by Audrey Paul, MD, PhD, FACEP , Karen Goodman, MD, and Catherine Verow, MS, CCLS

Normal temperature in a newborn generally ranges from 97ºF to 100.3ºF (36ºC – 38ºC). Any number above or below these temperature ranges can be cause of concern. A fever is defined as a temperature greater than or equal to 100.4º. A “cold” baby (“hypothermic” in medical speak) has a temperature below 97ºF.

If you suspect your baby has a fever, or low body temp, your baby’s temperature should be carefully taken with a rectal thermometer. Rectal thermometers are more accurate than underarm or ear thermometers.

Note: If you do not possess a thermometer and your baby feels very warm, it is best to err on the side of caution and assume your baby is febrile. Call your pediatrician and follow their directions for a febrile/sick newborn.

You should always call your pediatrician when you think your baby is too warm or too cold. Febrile newborns should receive immediate medical attention.

Do not to give your newborn acetaminophen (Tylenol®) until your baby has been evaluated.

Conclusion: If your newborn does not have a fever, and does not appear to be in immediate distress, but something still does not feel right to you, trust your instincts! Call your pediatrician. An ER visit may or may not be necessary, or your pediatrician may recommend that you go to a pediatric ER. When speaking to your pediatrician, ask if your ER is staffed with pediatric emergency medicine physicians 24/7, since pediatric emergency physicians are often more comfortable managing pediatric emergencies especially in newborns.

Ultimately, you are your baby’s best advocate, and you know your baby best. If you have any questions trust your instincts and always call your pediatrician. In an emergency, if you do go directly to the ER, you should contact your pediatrician. Your pediatrician can be helpful not only medically (by providing information to the hospital staff) but also emotionally. Your doctor knows you and your baby and can help you deal with a stressful situation.

Remember, newborns show symptoms and signs of illness differently than older children, so staying attuned of and being aware of the best expertise and being prepared for the places to go for any potential newborn emergency can be life saving!

The preceding information is intended to empower and inform your decisions. Its development was funded in part of a generous grant from R Baby Foundation. The R Baby Foundation seeks to save the lives of newborn babies by educating parents, supporting research, and providing emergency room equipment and training to medical professionals.