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Q. What are the signs of cord
infection?
If the cord gets
infected, it looks damp or wet. The skin
around the base of the cord may become red and
some-times pus may be seen there. A baby with
infection of the cord requires treatment and
must be shown to a doctor. If the treatment is
delayed, the baby may develop additional
features like fever, lethargy or poor feeding.
These signs indicate that the infection is
spreading to the rest of the body as well.
Early treatment of cord infection prevents
spread of infection to the rest of the body, a
serious illness in a newborn baby.
Q. What are the important points to be kept
in mind for home care of premature or low
birth babies (LBW)?
Any baby who is
born before completing 37 weeks of gestation
or has a weight less than 2 kg, requires
special care. This baby must be shown to a
doctor who will decide if the baby can be
treated at home or requires to be admitted for
medical supervision.
The key issues in
home care of premature/ low birth weight
babies include:
1. Feeding: Breast milk is ideal for these
babies. Milk of a mother with a premature baby
is specially suited to meet the requirements
of the premature baby. Most low birth weight
babies and premature infants born after 34-35
weeks of gestation can suckle at the breast
effectively. They may however get tired easily
by the effort involve in sucking. Therefore,
they need to be fed for a longer duration at
each feed. If a baby cannot suckle effectively
at the breast or gets tired easily, they can
be offered expressed breast milk with a cup
and spoon. If that is also difficult, then
these babies need to be admitted since they
may require to be given feeds using tube
feeding technique under medical supervision.
2. Temperature
regulation: Low birth weight infants are
more prone to develop hypothermia. Thus they
need to be kept covered with warm clothes even
more carefully, taking care to keep the feet
and head covered. Touching the feet of the
baby gives a good idea about his temperature.
As a rule, the feet should be pink in color
and feel warm to touch. If the feet are
turning blue or feel cold to touch, the baby
needs more warmth. This can be done if the
mother holds the baby close to her body so
that her body heat warms the baby. Heaters can
be used to increase the room temperature
taking care they are kept at a safe distance.
3. A LBW infant can
catch infection more easily than other babies.
Hands must be washed before touching or
feeding the baby and handling the baby by
visitors should be restricted to a minimum. If
the baby develops signs of sickness he should
be promptly shown to a doctor. These signs are
discussed in a separate section,
Q. What is the cause of vomiting in
neonates?
A large number of
babies vomit on the first day of life due to
irritation of stomach by swallowed amniotic
fluid. Vomiting/ regurgitation after feeds is
also very common and is due to ingestion of
air during feeding. The milk brought out is
usually small in amount and is curdled. The
baby continues to gain weight adequately. The
regurgitation of milk can be prevented by use
of proper feeding position by mother and
burping the baby for 10 to 15 minutes after
each feed. This helps in bringing out the
swallowed air. Burping is done by tapping on
the back keeping her/him in upright position
on the lap.
If the vomiting is
persistent, projectile, yellow/green colored
or is interfering with weight gain, the baby
needs to be evaluated by a doctor.
Q. Why do babies cry?
The babies usually
cry when they are hungry or in discomfort.
This may be due to an unpleasant sensation of
full bladder before passing urine, painful
evacuation of hard stools, tight fitting
clothes or mere soiling by urine and stools.
Some times they just want to be picked up.
Many babies are irritable when sleepy.The
spells of crying unrelieved by feeding,
changing the soiled napkins or by rocking the
baby may be due to abdominal pain.
Excessive,
inconsolable cry may be a sign of a medical
problem in a baby and must be shown to the
doctor.
Q. How should a nappy rash be treated?
A rash on the
buttocks usually results from maceration of
skin due to prolonged wetness. Use of plastic
nappies and delay in changing nappies is a
common cause of nappy rash. The buttocks
should be cleaned gently with wet cotton,
allowed to dry and exposed to air for at-least
some time during the day. Local application of
coconut oil helps in healing. A rash that does
not respond to these measures needs to be
shown to a doctor.
Q. Do all new born babies get
jaundice?
Many newborns who
are otherwise normal develop yellow colour of
their skin (jaundice) after the first day.
This is called physiological jaundice. It
appears on the second day, reaches a peak on
the 4th or 5th day and
then disappears by 7th or 8th
day.
If the baby has
jaundice that appears within 24 hours of
birth, persists beyond 14 days of life, or is
deep, involving abdomen, palms and soles, he
must be shown to a doctor. Mild neonatal
jaundice can be treated by exposing the baby
to sunlight in the morning or evening hours.
Q. What are the signs of serious sickness
in a neonate?
A baby who is
feeding well on the breast and has warm and
pink palms and soles is a healthy baby. The
following are the danger signs in neonates:
-
Fever/ feels
cold to touch despite adequate clothing and
warm environment
-
Loose stools
-
Abnormal
movements suggestive of convulsions
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Continuous
crying
-
Cough/breathing
difficulty
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Irritability
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Lethargy
-
Inability to
feed
-
Persistent
vomiting
-
Abdominal
distension
-
Pus from ears/
umbilical stump/ boils over skin
A baby with any of
these signs must be shown to a doctor without
delay.
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