Newborn Red Flags: What to Watch for in Your Baby
Bringing your baby home is one of the best feelings in the world—but it can also come with a lot of “is this normal?” moments.
As a labor and delivery nurse, I can tell you this: newborns do some weird things. A lot of them are completely normal… and some are not.
So let’s walk through a simple way to think about newborn red flags so you know when to trust your gut and get your baby checked out.
Activity: What’s Normal vs What’s Concerning
We’ve all seen the newborn scrunch—and honestly, put that on your list of videos to take because you will miss it when it’s gone.
Newborns are naturally curled up, with some tone in their arms and legs. That’s normal.
What’s not normal are the extremes.
If your baby is so tightly scrunched that it’s actually difficult to gently straighten their arms or legs, that can be concerning. On the flip side, if your baby feels very floppy, limp, or like they have little to no tension in their body, that’s also something that needs medical attention.
Sleep is another tricky one. Babies sleep a lot—sometimes 18 to 19 hours a day—but you should still be able to wake them for feeds. They should also be waking on their own every 2 to 4 hours to eat.
If your baby is very difficult to wake, not waking to feed, or doesn’t seem alert when they are awake, that’s something to pay attention to.
Breathing: What Should You Be Looking For
If you’ve found yourself watching your baby breathe… you’re not alone. I did the exact same thing.
Newborn breathing can look different from ours. It’s often faster and a bit irregular. While adults breathe around 12–20 times per minute, babies can breathe anywhere from 40–60 times per minute and still be completely normal.
But there are a few things that are not normal.
If your baby is consistently breathing faster than 60 breaths per minute, that’s a red flag.
It’s also important to watch the pattern. Newborns can pause between breaths, but if you notice a pause longer than about 10 seconds where you don’t see their chest rise or fall, that needs immediate attention.
You’ll also want to look at how hard your baby is working to breathe. Signs of increased effort include flaring nostrils, the skin between the ribs pulling inward, or visible pulling at the neck with each breath.
Babies can’t tell you they’re struggling to breathe—but their body will show you.
Color: What Changes Matter
Not all babies are pink—and they shouldn’t be expected to be.
Your baby’s normal color will generally reflect you and your partner. But there are certain color changes that are important to recognize.
A yellow tint to the skin or eyes can be a sign of jaundice. Some jaundice is normal in newborns, especially in the first few days of life, but more severe or spreading jaundice needs assessment.
Jaundice typically starts in the face and eyes, then moves downward toward the chest and legs. In babies with darker skin tones, it can be easier to see in the whites of the eyes, gums, palms, and nail beds.
On the other end of the spectrum, blue or pale coloring—especially around the lips, face, or chest—is a red flag and requires immediate medical attention.
There is one color change that often scares parents but is actually normal: blue or purple hands and feet. This is called acrocyanosis and is part of your baby adjusting to life outside the womb. The key difference is that it stays in the extremities and doesn’t involve the core of the body.
Hydration: What Diapers Can Tell You
One of the easiest ways to check if your baby is hydrated is by looking at their diapers.
Newborns should be peeing daily, and the number of wet diapers should increase as they get older. In the first few days, it typically follows a pattern—day one, one wet diaper; day two, two; and so on—until around day five, when you should consistently see at least five wet diapers per day.
The color of the urine matters too. It should gradually go from darker yellow to lighter, clearer yellow as hydration improves.
If your baby isn’t meeting these minimums, hasn’t peed in 24 hours, or their skin appears very tight and doesn’t bounce back when gently pinched, those are signs of possible dehydration.
A big one to remember: if your newborn hasn’t had a wet diaper in 12 hours, that needs immediate medical attention.
Expression and Movement: When Something Feels Off
This is where your intuition really matters.
If your baby is having unusual movements—like repetitive jerking that doesn’t stop when held, lip smacking, or unusual eye movements—those could be signs of a seizure.
If your baby is arching their back in a rigid way or holding their body in unusual positions, that’s also something that needs urgent assessment.
Crying is normal. Inconsolable crying that doesn’t improve and is paired with other symptoms—like fever, vomiting, or a firm belly—is not something to ignore.
If something feels off here, trust that feeling.
Fever: When to Take It Seriously
Fever in a newborn is always taken seriously.
A temperature of 37.5°C (99.5°F) or higher should be assessed by a medical provider.
Forehead thermometers aren’t the most reliable for newborns, especially under one month of age. The most accurate way to check temperature is rectally, though I know that can feel intimidating. If you’re unsure, ask your provider or your care team to show you before you leave the hospital.
The biggest takeaway here is this: any baby under 3 months old with a fever needs to be seen right away.
In my experience, babies can seem okay—and then decline quickly. It’s always better to have them assessed sooner rather than later.
A Simple Way to Remember It
If you’re in the thick of newborn life and everything feels overwhelming, having a simple framework can help.
Think your “ABC’s”:
Activity
Breathing
Color
Dehydration
Expression
Fever
This is a great mental checklist to run through when you’re trying to figure out if something is normal or not.
If You Want More Support Navigating Newborn Life
Honestly, this is just one small piece of the newborn puzzle.
A lot of new parents don’t just worry about red flags—they’re also wondering:
Is my baby eating enough?
Are they sleeping too much?
Why are they crying?
Am I doing this right?
If you want step-by-step guidance through those early weeks, my Newborn Care 101 course walks you through everything from feeding and diapering to sleep and normal newborn behavior—so you can feel confident instead of constantly second-guessing yourself.
Final Thoughts
Newborns don’t come with instructions—and it’s completely normal to question everything.
But here’s the thing: you don’t need to know everything. You just need to know when something doesn’t feel right.
If you’re ever unsure, I would always rather you get your baby checked out and it be nothing… than miss something that matters.
Save this, share it with expecting parents, and keep it handy—you never know when you might need it.
And as always… be happy, stay healthy, have fun 💛
