The Newborn

The newborn period—the first 28 days of life—is the most delicate and critical phase in a child’s development, as the baby tries to adapt to life outside the womb. A number of organs are still developing; they have limited immunity, and are significantly more predisposed to infection and thermal instability.

Care and attention must be given to ensure the child transitions through this period safely.

The first 24 hours after birth are usually spent in the health facility that the baby was delivered in, and the care of the baby and mother is overseen by the trained health workers. Hence, all that is needed by caregivers is compliance with the doctor's directive. 

However, here is a highlight of the care every newborn should get in the first 24 hours. So you can know what to expect.

Immediately after birth, the baby is thoroughly dried with two pieces of dry linen. If the child is crying, it's a sign of good respiration. He is then placed on the mother’s abdomen. 

The cord is clamped in the first few minutes, after which the baby is then returned to a position in between the mother's breasts, chest-to-chest. This helps the baby to easily locate the breast and start sucking. This should be done within the first 30 minutes. 

After the first hour, steps are taken to prevent infection and illnesses.

To help prevent infections in newborns, healthcare providers often use special medications. For example, chlorhexidine gel is applied to the baby's umbilical cord to protect it from germs, while erythromycin eye ointment is used to prevent eye infections that newborns can get during birth. The baby is also administered Vitamin K to reduce the risk of spontaneous bleeding. 

Following this, the baby is assessed. Important parameters such as weight, temperature, respiratory rate, heart rate are measured in this period, and the baby is classified into the appropriate state of health based on the results of these findings. 

For a child, who has been classified into the green zone (a healthy child), discharge happens about 24 hours after. 

Before discharge, the mother and relatives are now educated on how to take care of her baby. 

But, just in case you got a little carried away when you were being lectured by your doctor. Here's a comprehensive guide on how to care for your child in the first 28 days after discharge. This is the part that's rather more important for caregivers, as the care of the baby is left to the caregivers and their relatives. 

Here are some important things to note:

1.Feeding your baby: 

Watch for your baby's hunger signal, such as opening his mouth and turning his head. Feed your baby as much  and as often as he desires. At least every two to three hours, day and night. 

Feed your baby only your breast milk for the first 6 months. No water, sweetened water, honey, or even formula milk. 

About Colostrum:

This is the milk secreted in the later part of pregnancy and in the first 3–6 days after pregnancy. It is deep yellow in color. It is rich in proteins and minerals and contains immunoglobulin, especially IgA, which helps fight infections and develop your baby's immunity. It is your baby's liquid gold! 😁

About Meconium:

Meconium is the dark, sticky, and tar-like stool that newborns pass in the first 24–48 hours after birth. It is made up of amniotic fluid, mucus, and waste the baby ingested in the womb.

It is normal and expected. 

2. Warmth:

Ensure skin-to-skin contact for prolonged periods, especially for smaller babies. During this period, there is no need to wash him every day but be sure to keep his face and bottom clean. You may also delay bathing till after the first 24 hours.

Dress your child with an extra layer of clothing and a covering on his or her head.

Keep the room at a temperature of 22–26 °C. Avoid exposure to cold air and dress appropriately when going outside. 

Watch for signs of hypothermia (that is, low body temperature) like cold skin, weak cry, and difficulty feeding, and seek medical help if needed.

 

3. Breathing:

Ensure your baby sleeps on his back and not on his side or abdomen, as this can affect his breathing and lead to severe consequences. Also avoid exposure to smoke, as this can affect your baby's breathing control and blood oxygen levels. 

4. Prevention of infection:

Ensure your child sleeps under a long-lasting insecticide-treated mosquito net. 

5. Early Identification of Danger Signs in Your Baby

Fast breathing: Your child is breathing faster than normal (more than 60 times in a minute) 

Chest Indrawing: You notice that the chest draws in with every breath.

Cold body temperature: Your baby's belly and feet are cold compared to yours.

Hot body temperature: Your baby's body is hot to touch.

Not feeding: You notice your baby is not responding to feeds or not waking up to feed. 

Lethargy: The baby only moves when stimulated

Convulsions: The baby may have unusual eye or mouth movement or repetitive jerking of the arms and legs. 

Jaundice: Yellowness of the eyes and skin, especially persisting for more than two weeks. 

Failure of passage of meconium after 48 hours.

If you notice any of these signs above, see a doctor immediately!

In Conclusion:

The first 28 days of life are a critical period. The mother would have to rest a lot, as she is recovering from the energy expended during delivery. She would also have to adjust her sleep patterns to that of her baby so that she can be awake to provide feed as the baby demands. 

Hence, the need for maximum social, emotional, and financial support in this period. Help with household chores is very much needed at this time. 

The mother is also supposed to eat adequately nutritious food to aid. A healthy diet and increased fluids for the mother are needed in order for her to recover from pregnancy and make adequate breast milk. 

This may seem like a lot. It may actually be the most demanding period in the journey of raising a well child. Be of good cheer; a world changer is being groomed by you! ☺️