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Dr. Ann Kellams

Assistant Professor of Pediatrics, University of Virginia

Dr. Ann Lenox Kellams, assistant professor of clinical pediatrics in the Division of General Pediatrics and medical director of the newborn nursery at the University of Virginia Children’s Hospital, is an expert in newborn care and breastfeeding. Kellams teaches pediatric clinical skills to students and residents and authored the Newborn Nursery Resident and Student Curriculum and Orientation Manual for UVA Children’s Hospital. Kellams serves her surrounding community by being a mentor for the African American Student Mentorship Program, by serving on the Virginia Breastfeeding Advisory Committee and by hosting various community education workshops on newborn and infant care. She received the Outstanding Graduate Designation from her alma mater, the University of California, San Francisco School of Medicine.

What are some other warning signs I should look for regarding my baby?

Assistant Professor of Pediatrics Dr. Ann Kellams lists some baby health warning signs.

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Host: What are some other warning signs I should look for regarding my baby?

Dr. Ann Kellams: So the biggest things with babies and this is what we tell parents when they leave the hospital is if you have any questions or concerns about a newborn and you are just sitting there and you are looking at the baby and you are wondering is this okay, is this not, we recommend calling.

Babies can get sick very quickly and especially if you are a first time parent they can make a lot of funny sounds and twitches and things that are normal but don't take any chances. So with a newborn if you have questions, we want to hear about it. In particular, I am interested in if the baby had established a really good feeding pattern for breastfeeding every two to three hours at least, or bottle feeding every three to four and there is a change. The baby is not interested in eating or doesn't seem to be able to eat as much or is not waking up for feedings where they had been. Those are serious concerns.

Related to that, if there is a lot of, not spitting out, but vomiting particularly after every feeding or if the baby had been making X number of wet diapers and now is making less such that we think that it might be dehydrated. They will poop a lot and have a lot of bowel movements but if there is a change, if they have blood in them or there is twice as many as before or little hard pellets, that would be a reason to call the doctor and then think about the baby's color. We look right at the mouth but it is in tongue and those always should look nice and rosy pink. If there is any question of grey, blue, purple, we don't like that. That would be something to call for. Sometimes the hands and feet can look grey or purple and that's normal. That's called acrocynosis but right in the series, it should always be pink. If the baby were looking more yellow we worry about jaundice in infants and so a visible color change or more yellow or sometimes even an orangey look than the day before would be something to call the doctor about, fevers or a concern for low temperature. So anything, rectal temperature above about 100 we would like to hear about and if the baby overall just doesn't seem well, -- normally, when they are awake they are looking around and they are wiggling and when they are making all sorts of little noises and if that stops, if they are awake but they are laying there floppy like they don't feel good, that would be a concern. Crying inconsolably, if you have tried everything you can and it has been three hours and you cannot get him to stop crying, that would be a reason to call and breathing problems, I would throw in there too. So anything that's sustained either faster breathing or slower breathing or a concern that they stopped breathing would be absolutely something to call for.

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