Parents, and especially first parents, are often overwhelmed by a feeling of responsibility and the fact that their precious, new-born baby’s well-being is now in their hands. Emotions, fear, misinformation, misperception and insecurities often lead to unnecessary concern or worry.
With the insight of Dr HP van der Merwe, paediatrician at Mediclinic Paarl, we address these concerns. It is however important to ask your doctor questions if you are worried about something and to ensure that you obtain information from a trusted and experienced source.
APGAR SCORE
The first question parents often ask is what the APGAR test result of the baby is, and then they are worried if it is not 10/10. Dr Van der Merwe explains, “The count is done at 1 minute, 5 minutes and 10 minutes after the birth and is really only important when there has been foetal emergency or if it was a challenging labour. The important 5 minute count is an indication of the baby’s adjustment outside the womb and a count of 7 or more is more comforting. The one minute count on its own is less significant and has no prediction value.”
IMMUNISATIONS
Your baby will be immunised in the hospital against polio (drops) and tuberculosis (BCG) before discharge. BCG offers protection against serious forms of tuberculosis which can affect other organs apart from the lungs, e.g. the brain, kidneys and bone.
NUTRITION/FEEDING
Breastfeeding remains the preferred method of feeding for babies as it provides indisputable short and long term advantages. The mother’s breasts produce concentrated colostrum during the first few days which is little in volume. It is important to let the baby feed on the breasts every two hours and on request. Dr Van der Merwe explains that Lacto genesis 2 is the crossing to production of more mature breastmilk and that usually happens about 72 hours after birth.
URINE AND STOOL
Meconium is the thick, black substance that is formed intra uterine and which is excreted as stool for more or less the first three days. Thereafter it changes colour to yellow and the consistency is runny and more ‘seedy’ in appearance. According to Dr Van der Merwe, the first stool will normally be passed within the first 24 hours after birth.
Urine excretion provides a good measure for nutritional intake and for the first three to four days the minimum expected number of wet diapers per day equals the number of days after birth, in other words one wet diaper on day one, two wet diapers on day two etc. Parents are often worried that a red precipitation in a diaper might be blood, but this is urate crystals in a baby’s urine, which is normal.
SLEEPING POSITION
Dr Van der Merwe believes that the safest sleep position for a baby is to sleep on his/her back. Babies should under no circumstances sleep in their mother’s bed. Precautions should be taken that a baby cannot fall from the mothers’ arms, if she was to fall asleep while holding the baby, which may cause an injury to the baby. This is especially important in hospital, when the mother may be receiving painkillers, which could cause her to be drowsy.
TEMPERATURE
Babies have a relatively limited temperature control regulatory mechanism, in other words they struggle to get rid of excessive heat, just as much as they struggle to retain temperature when it is cold. The most common problem, especially during summer, is that babies are being dressed too warm and covered. The recommendation is that babies should not be dressed with more than one extra piece of clothing than what would have been comfortable for adults.
Fever during the first month of the baby’s life should be seen as an emergency. Fever per definition is a rectal temperature of 38 degrees Celsius or more. Other methods of measuring fever in young babies are not accurate and parents should know how to use a rectal thermometer.
JAUNDICE
This is the term used for a yellow discolouration of the skin. “The colour is caused by bilirubin which is usually produced in the body, but under some circumstances it reaches increased levels,” explains Dr Van der Merwe, “Jaundice in babies, is in the majority of cases, is not an illness and not painful. Most babies who develop jaundice need no treatment and direct sunlight exposure is not recommended. In cases where the baby’s bilirubin counts exceed certain levels, it will be required to place the baby under special blue lights to decrease the levels. This is usually a transient problem limited to the first week or 10 days after birth.”
DANGER SIGNS
Fortunately most babies are healthy and thrive on love, care and nutrition. They are, however, not ‘little adults’ and if there are concerns with regards to illness, a speedy response is required. If you spot any of the following symptoms, please consult your doctor.
- Fever (rectal temperature of 38 degrees Celsius or higher)
- Vomiting bile or excessively
- Hard, distended abdomen
- Abnormally pale / non-responsive/listless
- Shortness of breath
- Diarrhea/blood in stool
Mediclinic Paarl remains ready to safely receive any patient, whether it is for the confinement and delivery of your baby, or to manage any medical need your child may have.