FAQ - Care of the New Born

Care of the New Born

The newborn is the very spring of life and hope. A new born baby achieves a smooth transition from intra uterine to extra uterine life breathing a few seconds after birth. Science of newborn management has undergone a lot of technological revolution; anticipation and appropriate management of sickness is the cornerstone of improve life of a newborn.

Stages of Newborn Care : 1. Care at Delivery Fetal lungs are filled with fluid and as infant takes his first gasp, the circulation inside the baby changes from that through the umbilical chord to the lungs. This is an important event in the life of the baby.

Following should be done : 1) Good lighting, cleanliness, & no direct drought of air coming 2) Clear the mouth of the secretions 3) baby should be dry and warm 4) The umbilical cord is cut with sterile scissors and medical spirit is applied 5) See that the baby cries well and moves all his arms and legs 6) Observation for half an hour;. If any untoward happening like blueness of the skin, irregular respiration, etc. should be immediately informed. 7) Some abnormalities are diagnosed at birth. Example, cleft lip and / or plate, oro genital problem (hypospadias, undescended testes), Down’s Syndrome, developmental dysplasias, some congenital heart diseases, some neural tube defects like spina-bifida and anencephaly. 8) an injection of vitamin K is given as a preventive measure. Many times at birth, baby’s blood is taken for checking for - blood group, congenital hypothyroidism and sometimes for haemoglobinopathies and for bio chemical screening. 2. Care Immediately After Delivery * Warm Chain : Baby must be kept dry and warm; thus the age old custom of giving a bath immediate after birth is not be encouraged * Feeding of The Baby : Breast milk is the best nutrition provider. Immediately after delivery, your breast milk is yellowish and sticky. This milk is called as colostrums, which is secreted during the first week of delivery. This is actually more nutritious than mature milk because it contains more protein, more vitamins and more anti infective immunoglobulins which are necessary for the infants defence against infections. This colostrums must be fed. Sugar water, honey water or other concoctions should be avoided at all cost. Till breast milk starts, this colustrum is quite enough to satisfy baby’s needs.

Advantages of Breast Feeding 1) Complete and balanced food coming directly from the body, therefore fully sterile 2) Contains immunological defense ingredients 3) Contains lot of good quality protein 4) Cheaper then any milk substitute and also readily available 5) Increses mother baby bonding 6) Increases mother’s recovery after delivery * Care of Cord : Cut end of cord should be kept open. No binders or dressings required simple cleaning with spirit swab enough. * Care of Eyes : Routine care not required. If done should be cleaned with sterile normal saline soaked swabs frommedial end to lateral end and then discarded.

3. Care in Post Transition Period A) Technique of Breastfeeding Comfortable position for the mother Proper assurance to mother; to feed baby on demand; no feeding by bottle, no pacifiers, gripe water, herbal preparations, etc. Exclusive Breastfeeding - Even water is not Needed Baby should be stroked and made to complete the feed before it goes to sleep. During Each Feed, One Breast Be Emptied Completely Before The Baby Is Taken To Other Breast. Burping – after each feed, baby shouldheld upright against the shoulder and burped to prevent tegurgitation of feeds Sucking – is the best stimulation for increase in milk production and ejection. Adequacy – Baby is getting adequate feeds if - it sleeps comfotably for 3 to 4 hours at a stretch, has golden yellow semi-solid stools, passes urine atleast six times a day, and appears contented. B) Urination & Stools Habits Stools / meconium is passed latest by 24 hours of life and urine latest by 48 hours. Later on, urine is passed about 6 to 9 times per day, and stools 7 to 10 times per day. A fully brest fed baby can pass stools even once in 5 to 7 day. C) Weight Gain Pattern There is some loss of weight post delivery for 5 to 7 days, but it catches up as soon as feeding is established. D) Jaundice In Newborn Normally baby becomes yellowish from 4th day onwards and this decreases gradually till about 9th day of life - this is due to the destruction of fetal RBCs and has nothing to do with jaundice of childhood (infective type). If it appears early, or increases beyond a certain limit then treatment lke phototherapy etc. is required. E) Minor Problems Of The Baby 1) Skin rash – a whit pin point headed generalized rash on second or third day is mostly normal and should be tackled with normal talcum powder. Cotton clothing should be preferred and in hot climat, baby should not be fully clothed and draped. Melia are tiny yellowish spots which are common around the nose and disappear spontaneously over a month or two. Mongolian blue spots are blue black macular regions especially situated over the base of spine especially in asian infants. They fade slowly over first few years. increase till 6-9 months and then regress. 2) Gaseous distention / colicky pains – every time your baby feeds, it takes in a lot of air along with the milk. This is specially more for the first child and tough nipples. The baby has to be burped by holding it straight over the shoulder for about ten minutes after every feeding session. This will prevent the gaseous distention an / or the colicky pains. The common myth and misunderstanding that this happens because fo faulty maternal food habits should be removed. 3) Excessive crying – Causes are many – fromdiscomfort due to excess warmth or cold to wet diapers, thight clothing, inadequate feed on one breast completely (this does not allow hind milk to reach babys stomach), colicky pains etc. 4) Loose stools / Diarrhea in newborn – loose stools (transitional diarrhoea) are common in breast fed and preterm infants and are not a sign of disease. Modifying feeding technique, feeding at one breast at a time to ensure that babygets both foremilk and more of hindmilk, easily corrects this problem. Infective diarrheas are persistent 5) Constipation – a breast fed baby who has infrequent stools but soft and well formed in not constipated, even if passed very 7 to 8 days. 6) Fever – A baby may appear to have elevated temperature due to oveheated evironment, over draping etc. Babies with infective fever are pale, have cold extremities, are lethargic with refusal to feed in extreme condition and require treatment immediately. 7) Refusal of Feeds – Is very Important Sing of Sickness. It may be due to local problem like fungal infection, but it is a hallmark of disease and requires urgent medical attention.

 

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