Lethargy in newborns: Is my baby sleepy or sick?

What is lethargy?

Lethargy happens when there is a change in your baby’s typical level of energy or consciousness. It’s not the same as simply being sleepy or drowsy. Lethargic babies may appear sleepy or drowsy, but may also: 

• Have low or no energy
• Be hard to wake
• Appear less alert
• Not be as aware of sounds and sights 

Babies can appear to be lethargic for many reasons since lethargy is a sign or symptoms of other conditions, such as low blood sugar or an infection.

Lethargy may progress over time and gradually, which can also make it hard to tell whether your baby is lethargic.

Is it normal for my newborn to be hard to wake?

Because newborns sleep so much, it can be hard to tell the difference between normal sleepiness and lethargy. Although babies sleep a lot, they should be alert when they are awake, and ready to look around, play, and feed well. A baby who is sleeping more than usual, feeding poorly, or is not alert or not responding well even while awake should be examined immediately. 

If you are concerned about your baby’s level of alertness, seek medical help immediately.

How can I tell if my newborn is sick?

Some babies become lethargic when they are ill. Newborns and young infants get sick easily since their immune systems take time to mature and develop. Below are several signs and symptoms that may indicate your baby is sick.

Changes in behavior

Other changes in behavior, aside from lethargy, can occur during illness. Your baby may be restless, irritable, colicky, or hard to soothe. If your baby does not normally behave this way, the change in behavior could signal they are uncomfortable or not feeling well.

Fever

Fever is a telltale sign that your baby’s body is trying to fight off an illness or germ. A fever is a positive sign that your baby’s immune system is doing its job, but depending on your baby’s age and their exact body temperature, different approaches to treatment may be recommended. 

If your newborn has a fever, you should always seek medical attention from your local pediatrician or text a Summer Health pediatrician for guidance. A fever in older infants can be managed with acetaminophen or, for infants older than 6 months, ibuprofen.

Vomiting

Vomiting can be a sign of a gastrointestinal issue, overheating, or another condition, and can result in dehydration. If your newborn vomits, they should be seen by a medical professional immediately. 

Changes in breathing

Babies may breathe more quickly when they are fighting off an infection since their bodies are working hard. 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 ribcage or above their collarbones
• A baby turning blue or purple
• Slowed breathing or prolonged pauses in breathing 
• Persistent coughing 

Seek medical attention immediately if you notice any of these symptoms.

Changes in appetite and dehydration

Babies may not feed well if they are sick. This can be challenging if your baby is under 6 months old — or isn’t eating solids yet — since poor appetite can also lead to dehydration for young babies. If your newborn or young infant is not feeding well or is not making as many wet diapers as usual, contact your local pediatrician or text a Summer Health pediatrician.

Cold symptoms, like cough and runny nose

Respiratory infections like the common cold can lead to symptoms like runny nose, stuffy nose, cough, and even fever. On average, children under 6 years old will have 6 to 8 colds every year and symptoms can last around 10 days. Contact a pediatrician or text a Summer Health pediatrician if your child’s symptoms worsen or if they:

• Have changes in their breathing, such as rapid, slow, or noisy breathing or pauses in their breathing
• Have a fever longer than 2-3 days
• Aren’t feeding or drinking fluids well
• Aren’t urinating as often as usual
• Are lethargic or less alert or playful than usual
• Are irritable and hard to soothe

When should I seek medical attention for a lethargic newborn?

Usually a lethargic newborn has other symptoms of illness. If your newborn is lethargic and also vomiting or showing other signs of illness, contact your local pediatrician or text a Summer Health pediatrician.