47 - Real Emergency or Newborn Glitch? How to Know When to Head to the ER (and When to Breathe Instead) with Dr. Kailey Buller

Ever wondered if your baby’s weird noises, twitchy movements, or late-night fussing are totally normal—or something to panic about? In this week’s episode of Doula Talk: Postpartum, Babies, and the Battle for Sleep, Deb is joined by Dr. Kailey Buller, a double board-certified physician in family and emergency medicine (and mom of two), to demystify what’s normal, what’s not, and when it’s time to head to the ER.

Together, they unpack the confusing world of newborn behaviors like those gremlin grunts, gagging fits, and twitchy limbs, and walk you through the real red flags that every new parent should know. You’ll learn how to spot signs of true emergencies, build confidence in your instincts, and approach those “is my baby okay?” moments with calm instead of chaos.

If you’ve ever found yourself googling “newborn breathing normal or not” at 2 a.m., this episode is your permission slip to step away from the panic spiral and tune into what’s really going on.

Key Takeaways:

• Most middle-of-the-night worries are not emergencies—babies are just weird little humans learning how their bodies work.
• True emergencies include fever in a baby under 30 days, trouble breathing, dehydration (no wet diaper for 12+ hours), or unresponsiveness.
• If your gut says something’s wrong, that visit is justified—even if it’s not urgent.
• You’re not supposed to be the expert in everything. You’re supposed to be the expert in your baby.
• Trust your instincts. You know your baby best.

Resources Mentioned:

• Surviving Tiny Humans by Dr. Kailey Buller https://www.vitalswithdrbuller.com/ 
• Doula Deb’s Rooted Rest Sleep Course — A gentle, evidence-based guide to building healthy sleep foundations without sacrificing connection.
• The First Year Support Program — Ongoing guidance for families navigating the ups and downs of the first year.

Or click here to learn more about how I can support you at www.douladeb.com!

Transcript

Deb (00:50)
Hey friends, welcome back to Doula Talk, postpartum babies and the battle for sleep. I'm your host Deb, And today we are diving into one of those topics

that every new parent wonders about at 2 a.m. You know that moment. Babies make a weird noise. They flare an arm. They turn a funny color for like half a second. And suddenly you're on Google searching newborn breathing normal or not. And yeah, I've been there several times with both kids. So how do you actually know when something is an emergency and when your baby is just doing their normal gremlin impression? Well, today I am joined by

Dr. Kaylee Buller and she is a double board certified physician in both emergency and family medicine. And she's a mom who's been right there where you are. We're talking about real emergencies versus newborn glitches. What's normal, what's not, and how to trust yourself even when your anxiety is doing backflips. So go grab your coffee. It's probably cold but it's totally fine.

pause this, go get it warmed up or grab a new one. And let's get into it.

Deb (02:01)
welcome to the show. I'm so excited for you to be here. Why don't you go ahead and introduce yourself and let us know how you got here and what you're passionate about and then we'll dive in.

Kailey Buller (02:13)
Absolutely. I'm Dr. Kaylee Buller. I am a family physician by training. And the cool thing about family medicine is that you can realistically sub-specialize in just about anything. So my interests are in labor and delivery and in emergency medicine, which is actually all I do now. I just deliver babies and I work in the ER. And I think probably what's important for your listeners to know is that I am considered a

highly trained medical professional in the areas of prenatal and postpartum care, newborn care, routine visits, development, and critical care. And all of this did not help as much as you might think it would when I had my first child. And I know, I think actually you said something similar in one of your previous episodes that, you know, despite experience being a doula, I mean, it's...

Deb (02:57)
Yeah, I hear you.

Yeah. Yep.

Kailey Buller (03:09)
It's different when it's Right?

Deb (03:10)
It's so different. It's so different. My

husband often commented that my doula brain and my mom brain didn't connect and that he had to make it a different perspective. Like, what would you tell a client if we were having this problem? And I was like, blah, blah, blah, And he's like, should we do that then? I'm like, hmm, maybe. Yeah. Yeah. Yeah.

Kailey Buller (03:24)
Right? Absolutely. Yes. You second everything because you're not sure. And

I remember thinking, you know, if I have, gosh, 15 plus years of training and experience and I found this to be so overwhelming, how the hell does anyone else do it? Like, like,

Deb (03:44)
Mm-hmm.

Right, yes, so true.

Kailey Buller (03:51)
honestly, like these mothers out there, parents, but mostly mothers, well, first of all, you're bringing life into the world, you're a goddess, but they're figuring it out. And I just find that honestly is so amazing. But there was also so much that they just did not teach in medical school that I had to learn through trial and error as a mother. And now having both, I really wanted to fill that void, right? Like we do such a good job of prenatal care. We've got prenatal classes, we've got Lamaze. And then...

Deb (03:54)
Mm-hmm.

Right?

Yeah.

Mm-hmm.

Yeah. Right.

Kailey Buller (04:19)
We just, I don't know, pat ourselves on the back and say, good job, healthcare system, we're done. And then there's nothing. Right? So I wanted to put together classes similar to prenatal classes, but they would cover from the day baby's born through the first year. And I was like, okay, it's gonna be the same as prenatal classes. I'm gonna do weekly for four weeks. I'm gonna cover these 12 topics. So we'll do three every week.

Deb (04:23)
Right. Yeah. Don't let the door hit ya on the way out.

Hmm.

Kailey Buller (04:44)
And then I started writing down all the things I wanted to tell everybody and I just didn't stop writing for about a month. And yeah, and I turned it into a book. So it's called Surviving Tiny Humans and I teach the Surviving Tiny Humans classes. And it's not, you know, this sort of boring medical super specialized. It's what kind of car seat do I need? And when should I switch from rear-facing to forward-facing? What's the difference between baby lead weaning and purees and which one's better? And what do I need to know when I'm starting solids?

Deb (04:50)
Amazing. my gosh. ⁓

Great.

Great.

Kailey Buller (05:14)
These are not things that anyone teaches anybody else.

Deb (05:18)
Other than Instagram. You know, and then you don't know is this one random person, you know, is this accurate information and then it just goes down this rabbit hole and then pretty soon you're spinning. You're like, I have no idea.

Kailey Buller (05:20)
Right.

Absolutely. Well, and what's

so terrifying is that there was a study done and 25 % of what you hear on TikTok is not just controversial but wrong and of the millions, like millions of accounts that are so, you know, quote unquote, parenting experts, less than 1 % of those accounts are actual experts. Dula's midwives.

Deb (05:45)
Right. Inaccurate.

Right, they've been trained

and like, yeah, right. Yeah.

Kailey Buller (06:01)
Alright, the rest are moms who probably have a ton

of valuable experience, but you don't know.

Deb (06:06)
Well, they know their experience, right? Which is valuable, and I think there's something to be said about wise women in our community and using that resource. But it's so different than looking at the data and Yeah.

Kailey Buller (06:08)
exactly.

I think one

of my favorite arguments is, well, we didn't use seat belts and we survived. And I'm like, well, yeah, because the people who didn't turned around to tell us otherwise, you know? yeah.

Deb (06:26)
Right? So true!

Kailey Buller (06:28)
So, yes, I have this book. It is something that I am very passionate about, I answer these questions that are in this book every single day. Like, everyone has these questions. I think it's super important to get this information out there.

Deb (06:41)
It's so true. There's so many things that us doulas in their home are fielding on a daily basis that ⁓ a lot of, if they don't have doulas or they don't have a trusted source, they're going to the pediatrician with these questions. And if they're so common, we should just have that resource. So that's wonderful. ⁓ So you've worked both in emergency and family medicine and then raised two kids of your own. So how has that shaped the way you help parents navigate what's truly an emergency?

versus like what's normal behavior.

Kailey Buller (07:12)
Yeah, I actually, no, I think this, no, it's a great question. I laugh, I laugh because it's so true. I mean, there's something that's completely normal and sometimes it can be mixed up for an emergency, which is because babies are weird. Like, they do, they do bizarre things. Most of which, honestly, I don't think I knew as a physician and I learned more as a mom. And I think my favorite example of...

Deb (07:12)
That's a big question, sorry. ⁓

Yeah, so easily.

Totally. Yeah.

Kailey Buller (07:39)
is when babies are first running solids and they gag and they discover this gag reflex that they have and they're thinking, oh, what is this new fun thing that my body can do? And then they shove that whole hand in there and they start making themselves gag. Right? On purpose. Like, stop! What? you, absolutely, you have to wonder what's going on. And that's, they're just learning. They're just experimenting.

Deb (07:43)
Mmm, yes. Yeah.

Yeah. Yes. On purpose. You're like, what are you doing?

You're freaking me out, yeah. ⁓

they're learning.

Kailey Buller (08:09)
Right?

Deb (08:09)
Yeah.

Kailey Buller (08:09)
Or they make these little gremlin noises when they're sleeping. Babies are noisy sleepers and oftentimes that's normal. ⁓ So I think having been through the experience of knowing what's abnormal and then learning all the things that actually are normal, it's easier for me to sort of give a semblance of a guideline or structure to parents. ⁓ And of course there's nothing in medicine, certainly nothing in parenting that is universally true, but...

Deb (08:13)
Mm-hmm.

For sure.

Kailey Buller (08:40)
Absolutely.

Deb (08:39)
It's an of the

Kailey Buller (08:41)
But some things, like if it's inconsistent, it's probably normal. If it's not a pattern, it's probably normal. So if they're making gremlin noises and they take this big breath in, but then they're fine, that's probably normal. But if they're making that noise when they're breathing over and over, then maybe they're having trouble breathing and that's an emergency.

Deb (08:47)
Mm-hmm. Yeah.

Right. Yeah.

Mm-hmm. Yeah.

Right. that's a really key thing that with sleep, I get a lot of questions about that of like, my gosh, it was a horrible night. What do you think we should do? I'm like, well, they're human. So they had a bad night. You know, so let's see if there's a pattern. Let's see if there's something like going on. And I mean, so many things could have been going on. They had a itchy sock or whatever, but they were cold that night. So let's wait for the pattern to see if there's really like something to actually fix, quote, unquote.

Kailey Buller (09:34)
Absolutely. Right? Yes, absolutely.

Deb (09:34)
Yeah, yeah.

So what would be some of the most common reasons new parents end up in the ER? And how often do you feel like this probably was not an emergency?

Kailey Buller (09:48)
Good question. ⁓ Most commonly, colds and rashes. It's always colds and rashes. And don't get me wrong, there are so many rashes. Like, so many. And I think off the top of my head, my gosh, I could think of probably six or eight that are completely normal and you have to do nothing about. But you don't know that.

Deb (09:53)
Mmm.

Yeah, so many.

Right. And we can't distinguish

that from a serious thing. Yeah.

Kailey Buller (10:12)
Right, right, so

I see a lot of that. ⁓ Before I answer the next part, which is how often it's not a true emergency, because I'm going to sound like a judgmental ass, ⁓ is there's a difference between it not being a true emergency and whether or not that visit was justified.

Deb (10:22)
Hahaha!

True, that is a really good distinction. I love that, yeah.

Kailey Buller (10:31)
right?

So like 99 % of the time I'd say that the visit was justified because parents don't know and they're not expected to know, right? So if you're worried you come. That's why I'm here, right? But, probably 95 % are not emergencies and I would wager that 50 % probably didn't need to see a doctor at all.

Deb (10:37)
Right.

Right, that's why we have specialists. Yes, exactly, yeah.

Yeah. Yeah. Yeah.

Kailey Buller (10:59)
and could have probably stayed home. But again, if you don't know that,

you're going to come. And if you're worried, you should come. I don't want you to guess.

Deb (11:06)
yeah, absolutely. Totally.

Yeah. I always, always get checked out if you are worried about it. What would be some of those newborn glitches, as you call, that might look scary, but are kind of normal?

Kailey Buller (11:20)
Well, yeah. Oh gosh, there's so many. I think the ones that look... The breathing one is what, like the making noises when they sleep. I think that worries a lot of parents. Right? And then the strange things that they do, I mean, especially when babies start starting to move a bit more, roll over, do downward dog. I mean, they're gonna start banging their head on the floor. Or, you know, shaking their head side to side, or these big jerky movements. I know that freaks a lot of parents out too.

Deb (11:23)
Like the breathing one, you know, just mentioned that's a, yeah, that's a big one. Yeah.

Wait.

Yeah. Yeah.

Kailey Buller (11:50)
Like, why is my baby banging his head on the floor? Well, they just want to know how it feels. And that's really as simple as that, right? ⁓

Deb (11:51)
What are they doing? Yeah. Stimulating. Yeah. Yeah. Yeah.

Kailey Buller (11:59)
But the shaking their head back and forth or the eye movements sometimes, a lot of people worry that those are seizures. And it can be very hard to distinguish the two, especially if it's something like an absence seizure, which they just stare off into space because babies do that, especially when they're tired, right?

Deb (12:03)
Mmm... Mm-hmm, mm-hmm.

Yeah, they do when they're tired. Yep.

Yeah.

Kailey Buller (12:20)
So the key distinction I think for those is again what they're like after, right? If they are responsive and normal and not stiff, it was probably just them experimenting or staring off into space. But again, if your spidey senses are tingling because they're just not behaving themselves after an event like that, then maybe it's something more.

Deb (12:26)
Mm-hmm.

Yeah.

Mm-hmm.

Right. Yeah, and those are serious things to come in for. Yeah. Yeah. Have you seen a newborn? They do like a like a weird jerky like with their legs. Yeah, I feel like that's one that freaks parents out a lot. Yeah. Like the shiver, it's like a shiver kind of. Yeah. OK.

Kailey Buller (12:46)
Absolutely, yes.

yeah, absolutely. Yes.

my gosh, yes. Well, and that's okay. So yes, the the Moro reflex is what it's called. Yeah, so there's

something called a Moro. That's why we swaddle actually. It's so that they don't wake themselves up doing that. And that's actually why you tuck them in nice and snug. So otherwise they're gonna do this and wake themselves up. And that's a normal, that's a normal primitive reflex actually.

Deb (13:08)
Yeah, yeah.

Mm.

Yeah. Yeah.

Yeah, yeah, yeah, and that one, yeah, that's the arms and stuff, but I seen them just do one leg or the other, just that. They're just, it's like, yeah, yeah, it's so crazy.

Kailey Buller (13:27)
yeah, they just go, kind of yeah, totally normal. Yeah. And

it's just sometimes how they expel energy too, right? Or how they stimulate

Deb (13:38)
So what would be some of the top signs that do mean it is time to do not pass go, do not collect $200, go straight to the ER?

Kailey Buller (13:47)
I love that you use that reference. I wasn't sure if your listeners would be of the demographic where they would even know what that means. ⁓ good, good. So, I mean, there are a few symptoms that definitely warrant an eMERGE visit. And for anyone who wants to know this a bit more in depth, I actually have an entire chapter in the book that goes through like a four-color triage system. So green, don't worry. Yellow, keep an eye on it. Red.

Deb (13:52)
Yeah, we play it all the time, so. Yeah.

I love that.

Kailey Buller (14:15)
urgent within the next day or two and then category black. So black means don't pass go, do not collect your $200. And there are only a few category black, but they're worth remembering. ⁓ The first is fever and your baby's not yet 30 days old. They're less than 30 days old and they have a fever. doesn't matter what else is going on. They need to go to the hospital because they don't have an immune system yet and they get septic so fast.

Deb (14:19)
Yeah. Yeah.

Yeah, for sure.

Okay.

Yeah. Yeah.

Yeah.

Kailey Buller (14:42)
So we have to do at least a partial septic workup for those babies. The other one is a baby older than 30 days old who has a fever and you don't know why. If they don't have symptoms but they have this fever, you should get them looked at because some things like pneumonia or an ear infection, they're hard to see. But other things like meningitis, which is very serious, you might not be able to tell.

Deb (14:43)
Right. It's quickly. Yeah, act quickly. Mm-hmm. That makes sense.

Mm-hmm.

Right.

Yeah, that's a point.

Kailey Buller (15:13)
So when

they're at risk and you don't know why they have a fever, I would take them. So those are the two fever things.

Deb (15:18)
So if it's paired with a cold or paired with vaccinations, it's like, okay, you know, but totally makes sense. Watch it, you know, cause what's that danger zone that we should be taking them in.

Kailey Buller (15:24)
I can explain this fever away, absolutely.

Good question. So fevers on their own, I don't know that you need to go in at all unless it's been lasting like five days or longer. So a fever that's prolonged would be worth being assessed. The other one, I wouldn't go to the eMERGE necessarily for this, but if you have symptoms, if you have a cold and then you get a fever, so you've been sick for a few days and then get a fever, that's a bit unusual and that might be something like an ear infection.

Deb (15:40)
Mm-hmm. Mm-hmm.

Right.

Infection.

Yeah.

Kailey Buller (15:57)
Right?

But again, probably not an eMERGE visit, but urgent care or you you call your doctor and get in the next day or two.

Deb (16:04)
Yeah, yeah, yeah. Is there a temperature that you're like, hey, go right away? Like above 103? Ish? You know?

Kailey Buller (16:11)
So very good question. No, super

valuable question. There, yes, I mean above 103, 104, the threshold gets lower for seizures. So the higher your temperature gets, the more likely it is that you could have a febrile seizure. So a high temperature, yes, maybe you need to go in. But honestly, what we're gonna do for that baby is try to bring the temperature down. So doing a dose of Tylenol and then doing another dose of Tylenol, like we would just double the dose.

Deb (16:20)
Yeah.

Mm-hmm.

Kailey Buller (16:40)
take off all their layers, make sure the house isn't too hot, like try and cool them down. There's nothing else that we're gonna do unless they do have a seizure. yes and no, right? would be cautious of a baby who has a fever of 103-104 but if you can bring the temperature down at home, then all means.

Deb (16:44)
Right, yeah.

Yeah, yeah, Yeah.

then it's,

give it like after a dose of Tylenol, what is it? Like 30 minutes, an hour. Okay. Yeah. Okay. Cool.

Kailey Buller (17:00)
30 minutes. Yeah, 30 minutes. It's coming down. Yeah.

A couple other symptoms that I think are worth going to the Emerge for. Trouble breathing is obviously a worrisome sign. So if they are working hard to breathe, if they're using extra muscles that you wouldn't normally use, their belly, their ribs, their neck,

Deb (17:12)
Mm-hmm.

Kailey Buller (17:20)
breathe if they're flaring their nostrils making funny noises. If they are having trouble breathing, you go to the ER. And if they're dehydrated, which for a newborn is usually they haven't had a wet diaper in 12 hours or more, they're dehydrated, I would go. They're probably, again, we're probably not going to do much except say give a little syringe feed or small sips as much as you can and we'll reassess, but dehydration can become a problem quickly.

Deb (17:43)
Mm-hmm.

Yeah.

Kailey Buller (17:48)
And then there's just one other that is so important, and this is I think where most moms just get it right, is if they're just not themselves. So if your child is not acting the way that they normally do, and I don't mean, you know, your four year old is usually running around like they're high on sugar and they're feeling sick and so they want to sit on the couch, like that's understandable. But if your baby is crying inconsolably, you cannot soothe them, go to a merch.

Deb (17:55)
Mm. Mm.

Yeah.

Mm-hmm. Mm-hmm.

Yeah.

Kailey Buller (18:18)
If they are so sleepy that you can't wake them up or certainly if they're unresponsive, go to a merge. Right? So the kids that I really worry about are the ones that are laying in the hospital bed and we put in the IV and they watch us put in the IV and they don't even flinch. Those kids are sick. Right? Yeah. Like they just watch it happen because they feel so awful. Those are the kids that I worry about.

Deb (18:24)
Mm-hmm. Yeah.

Yeah, that's so sad. ⁓

Yeah, they can't

Kailey Buller (18:43)
So that's a big one.

Deb (18:45)
⁓ So a lot of parents when they do encounter something like this and they're just like, my gosh, I don't know what to do. They're frozen. They're panicking. They're overthinking. how can they build confidence in triaging those situations at home without like second guessing themselves?

Kailey Buller (18:45)
Yeah.

Good question. ⁓ I think the answer to that is that they are going to second guess themselves, right? I, step one is maybe expecting that, that they're gonna be worried. ⁓ So they're not blindsided by it and that it doesn't take control of them would be sort of step one. ⁓ But then I would say, do the same thing that you would do for a kid to teach emotional regulation, know, name it to tame it, right? I'm worried.

Deb (19:08)
Yeah.

Yeah. Yeah.

Mm-hmm.

Right.

Mm-hmm.

Kailey Buller (19:32)
And there's a reason why I'm worried. So why am I worried? What am I seeing that is making me feel this way?

Deb (19:36)
Yeah.

Kailey Buller (19:39)
if you take a look at the whole picture and say, why am I worried? I would start from worst case scenario and work your way back. Are they having trouble breathing? No. Do they have wet diapers? Yes. Good. Are they behaving themselves? Can I console them? Are they alert? Good. Do they have a fever? Do I know why? And if...

Deb (19:51)
Mmm.

Mm-hmm.

Kailey Buller (20:00)
all of that is normal, then you have time. Your baby is not in any imminent danger and you can try and figure it out. If they do have any of those things, you already know what to do.

Deb (20:03)
Yeah.

Mm-hmm.

Right, you just go.

I like that approach. So it's like kind of coming back from like, OK, this really isn't a true emergency. You know, they're breathing. They look fine. you can console them. Maybe they're not happy, but you can still console. I like that a lot. I can imagine being in the middle of the night doing that and be like, OK, they might not be feeling great. Right. Yeah, I love that.

Kailey Buller (20:26)
Mm-hmm. Yeah. And then it.

I need to bring myself back from the edge here. Yes, so I'm going to go through this. Yes, absolutely.

Deb (20:39)
let's just give an example. It's 2 a.m. Something feels off. Your baby's been crying for a while. What would your approach be

Kailey Buller (20:47)
So, I mean, I'm very fortunate to have worked in a lot of high stress situations and nothing really rattles me, right? But I can remember a time, two in the morning, ish. I mean, who knows what time it actually was. Right? Right? I remember, actually, this is completely out of the side, but I remember there was one time I went to feed my baby and it was right during, like, daylight savings. So I, like, went into the room at, 2.49.

Deb (20:53)
Mm-hmm.

Of course, right? It's that 2-3 a.m. It's like, yeah.

Mmm.

Kailey Buller (21:14)
And then when I came back, it was like 2.18. And I was like, did I just travel in time? Like it was so confusing. Right? Something is going on in my brain. But anyway, some time, right? At some point, yeah. It was like, oh right, yes, time change, got it. But you don't even keep track of days when you've got a newborn at home. So anyways.

Deb (21:16)
You're like, what is happening?

You're like, what's going on? Am I that tired? You're like, I might need to talk to someone tomorrow. Then you realize.

Yeah, no. Yeah, yeah, that's

funny.

Kailey Buller (21:41)
But

sometime, sometime in the middle of night I went in and my daughter was sick and I knew she was sick, she had a cold. And every time she gets a cold she usually gets croupy. And she'll have these coughing fits and she'll puke. She's a puker. She's always been a puker. So wake up in the middle of the night, cough cough cough cough cough. So I'm not worried. I'm tired and I'm not really looking forward to cleaning a puke. But I go into her room and she's standing in her crib and...

Deb (21:49)
Hmm.

Ugh, this is the worst.

Mmm.

for.

Kailey Buller (22:07)
she's working hard to breathe and I can see that and I'm still not worried because I know how to manage this. This is totally in my wheelhouse. And then I get a little closer and I notice that she's drooling and I panicked. And now I don't want any of your listeners to start panicking every time their baby drools because that's, they'll be panicked all the time. ⁓ But the combination of having a fever and a cold and trouble breathing and not able to swallow her own secretions,

Deb (22:10)
Hmm.

Right.

Hmm. Hmm.

Right.

Kailey Buller (22:36)
was a sign of potential epiglottitis, which is like, you're going to lose your airway. Your airway is going to close, kind of like anaphylaxis. And even though I knew exactly what was going on, and I know how to treat that, in that moment, I was mom first, doctor second, right? My baby is sick. My baby's in danger. You're going to panic. And I think that that is so important. It's a healthy response up to a certain point.

Deb (22:44)
Okay.

Yeah. Yeah.

Mm-hmm.

Kailey Buller (23:05)
course it's a protective response that you go into this fight or fight. Absolutely. So I think accepting the panic and just saying yeah I'm worried is probably step one. And then like I said taking it step by step from there and walking yourself back from the ledge.

Deb (23:07)
Alright, that's how we've survived.

Mm-hmm. Mm-hmm. Mm-hmm.

Mm-hmm. Yeah. Yeah, kind of like getting getting to a place of calm so that you can kind of think and intellectualize. OK, what is the next step that makes sense here? Like either we need to go or we know how to manage it. But yeah, I think that's so, so helpful.

Kailey Buller (23:42)
Absolutely, and think that was the only time I ever called 911, so...

Deb (23:46)
Yeah, well you have to finish this story now. Great. Okay, great. I'm all.

Kailey Buller (23:49)
She was fine, she was totally fine. Yeah, totally fine, yeah. It turns out that she just vomited and didn't

want to swallow the vomit, I think is what was happening. Right, it does, but at the time, she's staring there, staring and drooling and I thought, my God, she's dying.

Deb (23:58)
Yeah, I mean that makes sense, right?

Yeah, yeah,

my gosh. Well, and it's so easy to go there as a mom.

Kailey Buller (24:07)
So, and even when she went,

so even when we went to the emergency, she was absolutely fine. Like I thought we need to get like a soft tissue, not a lateral neck x-ray, like we gotta get the things and it was, you know, she was fine.

Deb (24:13)
Yeah. All these laughs. Yeah. Yeah. It's like,

it just tasted gross. She didn't even brush her teeth. gums, I guess, at that point. Yeah. Okay. So what is something you wish that every parent knew before showing up to the ER with their newborn? Because it's quite an experience and you're a postpartum.

Kailey Buller (24:25)
Right, yes.

my gosh, yes. ⁓ What I wish every parent knew with any age child on it, pack snacks. Pack snacks, pack toys. Like if you have time while you're waiting for the ambulance to come, pack a bag. Like if you are going to the emerge and your baby is sick, you're gonna be there for a while. We're gonna be doing treatment, we're gonna be running tests. If you're going to the emerge and we determine that your baby is not sick, you're gonna be there for a while, you're gonna be waiting. Like if you're going to the emerge, you need to expect that this is gonna be minimum four to six hours.

Deb (24:45)
Yeah. Yeah. ⁓

Mm-hmm.

Right.

Kailey Buller (25:07)
potentially

a full day affair. So if you have a few moments, throw some crap in a bag, bring it with you, and expect that you might be there a while.

Deb (25:09)
Mm-hmm.

Mm-hmm, yeah.

Mm-hmm. Yeah, that is so true because even if it is something simple there's emergent cases coming in that need to go before you and yeah, you just never know and kids get so bored especially toddlers It's so boring Yeah

Kailey Buller (25:30)
my gosh, they do. Absolutely. Yes, absolutely. And I

will, I'm super guilty of sneaking kids ahead of adults all the time because I'm like, it's like eight o'clock, it's way past their bedtime, I'm gonna see this kid. But you can only do that so many times before, well, if there are critically ill patients, know, sometimes they do have to, I feel so bad for these three and four year olds who are exhausted and not feeling well, sitting in a,

Deb (25:39)
Yeah, gotta get them in.

Summit before you get in trouble. Yeah. Right. You can't do that. Yeah.

Yeah.

Kailey Buller (25:59)
emergency room with grumpy adults.

Deb (26:01)
Yeah, yeah, what would that look like? Let's just say like they're worried about their breathing and they get in, let's say relatively quickly. What would be some of the things to expect when they're going in?

Kailey Buller (26:14)
Yeah. So if your child is having trouble breathing, I mean, that's you're getting a bed right away. The doctor's going to see you right away. Trouble breathing is not something that we take lightly. And we check their vital signs. We check for their ⁓ oxygen saturation. And we might be giving them oxygen if they need it. And chances are we're going to give them some treatments right away. So it might be something like Ventolin, which you would see in asthma, which can treat asthma, but other things as well. It might be like asthma in a mist form.

Deb (26:19)
Mm-hmm.

Mm-hmm.

Kailey Buller (26:44)
It might be epinephrine, like an EpiPen in a mist form to help open up their airways, but it can be really scary for parents coming into the emergency department and seeing their child surrounded by eight strangers putting, you know, a probe around their teeny tiny finger to see what their oxygen is like and, right, and putting a tiny little blood pressure cuff on their tiny little arm, right? And they're so cute.

Deb (27:00)
I know. That's so sad.

Yeah, so cute but so sad. Yeah.

Kailey Buller (27:12)
It's so sad, right?

⁓ So it's hard, but we never, I mean, you see in the shows all the time, like, get that mom out of here, like when we're resuscitating, never. I will never ever kick a parent out of the room. That's not something that happens in real life, at least not where I work. And we want you to be able to be there and know what's going on. We might need you to move out of the way, but we would never kick you out, absolutely. Yeah.

Deb (27:23)
Yeah.

Yeah.

Sure, so you can do your job.

Yeah, that makes sense. So as a parent, how would they advocate for themselves and their baby once they are in the ER? ⁓ Because sometimes I can imagine they might feel dismissed or overwhelmed in that situation.

Kailey Buller (27:55)
Yeah, you don't have to mince your words there. Like some doctors are assholes. Like I totally, and I, I get it. parents feel dismissed all the time because it's so easy for physicians who have had this information drilled into their brains and it's second nature to them to forget that not everyone knows this, right?

Deb (27:59)
Yeah, I know.

Right.

Yeah, they deal with it every day. They see it every day and it's like, it's not a big deal. And you're like, well, I didn't know. I'm just scared. Yeah.

Kailey Buller (28:22)
And we think it's so obvious.

But then like we call the neurosurgeon and the neurosurgeon is like, how did you not know? And like the same thing happens to us with the specialists and yet we still don't. Anyways, it's neither here nor there, but it happens. It absolutely happens. So I would say that any doctor worth their salt is going to take a parent's intuition, a parent's concern into consideration. That matters. If a parent is worried, if something's not right, something's not right.

Deb (28:31)
Right?

Yeah.

Yeah. Yeah.

Yeah.

Kailey Buller (28:50)
We can do some reassurance and education. But something's going on. They came in for a reason. They didn't want to waste their whole day here.

Deb (28:53)
Mm-hmm.

No, it's worried. It's yeah, the last place you want to be. Yeah.

Kailey Buller (28:59)
So the last place you want to hang out. if you

feel like you're not being taken seriously, I would say the best approach is to ask the questions, right? Well, if you don't think that I need to worry now, when do I need to worry? What should I be looking for? When do I come back? What should I be doing at home? Why don't you think that this is X, Y, or Z, right?

Deb (29:07)
Mm-hmm.

Right.

Right,

yep, ask for clarifying questions. Yeah, yeah.

Kailey Buller (29:23)
And that one in particular,

if you're worried about something specific, if you don't bring it up, I'm not going to bring it up. So for example, for example, I had a patient not that long ago who came in, prolonged fever, baby had had a fever, well, toddler had had a fever for five days. And she came in and I did my exam and I said, you know what, everything looks great. We've had a lot of kids with whatever the flavor of the month was then COVID influenza with prolonged fevers and, you know, come back if.

Deb (29:30)
Right?

Right. Yeah. Yeah.

Kailey Buller (29:53)
And she said, well, how do you know it's not Kawasaki's? And I was like, okay. So it turns out, well, it turns out, yeah, so she had her older child had had Kawasaki's a few years previous. And she had come to the department, not this department, I don't think, but she had come to the emerge and the doctor had said to her, everything looks fine and sent her home. And they didn't mention Kawasaki's because why would they if they didn't think that's what was going on. And it was missed. So either it was missed or they didn't have symptoms yet. I'm not sure what happened, obviously.

Deb (29:53)
Right.

Great, you did some research before you got here.

Kailey Buller (30:23)
But she was told everything was fine and it wasn't. So coming back a second time with a kid who's had a fever for five days, I was able then to say, I'm so glad you asked. This is actually the reason why we want you to bring your baby in after five days is because of Kawasaki's. So it's on the forefront of every emerged doc's mind. This is what we're looking for. We don't say that because we don't want to say, know, come back if you see signs of Kawasaki's vasculitis. Like we're not going to, we're going to say that.

Deb (30:26)
Mmm.

freak you out.

Yeah, yeah,

yeah.

Kailey Buller (30:55)
But I was able to with this mom and say, this is what it looks like. So they might have conjunctivitis, they might have a rash, they might have this, they might have that. And I could do much more specific teaching without overwhelming her because she already knew what we were looking for. And so she was reassured and I was reassured because now I know that she knows when to come back.

Deb (31:02)
Mmm.

This was something to look out for. Yeah.

Yeah, yeah, yeah. Yeah, that's a really good example. ⁓ asking the question, when do I need to be worried? Like at what point? if it gets worse, it doesn't get better by certain amount of days. You know, when do I need to come back? That's really great.

⁓ Okay, so this is last question. ⁓ If you could leave every new parent with one reassuring reminder for those middle of the night, is my baby okay moments? What would it be?

Kailey Buller (31:48)
I think the best response to this question would be that you have to trust yourself. Right? So if you are worried, there's a reason. And you should take stock and try to figure out what that reason is. And maybe you don't need to be panicked. Maybe it's just your instinct, your flight, coming into play and you can calm yourself down. But if you're worried,

Deb (32:00)
Mm-hmm.

Mm-hmm.

sure.

Kailey Buller (32:18)
and they have some of those sinister signs, go to a merge. If you're worried and you just don't know, go to a merge. You're not expected to know all the answers and that's why specialists like me exist, right?

Deb (32:31)
Mm-hmm. Yeah, I think that's a really good point is that we're not supposed to know this. you know, parents today put this expectation on themselves of I need to be a lactation consultant, a postpartum doctor, a pediatrician. Like all of these things all at once. You're like, no, you're just a parent. We have those people to help and support you and use your resources. ⁓ Yeah.

Kailey Buller (32:53)
Absolutely. And realizing that

access to resources is not easy for everybody, but no emergency department is going to turn you away. And like I said earlier, I even if your baby's not that sick, if you come to the emergency department, I'm going to assume that that reason is justified. Right? Like I'm going to assume that you're there for a reason, because you don't want to be there for fun.

Deb (32:58)
Yeah.

Yeah. Yeah.

Yeah, unfortunately we don't come to see you. ⁓ Although you seem very lovely.

Kailey Buller (33:19)
I know, I know, wants to be there.

Well, thank you.

Deb (33:25)
Well, I want to hear all about ⁓ your book a little bit more. How do people get in contact with you? Where are you on the social networks? And how do we get a hold of you?

Kailey Buller (33:36)
Absolutely. So the book is called Surviving Tiny Humans. It's available everywhere. So Amazon, Indigo, all major retailers. ⁓ If you want to find me, just remember Vitals with Dr. Buller. That's my website. That's my social handles. So Vitals with Dr. Buller. That's me.

Deb (33:48)
Great, great.

And you're on Instagram, where else? Yeah, yeah, I'm doing the same thing. I'm like kinda, maybe, I'm TikTok a little bit.

Kailey Buller (33:52)
I'm on Instagram, sometimes TikTok. Yeah,

so I'm mostly on Instagram.

Deb (34:02)
Perfect, well thank you so much. This has been really helpful. anything else you wanna share with us?

Kailey Buller (34:07)
No, just honestly remember that you're doing an awesome job and you're not supposed to be the expert in all the things, you're just supposed to be the expert in your baby. So remember that. If something's not right for your baby, we will take that seriously.

Deb (34:21)
Yeah, I love that. That's so important to listen to yourself. You know your baby best. Well, thank you so much for your time. you. Bye. ⁓

Kailey Buller (34:29)
Thanks again. We'll talk

soon. bye.

Deb (34:33)
Okay friends, let's bring this one home because wow, what a conversation. Here's a few takeaways from my chat with Dr. Buller that I really want you to remember. Number one, most middle of the night panic moments, not emergencies. Babies are noisy, twitchy, dramatic little beings. If it's not consistent or it doesn't follow a pattern, then it's probably normal. Number two, watch for the red flags.

If your baby's having trouble breathing, unresponsive, call 911 right away. But if your baby hasn't peed in 12 hours or is 30 days old with a fever, that's a go grab your bag and go. Do not collect $200, just go straight to the ER. Number three, you're not supposed to know everything.

As Dr. Buller said, 95 % of ER visits aren't emergencies, but 99 % are justified. You are not overreacting for wanting to make sure that your baby's okay. And number four, trust your gut. It's there for a reason. You are the expert on your baby.

If something feels off, slow down, breathe and check in what is actually making you concerned. And don't be afraid to ask your provider this isn't a concern, what else could it be? And when should I come back if things don't improve or get worse? And lastly, here's the pro tip. Always pack snacks, like always, not just for your kids, but for yourself.

If you love this episode, follow Dr. Buller over on Instagram at vitals with Dr. Buller, which is in the show notes and grab her book, Surviving Tiny Humans. It's the manual, Every Parent Wishes They Had. you're ready to feel more confident in your baby's rhythms, head to DoulaDeb.com

and go check out my first year support program where I support families through the months,

which helps parents build confidence and avoid feeling panicked

Just remember you are doing an incredible job. You don't need to be an expert in everything. You just need to be an expert in your baby. So take a deep breath, pour a fresh cup of coffee because you deserve it. And remember, you've got this.