Radhika ApteHappy Customer
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The arrival of a newborn baby into the family causes immense joy to the parents. At the same time they also experience a lot of anxiety about the well being of the new family member.
The development of fertilized ovum from a single cell to the full term baby is an extremely complicated process. It is indeed amazing that so many babies are born without any abnormality.
Once the newborn baby is handed over to the mother she should keep the baby warm at all times. A fetus spends about 40 weeks inside human body whose core temperature is fairly constant at 37 degree C. From such an atmosphere a baby is suddenly exposed to a temperature, which is much lower in most of the places.
This causes a lot of stress to the baby. It is important to always remember that a temperature which is comfortable for an adult is quite cold for a new born baby. When exposed to cold some babies develop bluish discoloration of fingers and toes. This disappears when the baby is kept warm.
A newborn baby should be put to sleep on the back. Do not put the baby on the abdomen, as there is a risk of suffocation.
Do not use a pillow for the baby. It is quite common for small babies to vomit and as the neck is small if a pillow is kept the vomited material cannot come out easily and may enter the airways causing difficulty in breathing.
Breast feeding should be started at the earliest and certainly within one hour. If the delivery is through caesarean it may be necessary to give one or two feeds of bottle milk. Every effort should be made to exclusively breast feed babies till six months.
Almost all babies pass motion within 24 hours. The first stool is greenish black and is called meconium. The color gradually changes to yellow.
There is a lot of variation in the number of times newborn babies pass motion. Some babies may pass up to 15 times per day while others may pass once in 2 days. If the baby is only breast fed and is otherwise normal there is no need to worry.
Many newborn babies pass urine just once during the first 48 hours. Hence there is no need to worry if urine is not passed within 24 hours. The frequently of urination is less during the first week of life. After that babies pass urine frequently.
A newborn baby may develop a red rash during the first few days. It may be limited to face or affect the entire body. There is no need to worry about this if the baby is feeding well and is otherwise normal. It subsides within a short period. Baby's skin is very delicate and can get damaged easily. Care should be taken while cleaning the skin.
Some mothers worry about a soft spot over the head of babies. This is normal, as the skull bones are not completely united at birth to facilitate the growth of brain. This soft area over the head of a newborn baby is known as anterior fontanelle. It should not be bulging or depressed when the baby is quiet.
A bulging fontanelle indicates that the pressure inside the head is abnormally high and requires investigation. It gradually decreases in size till it is no longer felt between one to one and a half years of age.
Sometimes a swelling may be seen over the head. This can be either a caput or cephalhematoma.
Caput is due to swelling of the scalp over the presenting part due to constricting effect of the uterus. This is a diffuse swelling and is not limited to a particular bone of the skull.
Cephalhematoma on the other hand is due to collection of blood under the scalp and is limited to one or two bones. It is clearly demarcated.
Both subside over a period of time and do not cause any harm-cephalhematoma taking longer than caput. If the cephalhematoma is big it can cause more jaundice requiring phototherapy.
Many newborn babies develop jaundice on the second or third day of life. This slightly increases till it reaches a peak on the fifth day and then gradually subsides. Usually no treatment is required. But any jaundice within the first 24 hours of delivery is abnormal.
If the jaundice is more blood has to be examined and if the test reveals high level of jaundice then the baby has to be kept under blue light for a few days. Rarely the jaundice can be severe enough to warrant a procedure called Exchange Transfusion in which the blood of the baby is removed in small quantities and replaced with another blood. The usual cause of such severe jaundice is incompatibility between the blood group of a mother and her baby leading to destruction of the red blood cells of the baby.
Enlargement of breasts is commonly seen in a newborn baby both male and female and many mothers are very anxious about this. This is due to transmission of maternal hormones through the placenta to the baby. The swelling subsides without any treatment and parents should avoid squeezing the breasts or doing anything else.
Female babies develop some vaginal discharge and even bleeding for a few days. This is also due to maternal hormones and there is absolutely no need for any treatment.
A few babies have mild degree of fever on the second or third day. Though this is normal the doctor should always be informed.
Some degree of bowing of legs is normal in newborn babies and infants. If it is severe consult your doctor.
Sneezing in normal for a few days. If there is continuous discharge from the nostrils you should inform the doctor. It is common to hear some noise when a baby breathes in and out. This is due to narrow airways of newborn babies. If the baby is feeding well and does not have cough you need not worry. Some babies develop hiccups which does not require any treatment. Yawning is also normal.
Often there is watery discharge from one or both eyes of babies. There is a small tube, which carries tears from eyes to the nose. This tube may not be fully open at birth resulting in tears coming out of eyes. It is advisable to massage the sides of the nose near the inner corner of the eyes to prevent tears from accumulating in the tube. Usually the tubes become patent by six to twelve months of age. Sometimes a minor operation may be required to remove any block.
Vomiting is common in newborn babies and then up to six months and is usually normal. Slight yellow coloration of the vomited material is normal but if it is green intestinal obstruction should be suspected. If it is frequent you should seek a doctor’s opinion.
Whenever a baby vomits turn the baby to one side. This allows the vomited material to come out of the mouth easily. Never lift the baby's head up. This may allow the vomited material to go down the wind pipe causing aspiration pneumonia.
Sometimes a newborn baby may vomit blood. Though this is frightening it is usually not due to any disease in the baby. During delivery some babies swallow maternal blood which they vomit. Later if mother has cracked nipples there may be some bleeding and the baby may swallow that blood and vomit.
If there is any doubt the vomited blood may be tested to find out whether it is from the mother or the baby. If it is found to be from the baby more tests will be needed to find out the cause but this is not common.
The umbilical cord is clamped and cut after birth. It is better to keep the cord dry till it falls off usually within one week. Sometimes there can be slight bleeding after the cord falls off and there is no need to worry. If the bleeding persists consultation is required.
The cord can get infected and hence it is better to apply an antiseptic solution for a few days till it falls. Sometimes a small reddish swelling appears after the cord falls off. This is called umbilical granuloma. If this happens, a crystal of common salt may be placed on it at night and a cloth tied gently to prevent it from rolling over. The cloth is removed in the morning. If this is repeated for three days the granuloma disappears.
Some babies have bluish spots over the skin which are very conspicuous in fair skinned babies. They are mostly seen over buttocks and thighs but may also be seen on legs and arms. They are called Mongolian spots.
There is no relationship between mongolism (Down syndrome) and these spots and they have no pathological significance. They gradually disappear and do not require any treatment.
Often a mother complains that her baby sleeps during day but cries during night. This is quite normal and the usual day-night rhythm will be established gradually. I keep telling mothers that a newborn baby does not know when it is day or night.
Some mothers ask how many hours per day a baby should sleep. They worry if the baby gets up and also get anxious when the baby sleeps for longer! There is lot of variation in the sleeping pattern of babies. Most of them usually sleep for sixteen hours or more. The duration of sleep gradually decreases as the baby grows older.
Heart (Cardiac) murmur in newborn baby
The blood circulation in the baby inside the womb is different from that of a newborn baby after birth. When the transition takes place at birth, certain changes occur inside the heart which can result in some abnormal sound being heard in the newborn baby when examined using a stethoscope. Such a sound is called murmur.
Many babies have a murmur after birth and some may have a murmur for several months. However a murmur may also be due to some structural abnormality of the heart. It is usually possible to make out clinically whether the murmur is normal or due to any abnormality. If there is a doubt an echocardiographic evaluation may be required.
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