Need of normal baby and child

Dr CHETAN DAS HOTWANIAssistant professor

Department of paediatrics

Jamshoro

ENCC 3 2

Need and Care of the baby at the time of birth

(Until around 1 hour after birth)

Need of newborn baby

• Provide a clean, warm, draught free room for delivery at 25-280C.

• After birth immediately dry baby with a clean, dry, warm cloth.

• Put baby on mother’s abdomen or a warm, clean, dry surface.

• Give baby to its mother for skin-to-skin contact.

• Cover baby’s head.

• Encourage breastfeeding as soon as possible after birth

• Use a radiant heater if the room is not warm or baby is small.

Drying the baby immediately after birth

Immediate newborn care

• Assess the baby’s breathing while drying.– Make sure there is not a second baby– Change gloves

• Clamp and cut the umbilical cord

• Put the baby between mother’s breasts for skin-to-skin care

• Cover mother and baby with warm cloth.

• Put a hat on the baby’s head.

• Encourage breastfeeding

Eye care at the time of birth

The first breastfeed To help a baby successfully breastfeed soon after

birth, we should:• Give the baby to its mother for skin-to-skin contact• Let the baby feed when it is ready.• Check the position and attachment when the baby is

feeding.• Let the baby feed for as long as it wants on both breasts.• Keep the mother and baby together for as long as possible

after delivery, • Delay tasks, such as weighing, washing etc until after the

first feed.

When should a newborn baby need to be examined?

After birth:• At around an hour • before discharge from hospital (no discharge before

12 hours of age)• If there is maternal concern about the baby’s

condition• If a danger sign observed during monitoring

After leaving the hospital:• during the first week of life at a routine visit• follow-up

Normal findings in neonatal age

A baby:• passes urine six or more times a day after

day 2.• May pass six to eight watery stools a day. • May have some vaginal bleeding for a few

days during the first week after birth. It is not a sign of a problem.

Normal respiratory rate of a newborn baby

• 30 to 60 breaths per minute.

• no chest in-drawing. • no grunting on breathing out.

• Pakistan is still one of the country where infant mortality rate is high.

• To reduce this mortality rate we have to work hard to achieve the millennium developmental goal.

NEED OF HEALTHY INFANT

• For a healthy infant, the mother should be present during this examination; even minor, seemingly insignificant anatomic variations may worry a family and should be explained.

• Initial concerns of mother about:• Eating,• Sleep regulation,• Repetitive (e.g., self-stimulating ) behaviors

are common.

neonatal causes

• Among the neonatal causes the common are neonatal asphyxia, neonatal tetanus, neonatal sepsis. These deaths and morbidity can be avoided by

Health education of mother during pregnancy Delivery conducted by trained personnel

• Delivery conducted in hygienically sound environment.

• Tetanus vaccination of the mother during pregnancy.

• Referral of high risk pregnancy to tertiary care hospital.

• Nearly all the major illness in Pakistan are preventable.

• gastroenteritis leading cause is Rota virus. Among other causes are giardiasis,shigella and e.coli

• The source of all these organisms is contaminated water and food.

• Prevention from all these is possible by safe water supply and food.

• In gastroentritis the major cause of death is dehydration .(50%)

• Although it has decreased in past 10 years but still Pakistan is among the top five countries where children die due to dehydration.

• These deaths can be avoided by early recognition of dehydration.

• The solution could be vaccination of Rota virus, safe supply of food and water and implementation of IMNCI to recognize the signs of dehydration.

• The second major illness is pneumonia.• Common organisms are different for each age group.• Among them some can be prevented by vaccines and

all by infection control strategies.• Recently pneumococcal vaccine included in EPI• IMNCI again is the solution for the early identification

of signs and symptoms of pneumonia

• Among others are typhoid fever, measles;hepatitis, and tuberculosis and malaria.Fortunately these all are vaccine preventable

disease except MALARIA.

• On top of all these are malnutrition .• A large percentage of our Pediatric population is

malnourished.• Various factors are responsible for it like poverty, lack

of education ,lack of hygiene, overcrowding .• The malnourish child is immunocompromised so all

the diseases are more prevalent in this population

Solution are

• Improve our vaccination coverage: If we increase our EPI coverage to more than

80% we can decreased the incidence of infectious diseases like Measles and TB

and it will help in decreasing morbidity and mortality in our infant and children

Decreasing malnutrition

If we address to malnutrition in our children and increase their nutritional intake then we can decrease our infant mortality rate.

• 3. Education and awareness: This is the government job to increase the literacy

rate of our population and we have studies which show that if the mother is educated she will be aware of their child, food and nutritional requirements and significance of vaccination.

Undernutrition and child mortality

Diarrhea12%

Measles5%

Perinatal & Newborn

22%

All other causes

29%

HIV/AIDS4%

Pneumonia20%

Malaria 8%

54% of child mortality is associated with underweight condition

9.5 million under five deaths in 2006

The single largest common denominator in global child deaths is malnutrition

Severe wasting is an important cause of these deaths (it is difficult to estimate)

Proportion associated with acute malnutrition often grows dramatically in emergency contexts

Malnutrition

54%

Caulfied, LE, M de Onis, M Blossner, and R Black, 2004

• It is the government responsibility for the provision of clean drinking water.

• WHO says that it is the right of every human being and they should have access to safe and clean drinking water.

Need of infant and child

• What is need of new born?• What step at home mother take for helthy

baby.• What are possible preventive step to promote

health of baby and child.• What step you take out side home for child

safty.

• Pakistan is still one of the country where infant mortality rate is I,50,000 .

• To reduce this mortality rate we have to work hard to achieve the millennium developmental goal.

The initial examination of a newborn infant should be

performed as soon as possible after delivery. Temperature, pulse, respiratory rate, color, type of

respiration, tone, activity, and level of consciousness of infants should

be monitored frequently until stabilization

• . Congenital anomalies of varying degrees of severity may be present in 3-5% of infants. After a stable delivery room course, a 2nd and more detailed examination should be performed within 24 hr of birth.

• For a healthy infant, the mother should be present during this examination; even minor, seemingly insignificant anatomic variations may worry a family and should be explained.

• The explanation must be careful and skillful so that otherwise unworried families are not unduly alarmed. Infants should not be discharged from the hospital without a final examination because certain abnormalities, particularly heart murmurs, often appear or disappear in the immediate neonatal period; in addition, evidence of disease that has just been acquired may be noted.

• Initial concerns about eating, sleep regulation, and repetitive (e.g., self-stimulating or self-soothing) behaviors are common.

• Sleep Concerns • Sleep is often disrupted as the child reacts to changes

in routines and environments.• Efforts to create continuity between the preadoption

and postadoption environment can be helpful.• Within the first few months, as the child's emotional

self-regulation improves, many sleep concerns subside. Similarly, stereotypic behaviors, such as rocking or head banging, often diminish within the first few months following adoption.