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Newborn

A newborn is a baby from birth to 3–4 weeks of life.

The body length of a healthy full-term baby at birth is on average 48–52 cm (from 45 to 56 cm). Its average body weight is 3200–3300 g (from 2500 to 6000 g). Body length is more constant and rather reflects the degree of development of the newborn.

Morphological and functional signs of the neonatal full-term: loud cry, pink skin color, satisfactory muscle tone , active movements, well-pronounced sucking reflex, regular breathing, loud heart sounds , rhythmic pulse , head circumference 1-2 cm more than the chest circumference, skull bones thick, open large and in some small fountains, hair on the head is 2-3 cm long, nails protrude beyond the edges of the fingers, boys have testicles in the scrotum, girls have small labia are covered with large lips. To determine the term of the newborn, it is necessary to take into account the duration of pregnancy.

From the moment of birth (the neonatal period), the functions of all organs and systems, the adaptation of the newborn to an independent extrauterine life take place. During this period, regular breathing appears, blood circulation is reorganized, the umbilical wound heals, a gradual increase in the activity and consumption of breast milk, the adaptation of the skin to the external environment, the development of thermoregulation , etc.

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In the newborn there are so-called special conditions. These include a generic tumor, physiological catarrh of the skin, physiological jaundice, physiological weight loss, hormonal sex crisis, transient fever.

A generic tumor occurs on the presenting part of the fetus during childbirth as a result of the serous soaking of soft tissues due to the stagnation of lymph and blood with the formation of small hemorrhages. Often the generic tumor is located in the region of the crown and occiput (see Cephalhematoma); it can be on the face, buttocks, limbs and genitals. Usually, in the next 2-3 days, the birth tumor disappears and does not require special therapeutic measures. With a large generic tumor, cold is shown (ice bubble at a distance of 20 cm from the child’s head) for the first 2 hours and antihemorrhagic treatment: 5% solution of calcium chloride, 5 ml 4 times a day, 0.02 g rutin and 0.002 g wikasol 2 times a day for three days.

Physiological catarrh of the skin is characterized by redness of the skin (erythema) as a result of the transition of the fetus to the dry air environment.

Erythema gradually disappears by the 5th – 7th day of life, and then in some of the children a strong peeling of the epidermis occurs. In addition, 30–50% of newborns on the 2–7th day of life develop a polymorphic rash consisting of small reddish spots and vesicles localized on the body, with the exception of the palms and soles. This is the so-called toxic erythema. She disappears in 2-3 days. Special therapeutic measures are not required.

Physiological jaundice is characterized by icteric staining of the skin, visible mucous membranes and sclera. It appears in 40–60% of newborns on the 2nd – 3rd day, less often on the 5–6th day of life, and usually disappears by the 7th – 10th day. The origin of physiological jaundice is explained by increased destruction of red blood cells and functional immaturity of the liver of the newborn. Physiological jaundice does not require specific treatment. Newborns are given 5% glucose or sugar solution (100 ml per day), isotonic sodium chloride solution (100 ml per day) and vitamin C (100 mg per day). Rapidly developing jaundice in the first days of a child's life suggests hemolytic disease of the newborn (see).

Jaundice in newborns can be a manifestation of various diseases (see Jaundice).

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Table of weight norms for newborns up to 1 year old by week *
Child's age in weeks weight standards for boys in kg weight standards for girls in kg
0
1
2
3
4
5
6
7
8
9
10
eleven
12
13
3.35
3.49
3.75
4.06
4.37
4.66
4.93
5.18
5.41
5.63
5.83
6.02
6.2
6.37
3.23
3.34
3.57
3.84
4.1
4.35
4.58
4.8
5.0
5.18
5.36
5.53
5.69
5.84
* Note : the weight of newborns in relation to age in weeks is given according to WHO 2006 data.

The physiological drop in the weight of the newborn is observed in the first 3-4 days of life (sometimes up to the 6th day) and usually does not exceed 8-10% of the weight at birth. Weight loss over a longer period of time or in excess of 8–10% indicates ill health in the child’s health or hypogalactia in the mother (see Lactation ).

Hormonal sexual crisis is observed in newborns due to the transition of the mother's estrogenic hormones to the fetus through the placenta and with milk. It occurs in 0.7% of cases and is expressed in girls with swelling of the mammary glands in combination with swelling of the labia majora and sometimes bloody-mucous secretions from the genital slit, in boys, swelling of the scrotum. It manifests itself on the 2nd-5th day of life, the maximum increase in the mammary glands occurs on the 8th-10th day and disappears on the 2nd-3rd week of life. Breast augmentation does not require treatment. However, if the child is anxious, the skin over the gland can be smeared with 2% iodine tincture or camphor oil and a light cotton bandage can be applied to reduce friction with clothes. During this period, infection of the mammary gland may develop its inflammation (mastitis), often with subsequent suppuration. Clinical manifestations of mastitis: hyperemia of the breast skin, an increase in the size of the gland, an increase in body temperature, soreness and swelling of the axillary lymph nodes and the gland itself. Initially, treatment may be conservative: ointment dressings, dry heat, UHF , antibiotics. In those cases when a softening area appears, a radial incision is made 1-1.5 cm long above the softening area. The wound heals on the 7-8th day.

Transient fever occurs in 0.5-17% of cases and is manifested by a sudden increase in body temperature to 38-40 °, not associated with overheating or illness of the newborn. It is observed on the 3-4th day of life and usually lasts several hours. Usually, the temperature increase coincides with the moment of the greatest physiological weight loss of the newborn. With proper feeding and sufficient fluid intake, fever is rarely observed.

Transient fever is sometimes difficult to distinguish from fever in any disease, if it lasts more than 1-2 days or is observed repeatedly. Transient fever does not noticeably affect the general condition of the newborn and does not require medical treatment. It is necessary for such newborns to be given more drinking - boiled water, tea , 5% glucose solution, isotonic sodium chloride solution at the rate of 80-100 ml per 1 kg of weight per day, to ensure proper care, to eliminate the possibility of overheating, to provide the baby with the necessary amount of breast milk.

fetal blood circulation systemnewborn's blood circulation scheme
Fig. 1 and 2. Diagram of changes in blood circulation occurring at birth.
Fig. 1. Diagram of fetal circulation.
Fig. 2. Circulation of the newborn. 1 - aa. carotides communes; 2 - vv. jugulares int .; 3 - v. brachiocephalica sin .; 4 - arcus aortae; 5 - ductus arteriosus; 5 '- lig. arteriosum; 6 - truncus pulinonalis; 7 - atrium sin .; 8 - arteries and veins of the upper limb; 9 - ventriculus sin .; 10 - pulmo sin .; 11 - aorta abdominalis; 12 - lien; 13 - ren sin .; 14 - v. cava inf .; 15 - r. iliaca communis sin .; 16 - v. iliaca communis sin .; 17 - a. iliaca int .; 18 - arteries and veins of the lower limb; 19 - placenta; 20 - umbilical cord vessels; 21 - aa. umbilicales; 21 '- liggurabilicalia lat .; 22 - anulus umbilicalis; 23 - the gastrointestinal tract and its vessels; 24 —v. portae; 25 - hepar; 26 —v. umbilicalis; 26 - lig. teres hepatis; 27 - ductus venosus; 27 '- lig. venosum; 28 - v. hepatica; 29 - ventriculus dext .; 30 — atrium dext .; 31 - foramen ovale; 31 '- fossa ovalis (septum interatriale); 32 — v. cava sup .; 33 —v. brachiocephalica dext.