When Molly brought her 2-month-old daughter, Kara, to see me one morning, one look told me something was wrong. I’d known Molly since the birth of her son, Kevin, about three years ago, and she is usually fairly relaxed and cheerful, even with a crying baby in tow. But this day her face was drawn, and her eyes looked worried.
The first line of the nurse’s brief note read, “Fussy, not eating well, no vomiting,” so I asked about the fussiness. Molly said Kara had been very fussy, but only for the past day. Evaluating fussiness in a baby can be tricky. It can signify a cold, an ear infection, or even meningitis. I quickly reviewed Kara’s short medical history: She had been a healthy full-term baby, and she had been doing well. But a couple of days ago, something changed. Molly said that even though Kara seemed hungry, she would only take a few swallows from her bottle and then stop, as if she were out of breath.
