Bringing your firstborn home from the hospital is a surreal moment. Sure you can argue that your baby has been riding in the car for months, just not on the back seat. Seeing them sitting in their car seat all buckled in for the very first time it really hits you. This little life you've been entrusted with is amazingly resilient yet very fragile at the same time. As a loving parent you want the best for your children and try as you may to keep them safe and healthy they'll inevitably get sick. Fortunately as your baby's immune system develops over time they'll become less susceptible to getting sick.

So how do you know when your baby is sick? Well it would be really convenient if you could just ask them point blank and they would respond. Unfortunately we're finding out that even 6 year olds can be rather hard to get a straight answer from. Since babies don't talk, shocking I know, you're going to have to deduce whether or not there's a problem without any spoken words. Don't think that determining if your baby is sick is entirely on your shoulders. As a parent you'll start to learn what's normal for your baby. If your baby deviates from their normal behavior that could be a sign that something out of the ordinary is going on.

The other more direct way you can tell is just by checking some of your baby's vitals, like the doctor does. This includes checking the baby's temperature, heartbeat and breathing rate. If by any chance you think your baby is experiencing a life threating issue don't hesitate to call the doctor immediately, get to a nearby ER or dial 911.

We've made a couple late night trips to the ER when our children had suspiciously high fevers and were unsure of the cause. In one case the fever was being caused by an ear infection and in the other case the fever was being caused by the early onset of bronchitis. Let's take a look at some of the signs your baby might be sending you to indicate they're sick.

Lethargic/Limp/Listless

If your baby is lethargic or listless it just means they have little or no energy. Babies exhibiting this often sleep longer than normal and may be difficult to wake up. They might also be less responsive to visual and audible stimulus. It's possible that this behavior is being caused by an infection or another condition like low blood glucose levels.

Irritable/Crying Inconsolably

Babies cry a lot. It's basically the only way for them to tell you that they aren't content with their current situation. Babies shouldn't cry all the time though. If your baby is very irritable or crying inconsolably it could be an indication that something is going on internally that's causing them discomfort.

Before you jump to any conclusions make sure the reason for their crying isn't something benign such as: being hungry, being tired, needing to be changed, needing to be burped, tightly fitting clothing or just needing to be held.

One commonly mentioned condition, colic, could also be the cause of your babies crying. There are several theories behind what causes this condition but we think we experienced the digestive variant. Our first born was primarily fed formula and it took several tries before we found one that worked with his digestive system. He experienced a great deal of abdominal discomfort and spit up a lot of formula that just didn't agree with him. This is a really hard thing to go through for both the baby and parents.

Refuse To Eat/Can't Eat

Most newborns need to eat every 2 to 3 hours. If your baby breaks their eating rhythm and either eats less or not at all that could be a sign that something isn't right. If your baby is having difficulty swallowing their food or is constantly spitting out that could also be a symptom of a deeper issue.

One thing you may need to try if you're bottle feeding is to adjust the flow rate of the nipple. This is done by swapping the nipple of the bottle with another one that has a smaller/larger opening. Most manufacturers will label their bottle nipples so you know what you have and what your purchasing. If your baby isn't eating it could be because the flow rate is too slow and you need to try a nipple with a larger flow rate. If your baby is spitting out more than they're eating it could be because the flow rate is too fast and you need to try a nipple with a slower flow rate.

Fever

If your baby has a fever it's a sign that they're fighting an infection of some kind. Most doctors consider a rectal temperature above 100.4 as qualifying as a fever. You might not be able to tell if your baby has a fever simply by feeling their skin so having a digital thermometer on hand that's dedicated to taking rectal temperatures is a must. Before using the thermometer make sure it's been sterilized and that you understand the manufacturers instructions for getting an accurate reading. Failure to follow the instructions could result in a bad reading.

Breathing Strained/Difficult

If your baby grunts while exhaling, bobs their head back and forth, or has blue lips it could be a sign that they're having a respiratory issue. Breathing is pretty important for us humans so you should take this sign very seriously. First make sure nothing the baby is wearing is impeding their ability to breathe. If there's nothing tight around their neck and nothing pressing on their chest it could mean there's an issue that warrants immediate attention. Call your baby's doctor immediately and let them know what's going on. If your doctor isn't reachable a trip to the ER or a call to 911 are two other options.

Slow/Fast Heartbeat

The average heartbeat rate for a baby is between 100-160 beats per minute (birth to 3 months of age). This is faster than adults because babies are growing so fast. Babies require a lot of oxygen rich blood to support all their growing and a fast heartbeat makes that possible. If your baby's heartbeat is well outside that range they could be dealing with arrhythmia. A slightly faster or slower heartbeat doesn't guarantee there's an issue so a call to your baby's doctor would be wise. A doctor will provide some other possibly symptoms and possibly order an EKG to be sure.

Head Swelling

If the soft spot on the top of your babies head, called the fontanel, is swelling it could be a symptom of brain tissue inflammation referred to as encephalitis. This inflammation could be caused by viral infections or in some cases bacterial infections. There are also a couple other potential causes for head swelling (hydrocephalus a.k.a water on the brain). Consult with your baby's doctor to try to identify the cause of the swelling.

Skin Rashes/Oozing/Bleeding

When you're bathing your baby be sure to look over their entire body to see if there's any signs of skin rashes, oozing or bleeding. It's fairly common for babies to get diaper rash which can be somewhat mitigated with diaper creams and powders. If you see anything that's persisting or found somewhere else on your baby's body it could be a symptom of something else rather than the root issue. Consult with your baby's doctor to try to identify the root cause of the issue.

Pale/Flush Complexion

Sometimes a cold or virus can cause your baby to look a little pale or flush. A less common cause may be anemia, or an iron deficiency that creates a reduction in oxygen-carrying red blood cells. Consult with your baby's doctor to try to identify any other symptoms that will help you determine the cause.

Vomiting/Diarrhea

It's normal for babies to spit up from time to time. The main reason this happens with babies is that the muscle that keeps food in the stomach is developing. It doesn't take much for food to bypass this muscle and come back up. In this situation there's nothing you need to contact your doctor about. Keeping your baby sitting upright and giving them plenty of time to burp might help reduce this from happening.

This issue can also appear as the result of a stomach bug, infection, or flu. If your seeing any other symptoms that might make you think your baby is ill (fever, irritable, etc) consult with your baby's doctor to try to determine if there's something more serious going on.

There are many causes for diarrhea as well including viral infections, bacterial infections or parasites. If your seeing any other symptoms that might make you think your baby is ill (fever, irritable, etc) consult with your baby's doctor to try to determine if there's something more serious going on. If the diarrhea persists your baby will begin to suffer from dehydration as well so don't wait to take action.

Even though your baby doesn't talk their little body provides lots of clues about how they're doing. When something out of the ordinary occurs or your little one just can't be made happy contact your baby's doctor for guidance. Your doctor will work with you to look for overlapping symptoms which will help pinpoint what's happening and what action you need to take. If your baby is experiencing a life threatening issue go directly to an ER or call 911.