Mothers presenting with their newborns to the Paediatric Emergency Department (PED) have variable maternal experience, social support, and perinatal instruction. We undertook a study to determine if maternal factors impact upon early neonatal morbidity in the PED. We conducted a retrospective chart review of the PED and maternal perinatal records for all neonates ≤8 days of age who presented to the PED from June 1990 to May 1995. Variables included method of referral, chief complaint, diagnoses, disposition, maternal age, marital status, parity, and prenatal instruction. Complete data was gathered for 452 maternal/neonate pairs. Self-referred patients were at a significantly lower risk of serious illness (16% admitted) than were consult(49% admitted) and transfer (90% admitted) patients. The rate of self-referral increased with (a) maternal age <21 yrs (81%) VS age ≥21 yrs (72%); (b) single status (84%) VS married (71%); (c) no prenatal classes (88%) VS attended (81%); and (d) primiparity (76%) VS multiparity (70%). Feeding problems were more common in mothers <21 yrs (13%) and in primips (11%) VS mothers ≥21 yrs (7%) and multips (5%). Admission rates were lower in mothers <21 yrs (28%) and in single moms (23%) VS mothers ≥21 yrs (32%) and married mothers (32%). Mothers who were young, single, or primiparous, or who had not attended prenatal classes presented with neonates who were less seriously ill. Identification and education directed towards mothers at risk for using PED services for healthy neonates may help to prevent unnecessary PED visits. Targeting young (<21 yrs) and primiparity mothers for early home care or nursing interventions may reduce their need to seek PED services.