Head: when the ratio of head to body is the largest at birth, some heads will appear sharp after being squeezed by the birth canal, but they will gradually return to normal shape as the head develops slowly;
Face: The face may appear a little puffy at birth, but it will soon return to normal;
Neck: the skin of the neck should be smooth and free of lumps, and some torticollis lumps caused by intrauterine position need medical treatment;
Chest and abdomen: You may find that your baby's chest is a little bulging, and sometimes there is milk secretion, which is due to the influence of maternal hormones. After leaving the mother 1-2 weeks, these will return to normal.
Limbs: the baby's limbs are in a state of flexion, just like in the mother's body.
Six hours after delivery
What needs to be mentioned here is the transition period from mother to mother, which is about six hours after delivery. During these six hours, the baby's lungs were opened more fully, more blood flowed through the lungs to exchange oxygen with the air the baby breathed, the liquid in the alveoli was gradually removed, and then the arterial duct (the duct between the aorta and the pulmonary artery, which is an important channel for fetal circulation in the mother's body and is no longer needed after the baby was born) was gradually closed functionally. During this transitional period, it is necessary to monitor the baby's vital signs every 30-60 minutes, including-
Body temperature: The normal range is 36.5 to 37.5℃. The initial high body temperature may be the influence of the temperature in the mother's body, and low body temperature should pay attention to metabolic disorder or hypoglycemia; If the body temperature continues to be too high or too low, we should pay attention to the possibility of infection.
Respiratory frequency: The normal range is 40 to 60 beats/min. Breathing too fast needs to consider the possibility of breathing or heart disease; Apnea needs to pay attention to the mother's recent anesthetic drugs, the baby's own neuropathy damage or infection.
Heart rate: The normal range is 120 ~ 160 beats/min, but it may temporarily drop to 85-90 beats/min during sleep. Too fast or too slow heart rate may indicate heart disease.
Skin color: Pay attention to the skin color of lips, tongue and trunk. If there is purple or lavender (medically called cyanosis), it is a sign of respiratory system or heart disease.
Muscle tension: no flaccid paralysis. When changing diapers, you can find that the baby's lower limbs are naturally separated (frog posture). If the muscle tone is abnormal, it means infection, nerve or hereditary disease.
Six hours later
After the baby has passed these six hours safely, we will continue to monitor the vital signs before leaving the hospital, and we need further care and evaluation. These measures include
Eye observation: whether there is an abnormal increase in eye secretions to prevent infection.
Intramuscular injection of vitamin K 1: prevention of neonatal bleeding (infants lacking vitamin K 1 are prone to bleeding)
Hepatitis B and BCG vaccination
Navel nursing: Nurses will clean the navel every day to keep it clean and dry.
Monitoring bilirubin: Because high serum bilirubin may cause bilirubin encephalopathy, it is necessary to monitor the speed and change of jaundice through the skin jaundice instrument from birth to discharge, generally at an interval of 8- 12 hours. If necessary, it may be necessary to take venous blood to detect bilirubin (for further understanding of neonatal jaundice, please refer to popular science articles).
Monitoring blood sugar: healthy asymptomatic infants generally do not routinely monitor blood sugar, but in premature infants (gestational age less than 37 weeks), infants older than or smaller than gestational age, mothers with gestational diabetes, and expired infants (gestational age greater than 42 weeks), blood sugar needs to be monitored to prevent brain damage caused by hypoglycemia;
Neonatal screening: heel peripheral blood was used. Newborn screening in China mainly includes three genetic and metabolic diseases: hypothyroidism, phenylketonuria and G6PD deficiency (commonly known as silkworm disease, mutation of G6PD gene of erythrocyte membrane enzyme, which leads to hemolytic anemia when exposed to specific foods, drugs or chemicals).
Hearing screening: Hearing impairment advocates early detection and early treatment to reduce the impact of hearing impairment on language development. What baby is prone to hearing impairment? Including hearing impairment, infection, pathological jaundice, external ear malformation, premature infants and other family history.
Feeding: Newborns should be fed as soon as possible after birth to prevent hypoglycemia. The frequency, duration and number of feeding should depend on whether the baby is breast-fed or formula-fed Every breast-feeding needs to be recorded, and formula milk needs to record the amount of breast-feeding every time. If there are no medical contraindications, breastfeeding is strongly recommended. For the knowledge about breastfeeding, please refer to the previous popular science articles.
Weight loss: Full-term babies will lose weight after birth, which is about 10% of their birth weight, but will return to their birth weight within 10 ~ 14 days after birth.
The standard that babies can be safely discharged from hospital.
When the baby reaches the following performance:
Vital signs are normal and stable (breathing
The baby has already urinated;
The baby has been successfully fed more than twice;
If the jaundice did not exceed the standard before discharge, we should still pay attention to the subsequent changes of jaundice;
Parents have received detailed family education, including keeping the baby in a supine position when sleeping, having a baby safety seat in the car, and hand hygiene of family caregivers.