EARLY TREATMENT
Successful transition from fetus immersed in amniotic fluid and completely dependent on the placenta (afterbirth) to meet the needs of food and oxygen, the baby is crying loudly and breathing air, was a miracle. Healthy newborns who require good maintenance in order to grow normally and healthy.
Immediately after birth, the doctor or nurse will gently cleanse mucus and other objects of the mouth, nose and throat baby with a vacuum. Babies will soon breathe its own. The umbilical cord is clamped in two places and cut between them. Infants then dried and laid on a sterile or warm blanket over the mother's abdomen.
Infants then weighed and measured length. The doctor will check for abnormalities that are clearly visible, whereas a complete physical examination will be done later.
Baby's overall condition assessed in the first minute and 5 minutes after birth using the Apgar score.
The Apgar score is the assessment of newborns that are based on:
- Baby's skin color (pink or blue)
- Heart rate
- Respiratory
- Response baby
- Muscle tension (weak or active).
Keeping the newborn warm is a very important thing.
As soon as possible given the baby clothes from a comfortable material, dibedong and his head covered to reduce loss of body heat. Awarded silver nitrate eye drops or antibiotics for protection against infection from contact with harmful organisms during labor.
Once transferred to the infirmary, the baby was placed in a small crib on his side and kept warm. Lull the baby on his side will prevent blockage of respiratory tract fluid or mucus that can obstruct breathing.
Because all babies born with low levels of vitamin K, a doctor or nurse gives an injection of vitamin K to prevent bleeding (hemorrhagic disease of the newborn). Antiseptic solution is applied to the freshly cut umbilical cord to prevent infection.
About 6 hours or more after birth, the baby is bathed. Nurses try to not clean the greasy white material (vernix caseosa) that covers almost the entire skin of a newborn, because this material helps protect against infection.
Causes of newborn larger or smaller than normal
Greater than normal
- My mother suffered from diabetes
- Mothers with overweight
- Infants with congenital heart
- Descendants
Smaller than normal
- Mom drugs or alcohol during pregnancy
- Maternal smoking during pregnancy
- Mothers with poor nutritional intake during pregnancy
- Mothers who did not perform well prenatal care
- Infants infected in utero
- Infants with chromosomal abnormalities.
PHYSICAL EXAMINATION
The doctor will perform a thorough physical examination within the first 12 hours after birth.
Examination begins with a series of measurements such as:
- Considering the weight, the average newborn weight was 3.5 kg
- Measure the length of the body, the average length of the newborn is 50 cm
- Measure the circumference of the head.
Next the doctor will assess the skin, head and face, heart and lungs, nervous system, stomach and genitals baby. The skin is usually red, although the fingers and toes appeared slightly bluish due to poor blood circulation in the first hours of life the newborn.
Normal deliveries with the head first out, will result in the baby's head shape changed and this persists for several days. The bones that form the skull overlap to facilitate the birth of the head through the birth canal. Bruising and swelling of the scalp is a frequently encountered.
In breech delivery breech birth where the first, and usually no change in the form of a baby's head, instead of experiencing limb swelling and bruising are the buttocks, genitals and legs. Sometimes bleeding can occur from the bones of the head and the cover layer (periosteum), resulting in the emergence of a bump on the head (sefal hematoma) that will disappear in a few weeks.
Emphasis during the normal birth process can cause bruising on the face. This pressure can also cause visible face is not symmetrical. Asymmetry of the face may also occur because of damage to one of the facial nerve. Healing in general will occur gradually in a few weeks.
Examination of the heart and lungs with a stethoscope performed to examine the existence of an abnormality. Abnormalities in any of these organs can also be seen through the baby's skin color and general condition. Examination of the pulse in the groin.
The doctor also will check for abnormalities in the nerves and reflexes to test the baby. Important reflex in the newborn is the Moro reflex, sucking reflex and reflex mencucur:
Moro reflex: when the newborn was startled, hands and feet will be stretched to the front of his body is like looking for a handle, with the fingers open.
Reflexes Mencucur: if one corner of the baby's mouth is touched, the baby will turn his head to the side.
This reflex helps the newborn to find the putting.
Sucking reflex: when an object is placed in the mouth of the baby, the baby will soon suck.
Examination of the abdominal area is done by assessing shape, and check the size, shape and position of such tools in kidney, liver and spleen. Kidney enlargement may reveal a blockage in the flow of urine out of the water.
Examination of the arms, legs and hips done by assessing the flexibility and mobility capabilities. The problem is often encountered in the newborn is hip dislocation. This situation can be overcome by installing or storing two or three tier diaper on the baby to hold the hip in its normal position, until healed. If necessary, can be fitted by an expert splint bone.
Examination of genitalia in boys one of them to make sure that both testicles fully in the scrotal pouch. Although it is rare and does not cause pain in newborns, can be twisted testicles (testicular torsion), which need to be addressed by emergency surgery. In a baby girl, her pussy lips protruding. Residual hormonal mother gained during pregnancy will cause the vaginal lips are swollen during the first few weeks.
THE FIRST FEW DAYS
Immediately after a normal birth, mother's helped by the officer to hold the baby delivery room. If the mother wants, breast-feeding can be started at this time. The father also encouraged to hold her baby and spend good times together.
Some experts believe that physical contact with the baby early will help the formation of strong bonds. But parents can form a strong bond with their babies even in the first hours they are not together.
During the first few days after the birth of her child, parents learn to feed, bathe and dress the baby and will soon get used to this activity. Although the mother and baby had to stay for a week and even more in the hospital, today's period of hospitalization ranged only between 2-3 days.
Plastic clamp on the baby's umbilical cord will be released within 24 hours. After that the remaining cord should always be wetted with a solution of alcohol, to speed drying and reduce the risk of infection. Circumcision (circumcision), if desired, usually done in the first days. But this procedure should be postponed if the penis is abnormal, which may require repairs before her skin through plastic surgery.
The decision to perform circumcision depends entirely on the confidence of parents baby. Medically this action is intended to remove the excess skin that can inhibit the flow of urine. Other reasons such as reducing the risk of penile cancer is still under debate.
Circumcision can be risky if the family have a history of blood disorders. Circumcision also be delayed if the mother consumes during pregnancy drugs that increase the risk of bleeding like anticoagulants or aspirin. The doctor will wait until all types of medicines are no longer in the baby's circulation. Infants also received vitamin K to prevent these anti clotting.
Most newborns will experience a skin rash within the first few weeks. The rash usually appears on the skin rubbing against clothes such as arms, legs and back. But it can also appear on the face.
This rash tends to disappear on their own without treatment. The use lotion or powder, scented soap, hot water for bathing and plastic pants for babies will exacerbate this situation, especially in hot weather. Drying and flaking of the skin often occurs after a few days, especially in the folds of the wrists and ankles.
Newborns have some hard lumps under the skin (subcutaneous fat necrosis), where suppression of bone damage some fatty tissue. On with the help of forceps deliveries, certain lumps are often found in the head, cheeks and neck. Lumps may break through the skin surface, clear yellow discharge, but usually will soon heal. Who are otherwise normal baby would look a little yellow on the second day. That must be considered is when the yellow came before the baby was 24 hours.
The first urine is concentrated and released babies contain chemicals that veins appear as pink coloration on the diapers. The doctor will examine the cause, if the baby has not urinate within 24 hours. Delays to urinate occurs more often in male infants. This delay might be due to his penis foreskin is too tight or because of a temporary swelling of the penis after circumcision.
The first stools called meconium out, greenish-black sticky consistency. Every baby should issue meconium within 24 hours after birth. Failure is usually caused by hardening of expenditure meconium meconium in the baby's intestines, which can usually be removed with one or two enemas gently. Congenital defects can cause more serious blockage. Newborns will lose 5-10% of body weight within the first few days.
This weight will soon come back after babies begin to receive food from outside.
GRANT OF EATING
Babies have a reflex mencucur normal and active sucking reflex, and can immediately begin to eat after birth. If the infant is not breastfed by his mother in the delivery room, feeding usually begins within 4 hours after birth. Spitting and spewing mucus are common place on the first day. If this is the case any longer, the doctor or nurse can remove excess mucus from the stomach by inserting a hose slowly through the nose to the stomach. Newborns are being bottle-fed may vomit because of an allergy to milk. Instead, given the low allergy formula.
If the infant is still vomiting, the cause must be sought. Continuous vomiting in babies who are breastfed may be caused by blockage of the gastrointestinal tract that inhibit gastric emptying. Babies never allergic to breast milk. Newborns will urinate as much as 6-8 times a day. They also bowel movement every day, crying loudly, good skin condition and have a strong sucking reflex. All these features indicate that the baby is getting enough breast milk or formula.
The addition of weight will strengthen it.
Sleep a long time between meals showed that the baby is getting milk in sufficient quantities. Although sometimes breastfed babies may sleep longer when they are not getting enough milk. Therefore, babies who are breastfed, premature and should be checked regularly by your doctor to ensure that the provision of sufficient food.
Provision of Milk bottles
Breastfed babies are often given through a bottle of sterile distilled water at the time of first feeding, to ensure that they can suck and swallow reflex vomit and that works fine. This water is not harmful to babies who have trouble feeding. If the baby does not spit out the water, the formula can be given at the next feeding.
At the hospital, babies are usually fed every 4 hours for reasons of efficiency. Infant formula that contains adequate calories and vitamins can be administered in a sterile bottle. Baby's mother should not be forced to quickly finish his milk. Let the baby drink as much as he wants. This feeding should be increased gradually during the first week of life.
Infant formula sold more preferred than in cow's milk, which is not appropriate for the first week of life. Although cow's milk has a composition of a balanced nutrition for infants, but contain less iron. Though iron is important for the formation of red blood cells.
Multivitamins are dropped, which contain vitamins A, C and D, should be given daily to infants who received formula or breast milk during the first year and in winter, where sunlight and vitamin D activation is limited. Fluorine can be added to the formula, if there is no water that contains fluoride.
Fed infants should be given a water bottle between the provision of milk, especially if the weather is hot or hot and dry environment.
Sometimes babies who are not adequately fed, may require supplementary feeding through an IV. The doctor will then try to figure out what causes it.
Giving Mother's Milk
Breast milk is the most ideal food for babies.
Advantages of breastfeeding over bottle feeding are:
Breast milk provides nutrients required infant in its most easily digested and most easily absorbed
Breast milk contains antibodies and white blood cells that protect the baby against infection
ASI can change the acidity of feces and intestinal flora that protects infants against diarrhea due to bacteria.
Due to the nature of such protection, breast-fed babies are generally less exposed to infection than bottle-fed infants. Benefits for mothers bond with babies is more powerful and mothers feel close to her baby.
Yellowish watery fluid, called colostrum, flows from the mother's nipple before breast milk is produced. Colostrum is rich in calories, proteins and antibodies. Antibodies in the colostrum will be very valuable when absorbed directly into the body of the stomach. In this way, infants are protected from disease by maternal antibodies have been formed.
Putting mother does not require special preparation before use for feeding. Manually remove the fluid before labor even in early labor, can lead to breast infection (mastitis). Naturally, the resulting lubricant to protect the surface of the areola and nipple are prepared to suck. This lubricant should not be cleaned / wiped.
Mother took a comfortable and relaxed position, may lie nearly flat and shifted to the left and right breast. Baby is facing mother. Mother holding her breasts, with the thumb and index finger on top of the breast and the other fingers under the breast, and touched her nipple into the baby's lower lip. This will stimulate the baby to open his mouth (mencucur reflex) and devouring breast. Mom pushed the nipple and areola into the baby's mouth, ensure that the nipple was in the middle to prevent injury to the nipple. Before the baby away from the nipple, the mother stopped breastfeeding this by inserting his finger into the baby's mouth and gently push the baby's chin down.
At first, the baby feeds only a few minutes each time. Feedback reflex (let-down reflex) in the mother's body will spur the establishment of breastfeeding. Excessive suction at the beginning of breastfeeding should be avoided. Putting the injury was the result of feeding position and more difficult to treat.
On the other hand, milk production depends on adequate feeding time. Feedings will gradually increase until the milk production totally stable. At first the baby is breastfed about 10 minutes, then breast-feeding for baby wants it.
For the first child, milk production usually occurs within 72-97 hours after delivery. For the next child, the milk will be more quickly formed. If the mother feels tired during the first nights, breastfeeding at midnight (hours 2 nights) can be replaced with water. But the lag time between breast-feeding can not be longer than 6 hours.
Breastfeeding infants should be based on the will, not by time. Similarly, the duration of breastfeeding, should be tailored to meet the needs of the baby. Mothers should check her baby to the doctor, especially at first child, at 7-10 days after delivery so the doctor can find out how the nursing process in progress and answer questions about breastfeeding.
Breasts tend to swell and cause discomfort during the first days of breastfeeding. This swelling can be reduced by more frequent feeding. Wearing a bra that is comfortable for 24 hours a day can help reduce pain. Removing the milk by hand will also reduce the pressure.
Mothers may need to manually remove her breastmilk before feeding so the baby's mouth can include swollen areola area. But spending too much time between feeding tends to cause swelling that persists and expenses should only be done manually to minimize discomfort.
Wrong position of the baby can also cause injury to the mother's nipples. Sometimes the baby pulled his bottom lip and sucked it, causing irritation to the nipple. When this happens, the mother can release the mother the baby's lips with your fingers.
After feeding, the milk is left in the nipple is left to dry by itself, do not wipe or wash off. Can also be dried with a hair dryer with low heat. In very dry climates, hypoallergenic lanolin or ointment can be applied to the nipple. BH-coated plastic should be avoided.
A mother who nursed her breastmilk, require additional nutrients, especially calcium. Dairy products are an excellent source of calcium. But if the mother does not like milk, can be replaced with nuts and green vegetables. Or mothers can also consume extra calcium in tablet form. Vitamin supplements are not needed anymore when nutritional needs are met in the mother's diet, which mainly have to contain vitamin C, vitamin B6 and vitamin B12 are sufficient.
When it's time a baby is weaned (stop getting milk), depending on the needs and desires of the mother and baby. Breastfeeding for at least 6 months will be very beneficial. Gradual weaning will be easier, both for mother and baby, from the sudden dismissal. At the time of weaning, usually infants introduced to solid foods. ASI awarded as much as 8-10 times / day, and solid foods are given to 3 times / day. Breastfeeding and then gradually reduced.
When the baby is 7 months old, one-time breastfeeding should be replaced with a bottle of fruit juice, milk or formula squeezed. Learning to drink from a glass is a time of significant development and can usually be done at the 10-month-old baby. Some babies still need 1-2 times / day to suckle his mother until the age of 18-24 months. If breastfeeding lasts longer, the child should also be given solid food and was taught to drink by the glass.
Solid Feeding
Time to start giving solid foods depends on the baby's needs and readiness. Usually before the age of 6 months, babies do not require solid foods, although they are able to swallow food at the age of 3 or 4 months.
Sometimes parents force infants to eat solid food so much sleep soundly at night. But this will not work and can cause feeding problems in the future. Many babies who received solid foods after drinking milk or milk bottle, so suck it needs are met and his hunger was gone.
The first time is usually given oatmeal, and fruits and vegetables. Allergy or sensitivity to foods is easier to detect if the baby be given porridge, fruit or vegetables the same for several days. These foods should be provided with a spoon so that baby learns a new way of eating.
Most baby food is bought and sold, especially the types of desserts and soups, contain high levels of starch. Flour contains no vitamin or mineral, high calorie and difficult to digest for babies. Some instant baby foods also contain very high levels of sodium.
Foods that are made in house price is much cheaper and much better nutritionally. Meat can be given after the baby is 7 months old. Meat is better than carbohydrate-rich foods, because babies need the protein in large quantities. Since most babies do not like meat, the gift must be careful and attentive.
Many children are allergic to wheat, eggs and chocolate, so his gift to the baby should be postponed until the age of 1 year. Giving these foods will cause allergies later in life. Giving honey preferably after age 1 year, because of the possibility of Clostridium botulinum spores. These spores can cause botulism in babies, but harmless to older children.
PHYSICAL DEVELOPMENT
Physical development of babies depends on heredity, nutrition and environment. Physical and psychological disorders can also affect growth. Growth requires optimal nutrition and optimal health as well. The length of the baby's body increased by about 30% at age 5 months and more than 50% in a year. Weight will be doubled in 3 months and tripled in a year.
Different organs grown with different levels. For example, reproductive system changes very little before puberty. While brain development is almost entirely fulfilled during the first year of a child's life. At birth the brain size of about 1 / 4 measure is in adulthood. At the age of one year size 3 / 4 adult size.
Renal function at the end of the first year has already reached adult function. Lower front teeth will appear at the age of 5-9 months. Upper front teeth will appear at the age of 8-12 months.
INTELLECTUAL DEVELOPMENT & BEHAVIOR
Behavioral and intellectual development levels differ between children with one another. Sometimes there are certain patterns in a family such as late walking or late talking.
Environmental factors such as lack of stimulation can inhibit normal development. Physical factors such as deafness can also slow the baby's development. Despite the development of children is usually kept continuous, but can stop on a particular function, such as speech.
At first babies sleep most of the time. Babies can eat, coughing when airway disturbed and crying in reaction to the disruption or inconvenience.
At the age of 6 weeks the baby will look directly at objects that are directly in front of him and smile when spoken to. His head was still shaking when baby is pulled into a sitting position.
At the age of 3 months, your baby smiles when they hear the voice of his mother, making noises and follow the first moving object. The head is steady when the infant in a sitting position. Infants will grasp the object in his hand.
At the age of 6 months, babies can sit with assistance and roll. Most babies can stand with assistance and can move an object from one hand to another hand. Babies make a sound when he was playing. At the age of 9 months, your baby can sit properly and a crawl, pull himself to a standing position and say "mama" and "dada" clearly. At 12 months of age infants are usually able to walk by holding someone's hand and say a few words.
EXAMINATION IN THE FIRST YEAR
Screening test (screening test) is intended to detect abnormalities at an early stage. Early diagnosis and proper management can reduce or prevent the disorder that will affect the baby's healthy development.
Before leaving the hospital, newborns have blood drawn for a number of laboratory tests. For example to determine levels of thyroid hormones in the blood, due to low levels can cause cretinism, a thyroid disorder characterized by chronic physical and mental development is stunted. A newborn with low thyroid hormone levels get thyroid hormone medication by mouth (orally) on days 7-10. Other disease, phenylketonuria, if untreated can cause mental retardation.
Many other tests screened can be done. Screened against homosistinuria example, maple syrup urine disease, galactosemia, and sickle cell disease. Sometimes this is done based on the screened background of ethnic and genetic parents.
Length, weight and head circumference are always checked at every routine visit to the doctor within the first year. At each visit the doctor will listen to the sound of the baby's heart with a stethoscope. An abnormal sound could indicate the presence of heart disease. At each visit, the doctor also will check the baby's abdomen for several rare cancers such as Wilms' tumor and neuroblastoma can be known only in line with the growing baby.
Babies born prematurely will periodically undergo an eye examination to discover the existence of retinopathy due to prematurity.
IMMUNIZATION
Children must be immunized to protect them against infectious diseases. Vaccines are very safe and effective, although some children may experience mild reactions after being immunized. Most vaccines are given by injection and some through the mouth, such as polio.
Infants received the first vaccine was Hepatitis B vaccine, then the first dose of vaccine is diberkan during the first week of life, sometimes keitka infants still in hospital. Other routine immunizations starting at week 6-8. Immunization should not be postponed, although the baby was having a mild fever due to infection usually mild.
Many vaccines require more than one dose to provide full protection. Immunization schedule to be provided is not a rigid schedule. Parents should try to bring their children for immunizations on schedule, but if there is a delay, the final results obtained immunity will not be affected. Nor is it necessary repetition of the initial vaccine series. Some of the recommended vaccines are given in certain circumstances. For example, Hepatitis A vaccine is given to people who continue their education or travel abroad.
On one visit to the doctor, may be given more than one vaccine. But some vaccines are often mixed in one injection, such as pertussis vaccine, diphtheria, tetanus and Hemophilus influenzae type B. A combination vaccine reduces the number of injections but does not guarantee the safety and effectiveness of the vaccine. To help prevent severe gastroenteritis due to rotavirus infection, rotavirus vaccine can be given by mouth (orally).
IMPORTANT EVENTS IN THE FIRST YEAR
1 month
- Bringing her hands to the eyes and mouth
- Move the head to the right and left if ditengkurapkan
- Following the movement of objects at a distance of about 15 cm from the center line of his face (right in front)
- Reacting to a shocked voice, weeping or silent
- Turning to a familiar voice or sound
- Paying attention to someone's face
3 months
- Lifting the head 45 degrees (possibly up to 90 degrees) if ditengkurapkan
- Opening and closing the hand
- If diberdirikan above a flat surface, pressing his foot down
- Following the swaying movement of the toy and try to achieve it
- Following the movement of objects in front of his face, from right to left or vice versa
- Noting the face more closely
- Smiling to hear mother's voice
- Start noises
5 months
- Start could hold his head steady
- Rolling from prone to supine
- Reaching the object
- Identify people at a certain distance
- Listen to the voice of people with carefully
- Smile spontaneous
- Screaming with joy
7 months
- Sit without help
- When diberdirikan, could hold some weight
- Moving objects from right hand to left hand or vice versa
- Paying attention to the object being dropped
- Reacting when his name was called
- Reacting where prohibited
- Babbling, combining vowels and consonants
- Swaying happily when invited to play
- Playing Peek-ba
9 months
- Trying to reach the toys that are beyond the scope
- There was an objection when the toy is taken
- Crawling or creeping on hands and lutunya
- Trying to stand
- Stand by holding
- Saying 'mama' or 'papa'
12 months
- Sitting of the prone position
- Walking with a holding, it may move 1-2 steps without assistance
- Stand up straight without assistance for a while
- Calling parents by saying 'mama' or 'papa'
- Drinking from a glass
- Clapping hands and waved.
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