More than 70% infant deaths occur within 24 hours of birth so the first “28 days”- known as the neonatal period is the most vulnerable time period for a child’s survival. UNICEF figures state that more than 2 million newborns died within first seven days, representing 73% of all neonatal deaths. Hence, Dr A.P. Mehta, Senior Consultant – Neonatology, says that the first 7 days of life are the most crucial for baby’s survival.
What should be the steps ahead?
Few things that you have to consider:
- Birth Place: You need to ensure that an adequate neonatal intensive care facility is available so that in the case of any emergency one does not have to run to other healthcare facilities. Neonatal transfer carries a lot of risk to the baby and shifting them in the utero (Mother is shifted to NICU before the birth of the baby) has scientifically proven to be beneficial in terms of survival and development of neonate.
- During Birth or after birth “initiation of respiration” is a critical step and may require paediatrician’s help. It is required that a doctor who is trained in neonatal resuscitation is present as he/she may be able to keep the baby warm, rule out any birth defect and initiate birth feeding activity.
- During the hospital stay, a mother should be encouraged for breastfeeding to avoid any prelacteal feeds. On demand, she should be able to put the baby on the breast the after every 2-3 hours. Adequacy of feeding can be judged by urine output ie. 3-4 wet diapers every 24 hours. Normally, a baby passes stool within 24 hours and urine within 48 hours of life. The baby is monitored for crying, temperature, feeding, jaundice and any parental concern. Before the mother is discharged, she should be confident in breastfeeding, evaluate for jaundice, maintain temperature and is vaccinated.
- Finally, going home with a new baby is exciting but it can be scary too. It sometimes becomes difficult to cater to the needs of a newborn like frequent feeds, and diaper changes. Their room temperature should be in a range of 27 to 29*C so that they do not waste calories in maintaining their body temperature. It is easy for a mother to judge her baby’s temperature by touching her hand and feet and comparing it with the abdomen. We can use AC/cooler with a slow fan speed for maintenance of room temperature. Cold air blasts should not be directed towards the baby.
What can be the common Newborn Issues?
There can be multiple medical problems for newborns, which if left unattended can become serious. Dehydration can be one of the concerns for newborns that can be judged by significant weight loss. Full terms babies loose nearly 10% weight while preterm up to 15% weight during the first 7 to 10 days of life and regain birth weight again by 3-4 days. After that, they start gaining weight by 10-15gms/kgs/ a day.
Parents should also watch for signs of infection in their newborn that can be easily picked up from birth or other people handling the baby. You can witness signs of infection around the belly button or circumcised foreskin. Moreover, babies with infections often complain of poor sucking during breastfeeding, poor weight gain, and increasing irritability among several others.
There can be other health issues that are different from older children and adults like diaper rash, cradle crap etc. Although most babies remain perfectly healthy after they are discharged from hospital but it is important to watch out for signs of illness like jaundice, and infections. It is necessary to take the baby to the paediatrician for evaluation within a day or two of leaving the hospital.
Tips for Parents for Newborn care
- Baby should be given only breast milk for first six months of life.
- Exclusive breastfeeding means nothing except breast-feeds not even water, ghuttis, gripe water, tonics or any form of milk.
- Babies need proper clothes, which covers them properly especially the head, hands and feet. They should not be over clothed as well.
- Breastfed Babies pass watery stools after first 3-4 days of life especially after every feed which is normal for them.
- A baby, who is feeding well, will be passing urine at least 8-10 times a day sleeps for 3-4 hrs in between feeds.
- Babies don't need any Kajal, Surma, Talcum powder or daily bath. Bathing should be postponed for first few days after birth. A good rule to follow is to delay bath till umbilical cord falls.
- Vaccination is the most cost-effective way of health for children.