Neonatal Health

Key interventions for improving newborn health include: ensuring a skilled attendant at every birth; tetanus toxoid immunization; and immediate and exclusive breastfeeding. The more you know about infant and toddler health, the more comfortable you'll feel caring for your child. Start by sharing your questions about infant and toddler health with your child's doctor. Remember, nothing is too trivial when it comes to your child's health.

A baby's birthweight is an important indicator of health. The average weight for term babies (born between 37 and 41 weeks gestation) is about 7 lbs (3.2 kg). In general, small babies and very large babies are more likely to have problems. Babies are weighed daily in the nursery to assess growth and fluid and nutrition needs. Newborn babies may lose as much as 10 percent of their birthweight. This means that a baby weighing 7 pounds 3 ounces at birth might lose as much as 10 ounces in the first few days.

The Apgar Score
About a minute after birth and again at five minutes your caregiver will check your baby and give him a 'score' using a five-point guideline called the Apgar test. The test assesses your baby's colour, breathing, heart-rate, muscle tone and response to stimuli, giving 0, 1 or 2 points for each. Most babies will have a score of around 8 points at one minute and 10 points at five minutes; however, if a baby has experienced a more difficult birth, the first score may be less than five. The score is widely used to give doctors an idea about how traumatic the baby's delivery has been and how well he may have recovered. Anything over six is normal, less means immediate attention is needed, with a score less than three indicating the baby may need resuscitation.
Sample Apgar Scoring Chart :

  0   1   2
Skin Colour:   Blue   Extremities - blue   Completely pink
Breathing:   Absent   Slow   Normal
Muscle Tone:   Limp   Some movement   Strong movement
Response to Stimuli:   Absent   Slight   Cry, cough or sneeze
Heart Rate:   Absent   Under 100 beats per minute   Over 100 beats per minute

There's no way to be completely prepared for complications during delivery or for the discovery that your child has a birth defect or medical problem. But understanding common newborn health problems and how they're treated might reduce anxiety about the potential that something might go wrong. With prenatal tests, doctors often can detect certain birth defects such as spina bifida, Down syndrome, congenital heart disease, exposed bowel, or cleft lip, before the baby is born. Other birth defects can't be discovered until after the baby is born. Delivery complications such as meconium aspiration (when a newborn inhales a mixture of meconium — the baby's first feces, ordinarily passed after birth — and amniotic fluid during labor and delivery) can occur. If a birth defect is discovered prenatally, your doctor may discuss what will happen in the time right after you deliver the baby. You and your doctor should discuss which hospital is best prepared to deal care for your baby so that you can plan to deliver there.

After losing some of the birth weight (up to 10%) during the first few days of life, your baby should have regained that weight and then some, gaining at least 2/3 ounce (18.9 grams) per day. As a 1- to 3-month-old, your baby will likely continue to grow at a similar rate, while also gaining 1 to 1.5 inches (2.54 to 3.81 centimeters) in length per month. These are just averages. Your baby may grow somewhat faster or slower, and is likely to experience growth spurts along with other times of slower growth. Your pediatrician will measure your baby's weight, length, and head circumference and track your baby's growth pattern on a standardized growth chart (there are different charts for boys and girls). Generally, whether your baby is large, small, or medium-sized, as long as your child's growth pattern stays consistent over time, chances are excellent that he or she is doing fine.

During pregnancy it is important for both you and your baby to be well nourished. It is as important to be fit. Being physically fit can help you stay healthy during pregnancy and can reduce the likelihood of complications during labor and actually make labor shorter.
How you feed your newborn is the first nutrition decision you will make for your child. The American Academy of Pediatrics (AAP) and other professional groups concerned with the care of newborns advocate breastfeeding as best for your baby. Specifically, the AAP recommends that babies be breastfed exclusively for about the first 6 months. Following the introduction of solid foods, breastfeeding should continue through the first year of life and beyond, if desired. Breastfeeding may not be possible or preferable for all women. Deciding to breastfeed or bottle-feed a baby is usually based on the mother's comfort level with breastfeeding as well as her lifestyle, but breastfeeding may not be recommended for some mothers and babies. If you have any questions about whether to breastfeed your child, talk to your pediatrician.

Your newborn should be nursing eight to 12 times per day during about the first month. In the beginning, mothers may want to try nursing 10 to 15 minutes on each breast, then vary the time as necessary. Once your milk supply is established, breastfeeding should be "on demand" (when your baby is hungry), which is generally every 1 to 3 hours. As newborns get older, they'll need to nurse less frequently — some may feed every hour and a half, whereas others may go 2 or 3 hours between feedings. For babies who are getting formula, they'll likely take about 2 to 3 ounces every 2 to 4 hours. Newborns should not go more than about 4 hours without feeding.

Breastfeeding your newborn has many advantages. Perhaps most important, breast milk is the perfect food for a human baby's digestive system. It contains the vitamins and minerals that a newborn requires, and all of its components — lactose, protein (whey and casein), and fat — are easily digested by a newborn's immature system. Commercial formulas try to imitate breast milk, and come close, but the exact composition cannot be duplicated. Also, breast milk contains antibodies that help protect infants from a wide variety of infectious diseases, including diarrhea. Studies suggest that breastfed babies are less likely to develop certain medical problems, including diabetes, high cholesterol, asthma, and allergies. Breastfeeding may also decrease the chances that the child will become overweight or obese.

Commercially prepared infant formula is a nutritious alternative to breast milk. Bottle-feeding can offer more freedom and flexibility for the mother, and it makes it easier to know how much the baby is getting. Because babies digest formula more slowly than breast milk, a baby who is getting formula may need fewer feedings than one who breastfeeds. Formula-feeding also can make it easier to feed the baby in public, and allows the father and other family members to help feed the baby, which can enhance bonding.

Educational programming for healthcare professionals

MEDIVISION ™ collaborates with recognized leaders in the fields of medical and pharmaceutical sciences to provide educational programming for medical specialists, universities and medical schools. Our DVD catalog contains over 200 titles in 35 separate healthcare fields, including a wide variety of specialist topics essential to healthcare professionals.

Neonatology programming >