New Baby Care & Look

There are many variation in infants regarding  color of skin, shape of head, weight chest, nose and overall structure of baby. Some of these differences seen just temporary, part of the physical adjustments a baby goes through. After few hours from birth , mostly all babies are awake and alert  mentally.

This topic consists of new baby look and how to take care of new baby?
The newborn baby at birth is about 50 -52 cm long. The head circumference is approximately 32 to 36 cm and the chest circumference is usually 3cm less .The upper segment to lower segment ratio is between 1.7 and 1.9 to 1 .The mid point of stature of the newborn lies approximately at the level of the umbilicus. Normally weight of baby approximately in between 2.5 to 3.5 kg. It may be reduce in some infants due to insufficient diet and some disease like diabetes or other disease in mother in pregnancy.

Normal Physical Appearance of baby :

• Skin
  The skin is pink or mottled and is covered with fine soft lanugo hair on the entire body in premature only on the upper back and dorsal aspect of limbs in mature infants. Laungo is  present over the face back and the extremities .A new infants have white oily layer on skin. In first bath it is removed. The sclerae appear slightly bluish. The ear cartilage is firm, fully curved, with good elastic recoil. A new born baby have little marks, spots and rashes, red or greenish blue on the skin of your . This is completely normal and some babies may have more than others. In some case skin may be peeling on the hands and feet and some babies may have noticeable downy body hair.
  
   
• Head
  The head is larger in compare to rest of body. Evidences of verifying degree of moduling are present in vaginal delivery with cephalic presentation. You feel a soft spot on the top of yours baby's head. Neck appear small in new born baby. The floor of the posterior fontanelle feels bony. The head may look pointed due of pressure during birth. Generally people suggest to give support to head by giving pillow below head. This is the part where the bones of the skull have not joined together.
   
• Face
  the face is comparatively smaller in relation to the head. The eyes remain closed most of the times. Pupillary light reflex is present. The gums are smooth. The cartilages of the ears and nose are well developed making then prominent. The cheeks are full due to sucking pads of fat.
   
• Hands and Feet
  The fingernails of the baby seems long at birth. The legs look bowed as he had been lying curled in the womb.
   
• Eyes
  You find no tears while crying in case of new infants. You may observed swollen eyes when baby wake up from sleep .In starting eyes may look as if they are squinting.
   
• Nose
  The nose may appear flat.
   
• Neck and Trunk
  The neck is short. The circumference of the chest is slightly less than that of head. The breathing is abdominal in type and the baby breaths the nose. Respiration rate is usually 30-60 per minute. Breath sounds are harsh.
   
• Genitals
  Most of the infants genitals look large. There may have a milky discharge from the breasts and sometimes blood or white sticky discharge from the vagina in a baby girl. 
   
• Chest
  The breast nodule is palpable, usually more than 5 mm in diameter.
   
• Mental Ability :
  Mostly all babies are awake and alert during the first few hours after birth. They are attracted to human sights especially faces and human sounds. They have a grasp reflex and sucking reflex.

The full term infant in an attitude of flexion similar to the position assumed in utero. Cry of the neonates is vigorous. Feeble, soft or high pitched shrieking cry is abnormal and indicates neurological disorder .Normal newborn spends 80 percent of the time in sleeping.
The heart rate ranges between 120 and 140 per minute within a few hours after birth. In a crying infant the heart rate may accelerate to 160 per minute. The respiratory rate stabilized at about 30 to 40 per minute, but may be as high as 60 per minute when crying.
Blood pressure is not easily obtained. It is generally 80-85/50-55mm hg. Abdomen is usually flat at birth. Liver is palpable, spleen may be slightly palpable in occasion.

The urine is usually passed during or shortly after birth. About 94 percent of newborn infants pass urine by 24hours after birth. The first stool is black, thick and is passed within 24 hours in a large proportion of babies.
Infant is ready to feed within a few hours after birth after recovering from the exhaustion of labor. Breast feeding should be offered as the "first feed". Colostrum should not be discarded. Most babies regularize their feeding pattern by the end of first week and demand feed every 3-4 hours. The baby lose about 7-8 percent of the birth weight during the first week of life. The baby regains his birth by 10th day and then continues to gain weight at the rate 20-30 g per for the next three months of age.

New infant sucks vigorously. When the breast is brought into contact with the infant's cheek, he/she seeks the nipple stimulation of the upper and lower lips produces movement of the lip and tongue in the direction of the stimulues.

Preterm Infants:

The preterm baby is small in size. The head is relatively large, sutures are widely separated and fontanel is large. The face appears small and the buccal pad of fat is minimal. The thin, pinkish skin appears shiny due to generalized edema. The breast nodule is absent or less than 5 mm wide. The ears are soft and flat with ear cartilage begin deficient and pliant.
General activity is poor and neonatal reflexes such as moro, sucking and swallowing are sluggish. The loss of fluids during the initial few days gives the baby a poorly  nourished appearance with pinched features and loose skin folds over thighs and arms.
 

Care of umbilical cord:
The cord is to be inspected once more for evidence of slipping of ligature. Dressing with bland powder and cord binder are not favored in places where the baby is placed in a clean environment. If the cord is left exposed to the air, without any application of dusting powder, it dries up and falls off much earlier.

Babies born with a birth weight of less than 2500g are low birth weight babies, those with birth weight less than 1500gms are very low birth weight babies  and those with a weight of less than 1000gms are extremely low birth weight .
The common causes of low birth weight babies are social or economical status, Poor nutritional status of mother, Poor care during pregnancy, Pregnancy at young age, High blood pressure, low pregnancy weight, maternal illness such as anemia, infections, Low maternal literacy, Complication in pregnancy ,smoking ,alcohol or drug abuse, Maternal nutrition plays an important role in newborn health.
Basic minimum care during pregnancy, nutrition counseling and supplementation of iron and vitamins.
Disorder of placenta, structural or functional abnormalities of placenta. First born babies are generally smaller, twinning and multiple pregnancies.


New born infants at High Risk:

The transition from the intrauterine to extrauterine life is a critical event in life. Any difficulties and hazards at this period may cause irreversible damage to vital organ and permanent handicap later in life.

It is necessary to prevent the difficulties in initiation of respiration at birth and anticipate other problem which survival by recognizing the high risk situation.
Keeping in view the physiological adjustments required at the time of birth, anticipatory preventive management should be undertaken. The following are situation associated with higher risk of birth hazards are complication of pregnancy, bad obstetric history, preterm delivery, multiple births, malpresentation of the fetus, cesarean section or forceps delivery, prolapse of the cord, fetal distress .Deliveries to be conducted at the institution or by trained medical personnel. All high-risk pregnancies where problems are anticipated should be conducted at hospitals or institutions.

Care of newborn in the delivery room:

Birth asphyxia constitutes a major neonates problem. It is essential that all health care personnel involved with deliveries and new born care are trained in neonatal resuscitation. An pediatrician must be prepared for an emergency in the labor room to save the life of the baby and prevent irreversible brain damage due to anoxia. When high risk delivery is expected, the obstetric and pediatric team should ready in labor room.
the infant should be placed in supine or on their side with the neck in a neonatal position. Over extension or flexion may produce airways obstruction should be avoided. Suctioning should be limited to 3-5 seconds at a time rather than 10 seconds .Heart should be monitored during suctioning.
Evaluation of the infant should begin during initial stabilization. It is necessary to wait for completion of initial steps .Positive pressure breathing should be initiated if there is no response to tactile stimulation within a few seconds. If infants is gasping, positive pressure ventilation may be initiated immediately.

Right After Birth the following things are important , first babies examination will  take place Weight, length, and head circumference will be measured, measurement of your baby's weight, length, and head circumference to assess how he or she has been doing since birth ,observation of your newborn's vision, hearing, and reflexes a total physical examination to check for any abnormalities of the body or organ function Temperature will be taken, and his or her breathing and heart rate will be measured, The doctor or nurse will monitor the color of his or her skin and his or her activity, Special eye drops will be given to ward off infection. Your baby will be given his or her first bath, and the umbilical cord stump will be cleaned. Most hospitals and birthing centers provide personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.