The arrival of a newborn brings immense joy and excitement to parents, particularly new ones.It's a time filled with celebration, happiness, and a lot of learning, especially for those experiencing parenthood for the first time. During this period, both the mother and the baby require extensive medical attention and the unwavering support of their loved ones.
During the first 28 days after birth, most newborns are incredibly fragile and vulnerable. It's alarming to know that over 70% of infant deaths occur within the first 24 hours of being born, and each year, more than 2 million newborns lose their lives within the first week. This highlights the critical role of newborn baby care in the initial month, as it directly impacts their survival and overall health.
Taking care of a newborn
In order to handle any emergency situation effectively, it is essential to have a well-equipped neonatal intensive care facility available. This eliminates the need for transferring newborns to other healthcare facilities, which can be risky. Studies have shown that shifting the mother to the NICU before the baby is born has positive effects on the survival and development of the newborn.
During birth or after birth, the start of respiration is a crucial step, and it's always beneficial to seek the guidance of a paediatrician. Having a doctor who is trained in neonatal resuscitation can help ensure that the baby remains warm, any potential birth defects are ruled out, and the process of initiating breastfeeding is facilitated.
During the hospital stay, it's important to encourage the mother to breastfeed and avoid giving the baby any prelacteal feeds. The mother should be able to breastfeed on-demand, placing the baby on the breast every 2-3 hours. To assess the adequacy of feeding, the urine output can serve as an indicator, with 3-4 wet diapers within a 24-hour period being a positive sign.
Typically, an infant excretes faeces (MECONIUM) within a day and urinates within two days after birth. The newborn's well-being is closely observed, considering factors such as crying, body temperature, feeding, jaundice, and any concerns expressed by the parents. Prior to the mother's discharge, it is essential for her to feel assured about breastfeeding, undergo an assessment for jaundice, ensure the baby's temperature is stable, and receive necessary vaccinations.
Going home with a new baby is such an exciting time, but it can also be a little scary. Taking care of a newborn can be challenging, especially when it comes to feeding them frequently and changing their diapers. Keep their room temperature between 27°C to 29°C, so they don't have to use up extra energy to maintain their body temperature. For maintaining the ideal room temperature, it's advisable to use an AC or cooler with a slow fan speed. However, make sure not to direct any cold air blasts towards the baby.
Common newborn issues
Newborns can experience various medical issues, and if these problems are not addressed, they can escalate into something more serious. One of the concerns for newborns is dehydration, which can be identified by a significant decrease in weight. Full-term babies typically lose around 10% of their weight, while preterm babies can lose up to 15% of their weight during the first 7 to 10 days of life. However, they usually regain their birth weight by 3-4 days and then start gaining weight at a rate of 10-15gms/kgs/day.
Newborns are vulnerable to infections, and parents need to be vigilant in spotting any signs. Infections can easily be transmitted during birth or when the baby is handled by others. Keep a close eye on the belly button or circumcised foreskin for any signs of infection. Additionally, if your baby is having trouble with breastfeeding, not gaining weight properly, or showing increased irritability, these could be indications of an infection.
Most babies usually stay in good health after leaving the hospital, but it's crucial to be vigilant for any signs of illness such as jaundice or infections. Schedule a visit to the paediatrician within a day or two of being discharged to ensure the baby's well-being.
A guide for parents
Handling a newborn baby
Learning how to handle a newborn is one of the most important skills for new parents. Since newborns haven't developed a strong immune system yet, they are more vulnerable to infections. Here are a few tips to help you handle your baby:
· Before touching the baby, make sure to wash or sanitize your hands.
· Always support the baby's head and neck when picking them up or carrying them.
· Remember to never shake the baby; instead, hold them securely and gently sway to comfort them.
· In the first 28 days, your baby is not ready for playtime, so avoid bouncing or jiggling them.
Feeding and burping your newborn baby
Doctors strongly advise mothers to exclusively breastfeed their babies for the first six months. This means refraining from giving them water, gripe water, or any other foods. It's important to feed the baby whenever they demand it, typically every 2-3 hours. While breastfeeding may not come naturally to every mother, there's no need to feel ashamed. If you're facing any challenges, consider seeking help from a lactation specialist who can provide valuable guidance. Additionally, remember to burp the baby after each feeding session. You can do this by holding them against your chest or sitting them up on your lap and gently patting their back with a flat palm.
Diapering your baby
Within the initial 24 hours after birth, newborn babies typically have their first bowel movement, and within 48 hours, they pass urine. Once your baby is adequately fed, they should wet around 3-4 diapers per day. As your baby grows, you may need to use approximately ten diapers daily. To ensure cleanliness, use water and a soft washcloth or wipes. If needed, apply a diaper rash cream. Discuss any signs of skin conditions, such as diaper rash or cradle cap, with your baby's paediatrician as part of their regular newborn care.
Umbilical cord care for new-born
Make sure to gather information about how to care for your baby's umbilical cord before you leave the hospital. Typically, the dried cord will naturally fall off within 10 days to three weeks. Avoid getting the cord wet or giving your baby a bath until the stump falls off. However, if you notice any redness, odour, or bleeding from the cord, it's crucial to seek medical attention.
Bathing basics for new-borns
In the initial weeks, it's advisable to refrain from using soap or strong shampoo on your baby. Once the umbilical cord stump has healed completely, you can begin bathing your newborn. Just remember to provide proper support to their neck and head during bath time. It's best to use a gentle cleanser and a soft washcloth to cleanse their body.
Bonding with new-born baby
The initial days after the arrival of a baby are truly magical as parents learn to comfort, swaddle, and connect with their little one. It's crucial to handle the newborn with utmost care during this precious time. Skin-to-skin contact is highly beneficial for most infants.
Sleeping basics for babies
Infants typically sleep for a duration of 2 to 4 hours at a stretch. Consequently, you might find yourself waking up multiple times during the night to attend to their feeding or changing needs. Position the babies on their backs when placing them in the crib, as this helps minimize the chances of sudden infant death syndrome. Additionally, it is advisable to remove pillows, stuffed animals, and blankets from the crib.
Vaccinating newborns
It is extremely important to vaccinate newborns as it plays a vital role in safeguarding their health and protecting them from serious diseases. To safeguard infants from preventable illnesses, it is essential to provide vaccines like the hepatitis B vaccine soon after birth. This helps build a strong defence system from day one, shielding them from potential health risks. Timely vaccinations not only protect the newborn but also help in building community immunity, ultimately reducing the overall risk of disease transmission.
To sum up, providing attentive care to newborns is the key to a lifetime of wellness. Through nurturing bonds and essential health practices like feeding and vaccinations, comprehensive care greatly supports the healthy growth and development of your newborn.
KM NU Hospitals in Ambur provides advanced paediatric and neonatology services. Our team of skilled healthcare professionals is committed to delivering exceptional care to newborns, tailored to their individual needs.
References:
1. A Guide for First-Time Parents. NEMOURS KidsHealth. https://kidshealth.org/en/parents/guide-parents.html.
2. Newborn care guide: 7 tips for the first weeks. Touro LCMC Health. https://www.lcmchealth.org/touro/blog/2022/june/newborn-care-guide-7-tips-for-the-first-weeks/.
3. Your baby's growth and development - 1 month old. pregnancybirth&baby. https://www.pregnancybirthbaby.org.au/babys-growth-and-development-1-month-old.
Author: Dr. Palanirajan P