Newborn Care: Appearance, Checkups, and Disorders
A newborn refers to a baby within four weeks of its birth. As it's still rather tiny, there are many unknown things which are worrying to its parents. However, don't underestimate this little baby – its survival instincts are amazing! Will there be any physical issues with the newborn? What types of checkups does it need? We should be aware of all these things.
Its hip joints are expanding and knees are bent. The legs will straighten with time.
When the parent is changing its diapers, it's good to help the newborn stretch its body.
Its soles are still flat and will become concave when it starts learning how to walk.
The body of a newborn tend to be smaller than its head in the beginning. For a baby boy, its chest circumference is 33.4 centimeters; a baby girl measures 33.1 centimeters. Six months after birth, the head and chest circumferences will be similar. After the baby's first birthday, its chest circumference will be bigger. Its stomach is protruded and it'll be using abdominal breathing.
In the beginning, the belly button is a little wet. After seven or 10 days, it'll be darkened, dried up and will fall off naturally. If there are pus and water discharges after the umbilical cord has fallen off, it's necessary to bring the newborn to the hospital for treatment.
For every newborn, regardless of its gender, the reproductive organs will be rather swollen. Everything will return to normal after two or three days. The baby girl's vagina may bleed as this is the effect of her mother's hormones. There's nothing to worry about. For baby boys, the size and color of its testicles and penis will be different from others.
Immediate Procedures after the Newborn's Birth
Remove foreign objects in the oral cavity to allow easier breathing
Remove amniotic fluid and foreign objects from the oral cavity so that the newborn could breathe easily. Foreign objects remaining in the throat and bronchi must be completely removed as well. In the neonatal room, the baby's head will be lowered for a few hours. Its purpose is also to remove foreign objects thoroughly.
Remove foreign objects from the lungs
Straight after coming out of the birth canal, the newborn's lungs will be compressed and foreign objects from the lungs will be expelled from its nose. A tiny suction tube will be inserted to completely remove remnants of foreign objects.
Umbilical cord will be cut short
The umbilical cord will be trimmed to between three and four centimeters straightaway after birth. An antiseptic gauze bandage will be placed on top of the wound.
Sterilize the newborn's eyes
As there's amniotic fluid in the eyes, it's difficult to clean them properly. Disinfectant liquid must be used to thoroughly wash the baby's eyes of amniotic fluid.
After all the basic after-birth procedures are completed, the newborn may be given a simple bathe. All vernix (the waxy or cheese-like white substance coating found on the skin of newborns) or blood picked up while the baby is passing through the birth canal should be cleansed completely.
The newborn's body weight, height and head circumference are recorded and its footprint is taken.
Hand and foot bands are attached and proceed to the neonatal room
The mother's name, baby's gender and birth time are recorded and attached to the newborn's hand and foot before proceeding to the neonatal room.
Regardless of gender, the breasts of every newborn are a little protruded. This is because they're affected by the hormones of their mother's breasts. Sometimes, the newborn's breast will secrete milk. Forcefully squeezing them will give rise to infections easily. So don't touch them – they'll become normal breasts after a few weeks.
When the newborn was just delivered, its body will be covered with a silky, oil-like layer called vernix. The skin color will be similar to skin exposed to water. It'll gradually change from a green-blue color to a rosy-red color. After three or four days, the vernix will dry up, flake and then fall off. After 12 weeks, clean, supple baby skin will appear.
The newborn's ears will have lots of shrinkage in the beginning – they'll be completely smoothened as time goes by. The shapes and sizes of its left and right ear will be different from each other.
The newborn's face will be a little swollen as it has just squeezed through the narrow birth canal to be born. There's a lot of grease and little red bumps that will appear on both sides of the cheeks. This is due to the effects of the mother's hormones and there's nothing to worry about.
There will be white, scale-like stuff on its tongue which will disappear after a few days. Little white pearl-like bumps, known as bivalve pearls, on the newborn's gums will completely disappear after a few days.
Finger and toe nails
The baby is born with translucent finger and toe nails. Some newborns' nails are so long that they've to be trimmed. The fingernails will be trimmed twice every seven days while toenails are trimmed once every 15 days.
The baby's hair will be in its newborn state. It's black, brown or comes in a variety of other colors. When nearly a 100 days old, its fetal hair will start falling off. After its first birthday, its fetal hair will be completely gone and new hair will start growing.
Its head is the biggest part of its body, occupying a quarter of its whole body size. Head circumference will be bigger than its chest circumference by about one centimeter. Generally, a baby boy's head circumference is 34.6 centimeters while a baby girl's is 34.1 centimeters. The top of its head is made up of five bones, but they're not completely fused together yet – there are gaps in the anterior and posterior fontanelles (soft spots on the newborn's head). These parts are covered by the hard scalp and will grow with the bones. The posterior fontanelle will close soon after the baby is born while the anterior fontanelle will close after one-and-a-half or two years after birth.
At this time, the newborn's eyes can only distinguish brightness and dimness. Some newborns have lots of gum in their eyes. It's important to check for hyperemia (excess of blood in a body part) or other abnormalities.
Due to the effects of its mother's hormones, there are little yellowish-white bumps on its nose. As the newborn's nostrils are very small, any secretions will block its nose and there will be a snoring sound when the baby breathes.
Various Checkups Newborns should have straight after Birth
Checks on the limbs
There are careful checks on the body posture and spine to determine whether if the newborn will be weak. There will also be checks on muscle tension and maturity of the nervous system. The doctors will touch the baby's body to check for abnormalities in major organs in the stomach, space between the legs and the thigh's arteries. The doctor will also use his hands to feel for hard lumps behind the newborn's neck and observe whether its neck will slide to one side when lying down.
A stethoscopic check
This is a check on the newborn's heart and lungs. As the heart is not yet fully developed, listening to its heartbeat for irregularities is necessary. Examinations will be made on both sides of the lungs, noting the number of breaths and method of breathing. Should there be congenital heart conditions, noise can be heard during the heart check. If the intestines are blocked, nothing can be heard.
A rosy-red color is normal while a skin color too pale or greenish may mean abnormalities.
Shape of the head
To check for sarcoma (a type of cancer which develops in certain tissues, like bone or muscle) and other abnormalities, the doctor will start feeling from the top of head, followed by the sides. He'll check for bruises or wounds which may be inflicted while the newborn was passing through the birth canal. An important check is for the size of the posterior fontanelle.
The doctor will check the interior and exterior of the ears by feeling and observing for unobstructed ear canals, pinna (also known as auricle, outer part of the ear), swellings or bumps on the ears.
A sterilized thermometer will be inserted into the anus to check for smooth passage. If there are abnormalities, they should be treated immediately.
Internal oral cavity check
The gums, tongue and palate are checked for irregularities and swellings. The root of the tongue and lower part of the oral cavity interior are checked to see if there are any foreign objects attached.
Reproductive organs check
For baby boys, the size of its scrotum will be examined. If one side is twice or thrice as big as the other side, it may have edema of scrotum (abnormal enlargement of the scrotum) or groin hernia (an intestinal loop protrudes through a weakness in the abdominal wall and the protrusion causes a visible lump in the groin area). For baby girls, the outer and inner labia are checked for proper connection. These tests are to be done again before the newborn leaves the hospital. If there are abnormal swellings, they'll disappear in due time.
Hip dislocation check
To check for hip dislocation, straighten the baby's legs and then open them with both hands. Observe whether there are any differences in the length of both legs and if the baby's legs look abnormal when spread open. If there's a hip dislocation, both legs will be of different lengths and the legs will also look unnatural when spread open.
Check for infantile jaundice
Newborns may develop jaundice two or three days after birth. The condition will generally disappear on its own. To check for jaundice, the newborn's blood is tested for bilirubin (a yellow substance that the body creates when it replaces old red blood cells) level. If jaundice happens within 24 hours of birth, the condition must be treated immediately. If the bilirubin number is very high and jaundice is very severe, the newborn must receive phototherapy (light treatment, the process of using light to eliminate excess bilirubin in the blood).
Illnesses that Arose from Congenital Metabolic Disorders
(PKU, a rare condition in which a baby is born without the ability to properly break down an amino acid called phenylalanine)
This involves symptoms such as pyloric stenosis (a narrowing of the opening from the stomach into the small intestine) and vomiting. There will be serious eczema, discoloration of the hair to yellow or light brown colors, twitching of the skin, a moldy or rat’s urine odor in the baby's perspiration and urine. This condition often leads to autism and mental retardation.
(A condition characterized by elevated blood levels of the amino acid histidine, a building block of most proteins)
As histidine (a semi-essential amino acid needed for growth and tissue repair) activity is insufficient, the levels of histidine in the blood increases. This will likely lead to complications such as intellectual disability, mental retardation and delayed language development
(A disorder in which the body is unable to process certain amino acids properly)
This condition may appear a few days or months after birth. When being breast-fed, the newborn will vomit, its growth is slow and body weight remains stagnant. If the condition is severe, the newborn may fall into a state of lethargic sleeping. If abnormalities in kidneys development and intellectual abilities appear and there are convulsions, lens dislocation and thrombosis (the formation of blood clot inside a blood vessel), the newborn may die of blood diseases.
Maple Syrup Urine Disease
(MSUD, a metabolic disorder in which the body is unable to break down certain amino acids)
If the newborn experiences lactation difficulty, vomiting, convulsions and is consistently in a lethargic sleeping state, it may have MSUD. The condition's characteristic is that the newborn's urine and perspiration will smell of maple syrup. If conditions such as convulsions, epilepsy, weakness in the whole body and lethargic sleeping are not treated, the newborn may die within two months of birth due to blood disease complications.
(A disease in which the transformation of galactose to glucose is blocked, allowing galactose to increase to toxic levels in the body)
When lactose in the milk is not digested and accumulates in the newborn's liver and spleen, galactosemia arises. After lactation has begun for a few days or weeks, if there's unsatisfactory weight gain, jaundice, diarrhea, vomiting and poor appetite, these may lead to liver cirrhosis (a serious condition where normal liver tissue is replaced by scar tissue and eventually damages the liver function), ascites (accumulation of fluid in the abdominal cavity), hemorrhage (profuse bleeding), cataracts and these impede the development of the whole motor system in the newborn's body.
Thyroid glands weakens
It's very difficult to detect this condition in the beginning. Jaundice will persist in the newborn for a long time, and it'll often hang out its tongue from an open mouth. Its hair is dry and breaks easily, have low body temperature, a slow pulse and its heart enlarges. There are many hernias (when part of an internal organ or tissue bulges through a weak area of muscle) from the belly button and muscle tensity decreases. It doesn't make any baby development in its height or teeth and becomes mentally retarded.
Those are the information about newborn babies after birth.