New Parent Alert: Early Oral Care and Red Flag Signs

Being a new parent comes with so many questions. One that might surprise you is about your baby’s oral care. Did you know you should be cleaning your newborn’s mouth even before their first tooth appears? It’s true! Along with knowing what warning signs to watch for, this simple routine can help keep your little one healthy from day one.

At Legacy Community Health, we know those first few weeks with your newborn can feel overwhelming. That’s why we want to share some essential care tips and help you recognize when it’s time to call your health care provider.

Why Clean Your Baby’s Mouth Before Teeth Arrive?

You might be thinking, “Why clean a mouth with no teeth?” Here’s the thing – bacteria can still build up in your baby’s mouth, and leftover milk from feeding can create the perfect environment for problems like thrush (those white patches you sometimes see in babies’ mouths).

Starting oral care early does more than prevent issues. It helps your baby get used to having their mouth cleaned, making tooth brushing much easier when those first teeth pop up around six months. Plus, it gives you a chance to check your baby’s mouth regularly for any changes.

The process is simple: wrap a clean, damp washcloth or gauze around your finger and gently wipe your baby’s gums, tongue, and inside of their cheeks after feedings. No scrubbing needed, just a gentle cleaning to remove milk residue and bacteria. Many parents make this part of their feeding routine, cleaning baby’s mouth before putting them down for a nap.

Common Oral Care Mistakes to Avoid

Dr. Muhammad Aly, a pediatrician at Legacy Community Health, sees new parents making similar mistakes when it comes to newborn oral care.

“Some of the most common mistakes regarding newborn oral care include not wiping gums after feeds, using honey or sugary substances on a pacifier, not cleaning the pacifier properly before use, like using your mouth to clean the pacifier, and not properly cleaning or sterilizing bottles,” he explains.

The takeaway? Establish good hygiene habits from the start. Always wipe those gums after feeding, keep pacifiers clean with proper sterilization, and never add honey or sugar to pacifiers, which can introduce harmful bacteria and increase cavity risk once teeth arrive.

Warning Signs That Need Immediate Attention

Every new parent worries about what’s normal and what isn’t. While your baby is adjusting to life outside the womb and many changes are perfectly normal, some signs should never be ignored.

• Breathing concerns are the most serious. Call your doctor immediately if you notice irregular breathing, persistent grunting, or bluish coloring around your baby’s lips or skin. If you see your baby’s ribs pulling in with each breath or their nostrils flaring while breathing, these could signal respiratory distress (NIH).
• Temperature issues are critical too. Newborns should have a rectal temperature between 97.5°F and 100.3°F. A fever of 100.4°F or higher, or a temperature below 97.5°F, means it’s time to call your health care provider right away. Dr. Aly emphasizes that “all fevers in infants less than 28 days old warrant further medical evaluation.”
• Feeding and bathroom patterns also matter. If your baby hasn’t urinated in a long time (tough to tell with disposable diapers, we know!) or hasn’t had a bowel movement in 48 hours, give your doctor a call. Dr. Aly notes that changes warranting immediate attention include “abrupt decrease in feeding, no wet diapers for over 24 hours, and unexplained sleepiness or lethargy.” Same goes for persistent vomiting, especially if it’s yellow or green, or if your baby seems too sleepy to feed properly.

What Parents Often Miss

According to Dr. Aly, there’s one warning sign that parents frequently overlook: reduced feeding volume. “This is because it can be especially difficult to be aware of the feeding volume in breastfed infants,” he explains. “Breastfeeding is also dependent on the quality of the latch, mother milk production, and environmental factors. This can make it challenging to know if baby is getting a consistent amount per feed.”

If you notice a decrease in the time or frequency of breastfeeding, it’s worth getting your baby weighed and evaluated to ensure they’re getting adequate nutrition.

Physical Changes to Keep an Eye On

Your baby will change so much in those first weeks. Most changes are totally normal, but some need medical attention.

Dr. Aly helps parents distinguish between normal variations and concerning changes: “There can often be variations in things like stool color or consistency, rashes, and nasal congestion that are often normal in newborns.” The key is knowing which changes cross the line into needing medical attention.

• Jaundice, that yellowish tint to the skin, is common in newborns but should be watched carefully. If you notice yellowing spreading beyond your baby’s face to their chest, arms, or legs, contact your health care provider.
• The umbilical cord area needs attention, too. Some drainage is normal as it heals, but watch for signs of infection like persistent redness, swelling, bad-smelling discharge, or bleeding.
• Changes in your baby’s behavior can also signal problems. While all newborns cry, inconsolable crying that doesn’t respond to your usual comfort tricks, extreme sleepiness, or signs of illness like persistent coughing or unusually pale skin should be checked out.

Don’t Forget About Mom: Postpartum Warning Signs

While you’re focused on your baby’s health, don’t forget to check in with yourself too. Your body just accomplished something incredible, and it’s still recovering. Some changes after birth are completely normal, but others need immediate medical attention.

Call your health care provider right away if you’re experiencing heavy bleeding (more than your usual period), a fever above 100.4°F, severe headaches that won’t go away, or vision changes. Watch for signs of infection, especially around C-section or episiotomy sites, like discharge, pain, or redness that’s getting worse instead of better.

Other serious warning signs include chest pain, trouble breathing, leg pain or swelling (particularly in your calves), or red streaks and painful lumps in your breasts. If you experience uncontrolled bleeding, signs of shock, or feel like something’s really wrong, don’t wait – call 911 (March of Dimes).

Trust Your Parent Instincts

Here’s the bottom line: you know your baby better than anyone. If something feels off, don’t hesitate to call.

Worried you might be overreacting? Dr. Aly wants you to know that’s actually a good sign. “It is important to reassure parents that ‘overreacting’ is simply a sign that the parent cares for the health of their baby,” he says. “The best way to respond to a potential warning sign is to access a medical provider to evaluate the baby. It is much better to have the baby evaluated and know that they are healthy than to wonder and wait with the possibility of worsening the condition of the baby.”

Building Confidence in Those First Weeks

Dr. Aly acknowledges what every new parent feels: “The most important thing is to understand that it is supposed to be challenging in the first weeks. Not only are parents adjusting to a new life in the home, but mother is going through hormonal and physical changes in addition to lack of sleep and other stressors.”

His advice? Build a support system. Make sure someone can help take care of the baby when Mom needs to rest. “Although it is difficult, Mom should always take a few hours to rest and take care of her health because her health will correlate with the health of the baby,” he emphasizes.

Dr. Aly also encourages parents to lean on their community: “It takes time to build confidence, especially with the first child. I encourage first-time parents to discuss any questions with medical providers during their visits, but it can also be helpful to have these discussions with friends or family members who have children and evaluate their experiences.”

Legacy Community Health offers comprehensive pediatric services. For urgent care, visit our walk-in clinic at Legacy Southwest Pediatrics, located at 6441 High Star Drive.

Becoming a parent is a huge learning curve, but with the right information and support, you’ve got this. Those early oral care routines and staying alert to warning signs will help you confidently navigate your baby’s first months.

Information about newborn warning signs is adapted from guidance by the March of Dimes and the National Institutes of Health (NIH).

For more information about our pediatric services or to schedule an appointment, call us at (832) 548-5000.