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The new born

Infant and Children, Pregnancy | March 5, 2019 | Author: Naturopath

pregnancy, infant

The new born

Bringing your newborn home from the security of the maternity setting can be a frightening and stressful experience. Not only are new parents feeling exhausted, the new mum may be sore and physically depleted, not to mention breast feeding dramas and maybe the 3-day blues. You have this new bundle of joy that is dependent on you for its every need. Funny and cute facial expressions accompany gurgles, hiccups, whimpers and crys from this helpless little being. Some of these sounds can be distressing to the new parents. Are they normal? Strange rashes appear – should they be concerned?

During pregnancy the foetus is dependent totally on the mother for its very existence. Oxygen, nutrients, waste removal and protection from physical and microbiological harm are supplied by the mother. At birth a physiologically mature baby is born much more self-supportive. The newborn’s body must make various adjustments to its new world, the major one being breathing on its own. The respiratory system is usually developed by the 7th month of gestation making it possible for some premature babies, born after this time, to be able to breath on their own. Any amniotic fluid left in the lung is absorbed. A full-term baby may breathe 45 times a minute for the first couple of weeks until it gradually adjusts to a normal rate of 12 breaths per minute.

After birth red blood cell and haemoglobin production is stimulated to allow for increased oxygen needs.

Baby gets its immunity from breastmilk

During late pregnancy and for the first few days after birth, a cloudy fluid called colostrum is secreted from the breast until the real milk comes in on about the 4th day.

Baby gets its immunity from breastmilkColostrum and maternal milk contain antibodies that protect the newborn during the first few months of life.

White blood cells present in milk ingest microbes in the gastrointestinal tract and plasma cells produce antibodies against specific microbes.

T lymphocytes kill microbes directly and help mobilize other defences.

A mother’s milk produces antibodies to any diseases present in her environment, meaning her breastmilk protects the new baby against those same specific infectious agents.

Breast feeding has been shown to reduce the incidence of diseases such as allergies, diarrhoea, meningitis, respiratory and gastrointestinal infection and ear infections as well as diseases of later life such as diabetes mellitus and heart disease.  

Baby gets its nutrition from breastmilk

Human milk is a sterile solution containing fatty acids, lactose, amino acids, vitamins, minerals and water specifically designed for the digestive system of the baby and development of the brain and growth.
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Common concerns

New baby has to adjust to life in the outside world and the immaturity of various organ systems of the body, especially the gastrointestinal system, and consequently problems can be encounted with the digestive process.

Colic

Colic (gastro-oesophageal reflux) is most common in new baby and is indicated by baby crying for no apparent reason for long periods of time.  Mature function of digestion usually is sorted by 3 months of age but until then colic can be very distressing for new parents. It is important to check with your doctor there is no medical reason for the baby’s crying. The probiotic Lactobacillus reuteri has been found to help with infant colic.
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Unusual noises

Most noises coming from your baby are normal – even grunting. Grunting can indicate an imminent bowel motion and occurs usually as baby is getting to know its digestive system. It may have a full tummy and feel a little uncomfortable. If grunting is accompanied by fever, or seems connected to breathing, or baby is distressed, it could be a sign of something more serious and should be checked by the doctor.

Nappy rash

Nappy rashThis skin rash is also known as nappy dermatitis and may afflict the baby anytime usually between the age of 3 weeks to 2 years.

Wet skin rubbing against the nappy causing the skin to become fragile is considered one of the culprits to this condition. Interaction between urine and faecal matter can cause skin irritation. Secondary fungal or bacterial infections can occur because of the fragile skin.

Baby's nappy should be changed directly after soiling to reduce skin irritation. Be mindful of skin cleaning products that may also be irritating skin. Less is best. Use a skin barrier cream to help repel moisture. Creams containing chamomile, calendula and zinc can help with irritated skin. Points to consider:

  • Change your baby’s nappy often
  • Keep your baby’s nappy off for short periods of time to allow the skin to dry
  • Wash the area well with mild soap and warm water, rinse and let dry completely when changing nappy
  • Use only alcohol-free and unscented wipes
  • Apply unscented barrier cream
  • Avoid using baby powder or talc

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Infantile Seborrhoeic dermatitis (ISD)

This is often known as cradle cap and appears as thick, greasy scales on areas where sebaceous glands are more abundant, such as the scalp, but also the eyebrows, skin behind the ears, nappy area, and skin creases of the neck and under arms. It can appears between ages 3 weeks to 2 years. This condition is not itchy or painful and will generally clear itself by four to six months of age in most cases.

The cause of ISD is not well understood, but several factors are thought to play a role; sebaceous gland secretions, microflora metabolism, and the susceptibility of the infant. One suggestion is circulating maternal hormones influence sebaceous glands. This causes a secretion of a greasy substance on the skin and results in an accumulation of dead skin cells which stick, instead of removing naturally. 

Another theory suggest a deficiency of essential fatty acids, specifically GLA. Age appropriate creams containing oils such as evening primrose oil, borage oil or black current seed oil have been found to help if parents are concerned. This due to the high concentrations of GLA in these oil.

Skin rashes

Rashes and pimples which appear on baby’s skin are usually harmless and will disappear without any treatment being needed

  • Vernix is a white, greasy substance coating the skin of the newborn. It protects baby’s skin in the mother’s uterus. Some babies are born with lots of vernix still on their skin which is harmless and can be washed or wiped off. Removing vernix may cause the skin to peel during but this is normal and skin will recover quickly.
  • Baby acne – pimples and rashes which will usually just disappear over time
  • Cutis marmorata – this is a marble effect from cold temperature that is harmless and will disappear over time
  • Erythema toxicum – is a splotchy red rash that commonly effects newborn in the first couple of weeks of life. It consists of a red flair over yellow or white bumps. This occurs in various places on the body and can come and go in hours. It will eventually disappear
  • Millia are tiny whiteheads on the face that will disappear over time
  • Heat rash – this red rash can appear in creases of skin anywhere on the body when baby gets over-heated. This can happen in hot humid weather or when there are too many layers of clothing. Remove excess clothing and heavy wraps, choose lightweight cotton for wraping baby. 

Diarrhoea

Teething, the use of antibiotics, allergies and infection are the usual cause of diarrhoea in infants. The main concern is the serious condition of dehydration resulting from fluid loss so a correct medical diagnosis is important.

Fever

FeverA fever is a heat reaction to a stimulus such as trauma or infection and is considered a natural response which in itself does not cause harm. It can be common in infants and children. It can occur with a respiratory tract infection and be self-limiting, or be more serious as in meningitis or pneumonia.  

Febrile seizures can be causes of alarm for parents and may accompany an increase in temperature but usually have no long- term complications.
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Most babies have an average body temperature of between 36.5°C to 38°C and a fever is considered when baby's body temperature rises above 38°C.

This may happen slowly over the day or occur quite quickly. You should seek medical advice if your baby is under 3 months of age and has a fever and if your child seems very sick.

The Gut Microbiota

A baby’s gastrointestinal is considered sterile, or at least minimally colonised, and is rapidly occupied by a plethora of microbial communities, established from maternal influence. Its development is modulated by specific dietary compounds from breastmilk. The infant gut bacteria, in particular bifidobacterial, are genetically adapted to utilize specific glycan (monosaccharide) components of breast milk. If that sounds confusing it basically means the newborn gets beneficial gut bacteria from its mum which procreate and is increased from the beneficial bacteria in breastmilk. The bacteria are able to use the ‘sugars’ in milk to survive.

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References

Tortora, Gerald J and Derrickson, Bryan 2006 Principles of Anatomy and Physiology 11th edition, John Wiley and sons, Inc, USA

Santich, Rob and Bone Kerry; 2008; Healthy children, Phytotherapy press, QLD, Aust

Skin care for your baby https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528704/

https://pursuit.unimelb.edu.au/articles/the-probiotic-hope-for-colic

The First Microbial Colonizers of the Human Gut: Composition, Activities, and Health Implications of the Infant Gut Microbiota https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706746/

https://www.schn.health.nsw.gov.au/fact-sheets/fever

https://www.healthline.com/health/parenting/newborn-grunting 

Interventions for infantile seborrhoeic dermatitis (including cradle cap) https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011380/full

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