Newborn Lethargy: What's Normal And What's Not?

Lethargy is a known sign of illness in newborns and young children. It is characterised by a change in a baby's typical level of energy or consciousness, and may manifest as low or no energy, a lack of awareness of sounds and sights, or difficulty waking up. While newborns sleep a lot, they should be alert when they are awake, ready to play, feed, and look around. If your newborn is sleeping more than usual, feeding poorly, or is not alert or responding well, even when awake, you should seek immediate medical attention.

Lethargy as a sign of illness

Lethargy is a known sign of illness in newborns and young children. It is characterised by a change in your baby's typical level of energy or consciousness. Lethargic babies may appear sleepy or drowsy, but they may also have low or no energy and be less aware of their surroundings.

Lethargy may be a sign of infection or other conditions such as low blood sugar. It can be challenging to identify lethargy in newborns as it may progress gradually over time. Newborns sleep a lot, but they should be alert when they are awake, ready to look around, play, and feed well. If your newborn is sleeping more than usual, feeding poorly, or is not alert or responding well, even while awake, seek medical attention immediately.

Other signs that your newborn may be unwell include restlessness, irritability, colic, or difficulty being soothed. Fever is also a telltale sign that your baby is fighting off an illness or germ. If your newborn has a fever, seek medical attention from your local pediatrician. Vomiting, changes in breathing and appetite, dehydration, and cold symptoms like a cough and runny nose may also indicate illness.

If your newborn is lethargic and exhibiting other symptoms of illness, such as vomiting, contact your local pediatrician or a medical professional immediately.

Signs of lethargy

Lethargy is a known sign of illness in newborns and young children. It is characterised by a change in your baby's typical level of energy or consciousness. Lethargic babies may appear sleepy or drowsy, but they may also have low or no energy, and not be as aware of sounds and sights.

• Low energy — Lethargic babies may appear sleepy or drowsy, and may sleep longer than normal. They may be difficult to wake for feedings.
• Lack of alertness — When awake, lethargic babies may not be alert or responsive. They may not pay attention to visual stimulation or sounds.
• Gradual progression — Lethargy may progress gradually over time, making it hard to tell if your baby is lethargic. Parents may not notice the gradual change.
• Other behavioural changes — Aside from lethargy, other changes in behaviour can occur during illness. Your baby may be restless, irritable, colicky, or hard to soothe. If your baby does not normally behave this way, this could signal that they are uncomfortable or unwell.
• Fever — Fever is a sign that your baby's body is fighting an infection. In newborn babies and young infants under three months of age, fever may be the first and only sign of a serious infection.
• Vomiting — Vomiting can be a sign of a gastrointestinal issue, overheating, or another condition, and can lead to dehydration.
• Changes in breathing — Babies may breathe more quickly when fighting an infection. Signs of emergency breathing patterns include rapid breathing (over 60 breaths in 1 minute), widened nostrils, a chest that pulls in around the ribcage or above the collarbones, and discolouration of the skin.
• Changes in appetite and dehydration — Sick babies may not feed well, which can lead to dehydration in young babies. Look out for a lack of wet diapers, which may indicate dehydration.
• Cold symptoms — Respiratory infections like the common cold can lead to symptoms such as a runny nose, stuffy nose, cough, and fever.

If you notice any of these signs of lethargy in your newborn, seek medical attention immediately.

How to tell if your newborn is sick

It can be difficult to tell if your newborn is sick, especially sincesection babies sleep a lot. However, there are some signs you can look out for that may indicate your newborn is unwell.

Lethargy

Lethargy is a known sign of illness in newborns. It is characterised by a change in your baby's typical level of energy or consciousness. Lethargic babies may sleep longer than usual, feed poorly, and be less alert and responsive than normal. They may also have low or no energy and be less aware of their surroundings.

Fever

A fever is usually a sign that your baby's body is fighting an infection. In newborns and young infants under three months of age, a fever may be the only sign of a serious infection. If you notice a temperature of 38°C (100.4°F) or above, seek medical attention immediately.

Vomiting and Diarrhea

Forceful or projectile vomiting, or spitting up large amounts of milk after feedings, can indicate a problem. It may be a sign of a gastrointestinal issue, overheating, or another condition, and can lead to dehydration. Diarrhea may also be a sign of a viral or bacterial intestinal infection, an obstruction, or another problem.

Changes in Breathing

Changes in breathing patterns can be a sign of illness in newborns. Rapid breathing (over 60 breaths in one minute), widening or flaring nostrils, a baby's chest pulling in around their ribcage or above their collarbones, turning blue or purple, and slowed breathing or prolonged pauses may be signs of an emergency.

Changes in Behaviour

Aside from lethargy, other changes in behaviour can occur when your baby is ill. Your baby may be restless, irritable, colicky, or hard to soothe. If your baby is usually calm and content, a sudden change in behaviour could signal that they are uncomfortable or unwell.

Weight Loss and Dehydration

Weight loss and dehydration can be dangerous for newborns. Weight loss of more than 10% of their birth weight in the first few days after birth or a lack of weight gain after 10-14 days may be a sign of illness. Dehydration can occur due to poor feeding or diarrhea and can be identified by signs such as a decrease in the number of wet diapers.

If you notice any of these signs, it is important to seek medical advice from your healthcare provider or local pediatrician.

When to seek medical attention

Lethargy is a known sign of illness in newborns and young children. It occurs when there is a change in your baby's typical level of energy or consciousness. It is distinct from sleepiness or drowsiness.

If your newborn is lethargic, you should seek medical attention immediately. Lethargy may be a sign of infection or other conditions such as low blood sugar. Usually, a lethargic newborn will exhibit other symptoms of illness, such as vomiting.

• Fever: In newborn babies and young infants three months of age or younger, fever may be the first and only sign of a serious infection. A normal temperature is less than 38°C (100.4°F). If your newborn's temperature is slightly above the normal range, seek medical attention right away.
• Changes in behaviour: Fussiness, irritability, and decreased energy can be signs of illness. If your baby becomes very sleepy, fussy, or listless, it may be time to seek medical attention. Fussiness may be a sign of gas, abdominal pain, an earache, or a viral or bacterial infection.
• Persistent crying: If your baby is continuously fretful and fussy, crying for long periods, or has a cry that sounds unusual, it may indicate illness or pain.
• Changes in appetite and dehydration: If your newborn is not feeding well or producing as many wet diapers as usual, contact a healthcare provider. Poor appetite can lead to dehydration in young babies.
• Cold symptoms: Respiratory infections like the common cold can lead to symptoms such as a runny nose, stuffy nose, cough, and fever. Contact a healthcare provider if your child's symptoms worsen or if they have changes in breathing, prolonged fever, decreased feeding or drinking, reduced urination, lethargy, or irritability.
• Vomiting: Forceful or projectile vomiting, or spitting up large amounts of milk after most feedings, can indicate a problem. Discoloured or green-tinged vomit may signal an intestinal obstruction.
• Diarrhea: This could signal a viral or bacterial intestinal infection, an obstruction, or another problem. Persistent diarrhea can lead to dehydration.
• Weight loss: Lack of weight gain or continued weight loss in a newborn may be a sign of illness or other conditions. Signs to look for include a thin, drawn face, loose skin, and a decreased number of wet or soiled diapers.
• Breathing difficulties: Any of the following breathing patterns may be signs of emergency: rapid breathing (over 60 breaths in 1 minute), nostrils widening or flaring when breathing in, a baby's chest pulling in around their rib cage or above their collarbones, a baby turning blue or purple, slowed breathing, or prolonged pauses in breathing.

Remember, if you are concerned about your newborn's lethargy or other symptoms, don't hesitate to seek medical attention.

Other signs of illness

Lethargy is often a sign of illness in newborns, and it is important to be vigilant for other symptoms that could indicate an underlying health issue.

• Fever: A fever is usually a sign that your newborn's body is fighting an infection. In newborns and young infants under three months of age, fever may be the only sign of a serious infection. If your newborn has a fever, seek medical attention immediately.
• Refusal to feed: Newborns are usually ready to eat every 2 to 4 hours after the first day of birth. If your baby refuses to eat or misses several feedings, this could be a sign of illness.
• Projectile vomiting: Spitting up and dribbling milk after feedings is common in newborns due to an immature sphincter muscle. However, forceful vomiting or spitting up large amounts of milk after most feedings can indicate a problem.
• Dehydration: Poor feeding and dehydration often go hand in hand. If your newborn is not producing enough wet diapers, it could be a sign of dehydration.
• Changes in breathing: Rapid breathing, widened nostrils, a chest that pulls in around the rib cage, and blue or purple skin are all signs of breathing difficulties. These could indicate a respiratory infection and require immediate medical attention.
• Diarrhea: Diarrhea could signal a viral or bacterial intestinal infection, an obstruction, or another problem. It can also lead to dehydration, so it is important to monitor your newborn closely and seek medical advice if diarrhea persists.
• Weight loss: Newborns typically lose about 10% of their birth weight in the first 2 to 3 days, but they should regain this weight within 10 to 14 days. Lack of weight gain or continued weight loss could be a sign of illness.
• Umbilical cord infection: If you notice pus or redness around the umbilical cord stump, or detect an unpleasant smell, it could be infected. Discuss this with your healthcare provider.
• Convulsions (seizures): Febrile seizures can be triggered by fever in children between 6 months and 5 years of age. While usually harmless, it is important to inform your child's doctor if this occurs.
• Purple splotches on the skin: These could be a sign of a serious bloodstream infection.
• Swelling of the soft spot on the head: If the soft spot on your newborn's head is tense and bulging, it could indicate increased pressure on the brain.
• Constant crying: While all babies cry, inconsolable crying could be a sign of pain or illness. If your baby is crying for longer than usual or displays other signs of distress, seek medical advice.

Frequently asked questions