know they are infected. Antibiotic eye treatment right after birth will prevent eye problems from gonorrhea that has passed from the mother to the baby.

A red, swollen eyelid with bloody pus after the baby is 5 days old is likely a chlamydia or gonorrhea infection in the eye. The treatment for chlamydia is erythromycin by mouth, by grinding it up and mixing it into a little breast milk for the baby. The treatment for gonorrhea is an injection of ceftriaxone. If you cannot test to know which disease is causing the infection, give medicines for both. The mother and father should also be treated for chlamydia and gonorrhea. See Sexually Transmitted Infections. If an eye infection does not improve in a day or two, you need another antibiotic to prevent blindness. Get help.

The soft spot

The soft spot on the top of the head should be flat. A sunken or swollen soft spot are both signs of very dangerous problems.

NWTND Newb Page 16-3.png
NWTND Newb Page 16-2.png
A sunken soft spot is a sign of
dehydration. Give more breast milk
and rehydration drink.
A swollen soft spot is a sign of
meningitis. Give antibiotics.

The cord

After the cord is cut, leave the stump alone. Do not cover it. Keep diapers and clothes away. Avoid touching it, but if you must touch it, first wash your hands with soap and water. If the stump or belly button become dirty or caked with dried blood, clean with soap and water and a very clean cloth.

If the mother does cover the cord stump with a band or cloth, make sure it is clean and loose, and change the cloth a few times each day.

NWTND Newb Page 17-1.png
Keep away from the baby’s cord — and you will keep infection away too.

The stump should dry and fall off in about a week.

If the area around the cord becomes red or hot, smells bad, or drains pus, it is probably infected. Clean it well and give the baby amoxicillin.

If the baby has a grimace, cannot nurse, or seems stiff, especially if the area around the cord seems infected, she may have tetanus.This is an emergency.

This page was updated:13 Jan 2021