Important practices about newborn care – a pediatrician’s guide
Hello beautiful mommies and moms to be! When a baby is born, the paediatrician becomes the most important person to us in the world! Correct me if I am wrong.😁
So, I thought of sharing with you some expert advice by a dear friend and an accomplished doctor, DR. GEETANJALI SRIVASTAVA. She is a paediatrician with superspecialisation in Neonatology and is currently working as a consultant neonatologist and pediatrician in Safe Kids Hospital, Hyderabad. She was kind enough to write this article for me when I requested her to share some information on childcare.
A baby is something which you carry inside you for 9 months , in your arms for 3 years and in your heart until the day you die. In order to carry on this difficult yet so fortunate responsibility effectively we have tried to put together bits of extremely simple but very important day to day practices together to ensure intact survival of your newborn.
What is a normal newborn ?
The neonate at birth is considered as normal if,
i. Birth weight is 2500g or more
ii. Gestation is 37 weeks or more
iii. Body weight is appropriate for dates
iv. Baby did not need any resuscitation after birth
v. Baby did not suffer from any significant postnatal illness
vi. Mother did not suffer from any serious complications after delivery.
Mother’s role in baby care
Mother is the best primary health worker. Early involvement of the mother in the care of her baby is the best way to promote and encourage breastfeeding. The healthy normal babies should not be housed in the nursery. Mother is the best person to identify minor developmental deviations and early evidences of disease process because she is constantly and closely observing her baby.
Mothers should be emotionally and physically prepared and motivated for breast feeding. Skin to skin contact immediately after delivery and rooming in with the mother encourages breast feeding. Here are few important points that need special mention :
i. Any prelacteal feeds like honey, glucose , water or tea should not be administered to the baby
ii. The milk secreted in first three days of delivery is known as colostrum. This is very small in quantity but very rich in proteins and anti-infective factors. Hence, colostrum must never be discarded and all babies must invariably receive it.
iii. Colostrum is adequate to meet the nutritional needs of healthy term babies.
iv. No supplemental feeds should be introduced even in first three days to support breast feeding. This may lead to refusal of feeds by the baby resulting in delayed establishment of lactation.
v. The mother should be assured that sucking by baby is the best stimulus for milk production.
Maintenance of body temperature
Newborns are vulnerable to develop cold stress due to poor skin integrity and extracellular fluid loss. When the trunk and extremities both are warm to touch, the baby is not having any cold stress. Following points need special mention :
• The room should be kept warm(25-27 degree celcius)
• The baby should be nursed in close proximity to the mother.
• The baby should be kept dried and adequately clothed.
• Baby should be provided caps, socks and mittens.
Oil massage should be postponed till the baby is 3-4 weeks old. Oil massage improves circulation and tone of muscles and gives comfort to the baby. This in turn leads to improved weight gain, reduction of stress and improvement in immunological functions.
• Use a non irritating vegetable oil like olive, sunflower or coconut oil for massage.
• Massage should be done before giving bath to the baby.
• Baby should be placed supine and massage started from head, face, chest, abdomen from above downwards.
• Gentle but firm and rhythmic strokes are provided followed by kinesthetic stimulation by performing alternate flexion and extension movements of major joints of upper and lower limbs.
• Mother should actively interact with her baby during the massage session.
Skin care and Baby bath
Bathing ritual can be performed once the baby is above 2 kg. The baby should be bathed using unmedicated soap and clean lukewarm water. Bathe by wetting and applying soap to small areas beginning from above and proceeding downwards. After bathing baby should be given breast feed.
Care of Umbilical stump
In order to clean the umbilical stump chlorhexidine solution should be applied daily at the tip and base of stump. The cord normally falls after 5 to 10 days of birth. The cord area must be kept dry till it falls off.