Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services if the baby has difficulty breathing, turns blue or grey, becomes unresponsive, has uncontrolled mouth bleeding or appears to be choking.
Epstein pearls do not normally cause these symptoms, so emergency assessment is needed to identify the problem.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek prompt medical advice if:
The bump grows, bleeds or develops redness or discharge
White patches spread across the tongue, cheeks or palate
The baby appears to have pain when feeding
Feeding becomes difficult or the baby has fewer wet diapers
A hard or loose tooth-like structure is present
The baby seems unusually sleepy, irritable or unwell
A newborn develops a fever
These findings are not typical of Epstein pearls and may have another cause.
3
Does any of this apply?
Book an appointment
Mention the bump during a routine newborn or primary care visit if you are unsure what it is.
A routine appointment is also appropriate if it has not disappeared after several months or looks different from a typical small, firm white pearl.
Every sign above is quoted from the sofidex article on Epstein pearls. If you are not sure, err upward — it is always reasonable to be checked.