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Warning-sign checks

Neonatal respiratory distress syndrome: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Breathing distress in a newborn is an emergency.

    In hospital, neonatal staff monitor the baby continuously.

    After leaving hospital, call emergency services if your baby:

    • Stops breathing or has repeated long pauses
    • Has blue or grey lips or tongue
    • Is struggling for each breath or has marked chest pulling
    • Is very difficult to wake, limp, or unresponsive
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Tell the bedside nurse immediately if you notice a new colour change, longer pauses in breathing, unusual limpness, or a sudden change in responsiveness, even if monitors have not sounded.

    Seek urgent medical assessment for worsening fast breathing, poor feeding, repeated vomiting, fewer wet nappies, unusual sleepiness, fever, or an unusually low temperature.

    Newborns can become unwell quickly, and these symptoms may have causes other than respiratory distress syndrome.

    Routine follow-up is different from urgent care.

    Keep scheduled neonatal, breathing, growth, eye, hearing, and developmental appointments.

  3. 3

    Does any of this apply?

    Book an appointment

    Contact the follow-up team between visits if feeding, growth, oxygen use, or breathing is changing gradually.

Every sign above is quoted from the sofidex article on Neonatal respiratory distress syndrome. If you are not sure, err upward — it is always reasonable to be checked.