Article

Newborn baby or Neonate refers to babies from birth till 28 days. Neonatal period is a very vulnerable period as newborns are prone to susceptible infection from external environment. Also many new parents have anxiety about the newborn care which inreturn results in stress, hampering the care of the newborn.

According to Nepal’s Demographic Health survey of 2016, 1 in 48 babies die in their first 28 days of life, making upto 13,000 newborn deaths every year in Nepal. Neonatal sepsis accounts for one third of neonatal death. Main source of infection are by touching as hands can be contaminated and can spread germs.

As many new parents are unaware about the new life coming to their lives, there are certain things which should be taken care of to make things easy.

Here are some of these points for the neonatal care

• After baby is born, whether normal delivery or caesarian section, baby should be fed within 1 hour of birth, preferably mother’s milk as soon as possible. Initial breast milk can be yellowish colored which is known as colostrum and must also be fed to the baby. Mother’s milk is the best choice for baby, as it provides immunity as well as nutrition required for the baby.
• It should be noted that the baby passes adequate amount of urine and stool frequently. Greenish stool (Meconium), should be passed within 48 hours of life in the neonatal period. Urine must be passed within 30 hours of life. Delay in passage of urine or stool is a cause for concern and must be investigated and should be consulted with the pediatrician.
• Proper wrapping and clothing should be done to baby in layers to prevent hypothermia such as cap, gloves, socks, blankets etc.
• New clothes should be washed first as it may cause skin infection and rashes.
• Babies should be fed frequently 2-3 hourly in the initial phase. After baby develops good suckling, feeding can be given on demand.
• Burping should be practiced after feeding to prevent babies from bloating which can lead to abdominal discomfort and crying.
• In our culture we have a practice to give oil massage, which is very good for baby’s health which helps in stimulation and growth of baby and should be done lightly.
• In the early days, neonates may have physiological jaundice which refers to the yellowish discoloration of skin that appears after 24 hours of birth. It normally subsides within a few days. Jaundice which occurs within 24 hours is pathological jaundice and immediate consultation must be done with a pediatrician.
• Neonates can be kept under sunlight in early morning for 15-30 mins. Eyes and genitals must be covered while doing so.
• As many parents are worried about whether giving bath or not, normally bath can be given after 24 hours of life.
• Proper care of the eyes should be taken. Avoid putting kajal over eyes.
• Umbilical cord care should be taken properly. It should be kept dry as it promotes early detachment of the umbilical stump. If any redness is noted or there is presence of pus discharge, seek pediatrician immediately.
• Visitors are advised to be limited in the initial phase as to prevent exposure to infection. However, siblings visit is encouraged. But visitor with fever, signs of respiratory illness, history of exposure to communicable disease such as chicken pox are discouraged from visiting.
• Neonate should be prevented from second hand smoke as it can lead to respiratory problems including asthma in later period.
• Neonates should be given immunization as per National program on Immunization.
• If any noted signs of danger such as fast breathing, fever, excessive crying, vomiting occurs, pediatrician should be contacted immediately.
• Proper hand washing with soap should be done at least for 20 seconds and hand sanitizers must be used to prevent infection.
• Emotional support to the mother is very important during neonatal period as she may undergo Postpartum Depression.
• Exclusive breast feeding upto 6 months is recommended and thereafter can be continued for upto 2 years of life.
• Keep perineal area clean with wet wipes or water and dry immediately after baby passes stool to prevent diaper rash.
• Do not put oil in eyes, nose, ear, umbilicus. Do not squeeze newborn breast.
• Do not give any medicine without consulting doctor.

Dr Needa Shrestha

MD Pediatrics

Paropakar Maternity and Woman’s Hospital