Friday, August 8, 2008

Health Care and Newborns

Going home with a new baby is exciting, but it can be scary, too, according to the National Institutes of Health. Newborns have many needs, like frequent feedings and diaper changes. Babies can have health issues that are different from older children and adults, like diaper rash and cradle cap. Your baby will go through many changes during the first year of life. You may feel uneasy at first. Ask your health care provider for help if you need it. And, according to the Nemours Foundation, consider recruiting help from friends and family to get through this time, which can be very hectic and overwhelming.

While in the hospital, use the expertise around you. Many hospitals have feeding specialists or lactation consultants who can help you get started nursing or bottle-feeding. In addition, nurses are a great resource to show you how to hold, burp, change, and care for your baby. For in-home help, you might want to hire a baby nurse or a responsible neighborhood teenager to help you for a short time after the birth. In addition, relatives and friends can be a great resource. They may be more than eager to help, and although you may disagree on certain things, don't dismiss their experience. But if you don't feel up to having guests or you have other concerns, don't feel guilty about placing restrictions on visitors. The University of Virginia Health System says that assessing the health of a newborn is very important for detecting any problems in their earliest, most treatable, stages.

Since newborns require constant attention, the UVAHS also provides valuable information about looking for any warning signs to monitor the health of babies. Your newborn baby is going through many changes in getting used to life in the outside world. Almost always this adjustment goes well, however there are certain warning signs you should watch for. Some general warning signs with newborns include, but are not limited to:
--no urine in the first 24 hours at home. This can be difficult to assess, especially with disposable diapers.
--no bowel movement in the first 48 hours.
--a rectal temperature over 100.4° F (38° C) or less than 97.5° F (36.5° C).
--a rapid breathing rate over 60 per minute, or a blue coloring that does not go away. Newborns normally have irregular respirations, so you need to count for a full minute. There should be no pauses longer than about 5 seconds between breaths.
--retractions, or pulling in of the ribs with respirations.
--wheezing, grunting, or whistling sounds while breathing.
--odor, drainage, or bleeding from the umbilical cord.
--yellow coloring of the eyes, chest, or extremities.
--crying, irritability, or twitching which does not improve with cuddling and comfort.
--a sleepy baby who cannot be awakened enough to nurse or nipple.
--any signs of sickness (i.e., cough, diarrhea, pale color).
--the baby's appetite or suck becomes poor or weak.

Every child is different, so trust your knowledge of your child and call your child's physician if you see signs that are worrisome to you. If any of these signs should occur, you should contact the doctor right away or take the newborn to the nearest medical facility. Waiting too long or ignoring these medical issues may seriously jeopardize the health of the newborn. Even if the infant is not in imminent danger, any significant change of health, especially in the first 30 days or less, should be addressed as a matter of precaution. Newborns are, indeed, fragile. And they are totally dependent on adults to make sure that their health needs are attended to as a matter of safety and ongoing care during the first days and weeks of life out of the womb.

A very good online resource for newborn information is KeepingKidsHealthy.com. One of the areas they detail is material concerning pre-mature babies. These newborns require extreme care from health care facilities, physicians, medical staff, and parents. A normal pregnancy lasts nine months, or about 38 to 42 weeks. Newborns are considered to be premature if they are born before they are 37 weeks old. Although there are many risk factors that can help to predict which pregnancies are at risk for premature delivery, in most cases, no cause is found. Among the risk factors that may increase your chances of having a premature baby include:
--Having delivered a previous premature baby, which puts you at a 20-40% of having another premature baby.
--Multiple gestation pregnancies, such as twins, triplets, etc. The risk increases with each additional fetus.
--Placental abruptions and placenta previa are two causes of bleeding that can lead to a premature delivery.
--Having too much (polyhydramnios) or too little (oligohydramnios) amniotic fluid.
--Infections during pregnancy, especially if they spread to the uterus or placenta.
--Diabetes.
--High blood pressure.
--Preeclampsia, which causes maternal high blood pressure, proteinuria (spilling protein in your urine), and swelling.
--Maternal smoking or use of illicit drugs.
--Maternal malnutrition, especially if it leads to poor weight gain during pregnancy.
--Fibroids, an abnormally shaped uterus and cervical incompetence.
--Becoming pregnant while being treated for infertility, having a previous abortion in the 2nd trimester, and not having prenatal care.
--Problems with the fetus can also lead to a premature delivery, including infections, poor growth and certain birth defects.

The site also recommends that if you think you have risk factors for having a premature baby, be sure to discuss them with your obstetrician. You may have to be seen by a perinatologist, who is a doctor that specializes in high risk pregnancies. If you believe that you are having preterm labor, then you should call your doctor. Among the symptoms of preterm labor include frequent uterine contractions, pain, and increased vaginal discharge, especially if bloody (it may be your mucus plug) or a lot of clear fluid (which can be your water breaking). The more mature your baby is at birth, the more likely that it is that he will not have any problems, so that babies born at 26-29 weeks have a much better chance of surviving and growing up either normal or with mild or moderate problems. Babies born at 30-33 weeks usually do even better, and have a very high rate of survival. After 34 weeks, babies are usually only mildly immature and usually do very well. KeepingKidsHealthy.com has much more detail that can assist you in learning more about pre-mature birth and other newborn needs.

The Pregnancy & Parenting section on iVillage.com has information about newborns and the first hours of life related to tests done by the hospital staff. After your child's birth, your baby will experience many important medical procedures, many of them mandated by law. But as long as your child is healthy (and 90% of full-term newborns are), we recommend requesting that all tests (except the Apgar evaluation, which must be performed immediately after the birth) be delayed for at least the first hour of your child's life. This will preserve a very special time for you and your partner to bond with your child immediately after the birth. The following tests and procedures may be performed: Apgar evaluation, eye prophylaxis, vitamin K injection, newborn metabolic screening, blood sugar testing, and hepatitis B vaccine. The Apgar test is a score (named for its creator, Virginia Apgar) that helps evaluate your baby's general condition at birth. The test is performed at one and five minutes after birth by evaluating the infant's heart rate, breathing efforts, muscle tone, reflexes and color and assigning a score of 0, 1 or 2 to each category. A total score of 10 is the highest, and most babies will rate between seven and nine by five minutes.

According to the March of Dimes, newborns send signals to their parents about how they feel and what they need. But as a new parent, you may not know how to read those signals. As the parent of a newborn, you will want to be aware of the following:
--How babies signal that they're hungry, tired, don't feel well or want to play.
--How sleep patterns change over time.
--How a newborn responds and moves.
--How to manage a crying baby.
And, among other issues, you will also want to be knowledgeable about these newborn traits:
--States of awareness
--Sleeping
--The newborn's senses
--Reflexes and movements
--Crying
--Eating
--Playing and break time

Providing nurture and care for a newborn is a full time job not to be taken lightly by any parent or health care provider. Knowing what to do is also as important as when to do it. If you have experienced a recent birth or are about to for the first time, take time to get educated on the best ways to manage their care. There are plenty of resources available that leave no doubt about the care and treatment for newborns. Newborns, regardless of whom or where, are precious gifts from God. Treat them accordingly.

Until next time. Let me know what you think.

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