Real Emergency or Newborn Glitch? How to Know When to Head to the ER (and When to Breathe Instead)

Jan 20

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You’re finally home with your new baby. You’ve survived labor, mastered the art of diaper changes at 3 a.m., and maybe even managed to drink a full cup of coffee before it went cold. Then suddenly, your baby makes a strange noise, turns a little red, flails their arms dramatically, and your heart leaps into your throat.

Do you call the pediatrician? Head to the ER? Or just sit there refreshing Google and hoping the answer magically appears?

If this sounds familiar, you’re not alone. Every new parent has that moment, the one where you wonder if you’re overreacting or missing something serious. And thanks to the internet, where 25% of parenting info on TikTok is flat-out wrong (yep, actual study), it’s no wonder you feel unsure.

In this week’s episode of Doula Talk: Postpartum, Babies, and the Battle for Sleep, I sat down with Dr. Kailey Buller, a double-board-certified physician in emergency and family medicine, and a mom of two, to talk about real emergencies versus newborn glitches. Together, we broke down what’s normal, what’s not, and how to trust yourself in those middle-of-the-night “is my baby okay?” moments.

The Truth About Newborns: They’re Weird. Beautifully Weird.

Let’s start here: newborns are tiny, miraculous, and utterly unpredictable creatures. They make grunting sounds that would impress a gremlin, sneeze five times in a row, and sometimes twitch like they’re rehearsing for a dance battle.

Most of these behaviors are completely normal.

What’s not normal is how little parents are told to expect it.

Dr. Buller explains that most newborn “symptoms” are simply their nervous systems learning to regulate. That dramatic shiver? A Moro reflex, an instinctive startle that helps protect them. That occasional gagging while learning to eat solids? Totally normal experimentation.

“Babies are just trying things out,” Dr. Buller says. “They’ll gag, flail, and sometimes even stick their whole hand in their mouth, just because they can.”

So before panic sets in, pause and observe. If the behavior comes and goes, or doesn’t follow a consistent pattern, it’s likely just part of your baby figuring out how to be human.

When to Worry: The Real Emergency Red Flags

Now, while most baby quirks are harmless, there are certain signs that absolutely do mean it’s time to head to the ER, no hesitation, no guilt trip.

Dr. Buller uses a “four-color triage system” in her book Surviving Tiny Humans, and here’s a simplified version for new parents:

Green Zone: Normal, No Worries

Occasional sneezing, hiccupping, or gagging
Twitchy legs or jerky arm movements during sleep
Temporary grunting or funny noises while breathing

Yellow Zone: Keep an Eye On It

Mild congestion or cough
Low-grade fever after vaccines
Changes in feeding or mood that resolve within 24 hours

Red Zone: Call Your Doctor or Urgent Care

Fever lasting more than five days
Breathing that looks harder than usual (extra belly or neck movement)
Fewer than six wet diapers in 24 hours

Black Zone: Go Straight to the ER

Any fever in a baby under 30 days old
Difficulty breathing or pauses in breathing
Unresponsiveness, extreme lethargy, or inconsolable crying
No wet diapers for more than 12 hours

Dr. Buller says it best: “If your gut says something’s wrong, that visit is justified, even if it turns out not to be an emergency.”

That’s the kind of grace we all need as new parents.

How to Build Confidence in the Middle of Chaos

Let’s be real, when your baby does something alarming at 2 a.m., calm, logical thinking isn’t always your first instinct. You’re tired, your hormones are roller-coastering, and your anxiety brain starts narrating worst-case scenarios.

So how do you find your footing again?

Step 1: Expect the panic: You’re going to second-guess yourself. That doesn’t mean you’re doing it wrong, it means you care. Take a deep breath and name what you’re feeling. (“I’m scared. I’m not sure what’s happening.”)

Step 2: Start with worst-case and work backward: Ask yourself, is my baby breathing normally? Are they responsive? Have they had wet diapers? Do they have a fever? If all those answers are okay, you probably have time to observe before rushing out the door.

Step 3: Trust your instincts, but check the facts: Parental intuition is powerful. But pair it with evidence. Knowing what’s actually dangerous helps you feel grounded instead of overwhelmed.

And remember, even medical professionals panic as parents. Dr. Buller shared a story about rushing her own daughter to the ER, convinced she was in danger, only to learn her baby had just puked and didn’t want to swallow it. “Even though I knew better, I was mom first, doctor second,” she admitted.

That, my friends, is proof that instincts and anxiety can coexist, and both are valid.

Advocating for Yourself in the ER

If you ever do end up in the emergency room, you deserve to be taken seriously. Unfortunately, many parents (especially moms) leave feeling brushed off or unheard.

Here’s Dr. Buller’s advice:

Ask questions. “If you don’t think it’s serious, when should I worry? What should I watch for?”
Be specific. Mention what’s different about your baby’s usual behavior. (“She’s never this quiet,” or “He’s refusing all feeds.”)
Stay calm but firm. You don’t need to prove your fear is valid, just explain what’s happening.

And yes, pack snacks. Whether your baby’s sick or not, the ER is an endurance sport.

You’re Not Supposed to Be the Expert in Everything

Modern parents are under impossible pressure. We’re told to be our child’s nutritionist, therapist, pediatrician, and sleep consultant all rolled into one.

But as Dr. Buller reminded us, “You’re not supposed to be the expert in everything, you’re just supposed to be the expert in your baby.”

That means you don’t have to memorize every rash or medical term. You just have to notice when something feels different and trust yourself enough to ask for help.

If you take nothing else from this episode, take this: your concern is always valid. Whether it ends with reassurance, a treatment plan, or just a good night’s sleep, you’re doing your job.

The Bottom Line

Parenthood is a constant dance between trusting your instincts and learning new information. Some nights you’ll overreact. Some nights you’ll nail it. All of it is part of becoming the expert in your baby.

So when your little one makes their next dramatic grunt or flails like they’re doing interpretive dance, take a breath and remember: babies are weird, and that’s okay.

And if you’re ever unsure? It’s always better to check than to wonder.

Resources and Support

You can find Dr. Kailey Buller on Instagram at @vitalswithdrbuller and grab her book Surviving Tiny Humans anywhere books are sold.

And if you’re craving more calm and confidence in your baby’s first year, check out my Rooted Rest Sleep Course or the First Year Support Program, designed to help you understand your baby’s rhythms, regulate your nervous system, and get real, sustainable rest.

You don’t have to do this alone. You’re already doing an amazing job.

Podcast Guest:

Dr. Kailey Buller, Author
Vitals with Doctor Buller

Dr. Kailey Buller is a double board-certified physician in emergency and family medicine who has delivered hundreds of babies (and raised two of her own). Dr. Buller combines her medical expertise with her lived experience to provide practical, evidence-based postpartum and newborn care for new parents. Her mission is to help new parents cut

through the noise, ditch the guilt, and survive the first year with their sanity (mostly) intact.

In her book, Surviving Tiny Humans, she brings the calm, practical advice of a doctor with the unfiltered honesty of a parent who's been there — through sleepless nights, mystery rashes, and 3 a.m. Googling of "is this normal?"

When she's not soothing the emotional toll of a broken banana or stitching up ER patients, Dr. Buller teaches postpartum classes, busts parenting myths online, and fiercely believes that telling parents the truth (with compassion and a bit of humour) is the most helpful thing of all.