Breastfeeding and Feeding Feeding a newborn is a big learning curve. The experts’ opinion is that breastfeeding is better as early as possible after birth, usually about half an hour after birth. If the mother does not secrete milk temporarily, we should also try to let the newborn suck the nipple to promote milk secretion and enhance the feelings of mother and baby to facilitate the healing of the mother’s postpartum wounds caused by childbirth. The newborn should be held in a vertical position, with the head slightly elevated, which is the most ideal and natural way to breastfeed. In this position, the newborn and the parents look at each other, which can also increase the feeling of mutual intimacy; before breastfeeding, you should wash your hands and clean your nipples, the mother should wear a mask when feeding if she has respiratory diseases, and if the skin on the breast is broken or inflamed, you should consult a doctor to decide whether to continue breastfeeding according to the specific situation. When breastfeeding, it is best to suck one breast empty and feed it to the full and then switch to the other breast next time to prevent residual milk from accumulating in the breast. If there is still extra milk in one breast after feeding, it is best to express it to promote normal lactation and avoid milk stagnation or secondary infection. If you are feeding a newborn, try not to feed the fresh milk directly, because the protein and other nutrients contained in it are not suitable for the newborn; mixed feeding (breastfeeding and milk substitute feeding combined), breastfeeding should be the first priority. When artificial feeding, the size of the pacifier hole should be moderate and pay attention to the temperature. When pacifier feeding, try not to let the baby suck in air to avoid spitting up, and after feeding, you can pat the baby’s back to avoid accumulating gas. In addition, bottles and pacifiers should be sterilized by strict boiling. Feeding does not need to be timed too much. In general, feed your baby once every 3 hours, and take the principle of having enough and eating well each time: that is, your baby does not cry or make noise after feeding, and his weight grows normally. Prevent infection When caring for a newborn, pay attention to hygiene, and wash your hands before each care to prevent infection from being brought to the newborn’s delicate skin, such as caregivers with infectious diseases or germ carriers should not touch the newborn to prevent infection. If infectious diseases occur in newborns, they must be treated in strict isolation, and contacts must be isolated and observed. The mother’s lounge should be closed to visits during nursing time to reduce the chance of infection of the newborn. Skin care For newborns shortly after birth, before the umbilical cord falls off, try not to use a tub bath, but use the dry cleaning method to wipe the newborn’s body. After the umbilical cord falls off, the baby can be given a tub bath, it is appropriate to use non-irritating baby soap, after the bath to use a dry soft towel to absorb the water on the body, and can be applied to the folds of the skin a little powder. Be sure to wipe the buttocks clean with a warm towel after each diaper change. Sometimes the skin of the buttocks becomes red due to urine irritation, and a little sterile vegetable oil can be applied at this time. In the cold season, when the redness of the buttocks is obvious, you can also use a hairdryer to blow and bake on the red buttocks 3 to 4 times a day for 5 to 10 minutes each time (the hairdryer should not be too close to the skin to prevent burns). Five senses care Attention should be paid to the cleanliness of the face and external ear canal mouth and nostrils, but do not dig the external ear canal and nasal cavity. As the oral mucosa is delicate and vascular, it is easy to bruise and cause infection, so do not scrub the mouth with force, and do not use needles, especially unclean needles to pick and grind the small white spots on the gums – epithelial beads (commonly known as “horse teeth” or “slatted teeth”), to prevent bacteria from entering the body here and causing sepsis. Newborns do not need soap. Soap is a degreasing agent, and a baby’s skin is very delicate. He needs to retain all of his natural oils, so he should only be washed with water until 6 weeks. after 6 weeks, you can use any soap you choose. You may want to try a special liquid soap that is simply added to the bath water without rinsing. Be sure to scrub well over all the folds with soapy fingers and then rinse well. Dry the skin thoroughly; wet folds can be very inflammatory; never use talcum powder. Eye care When cleaning the baby’s eyes, wet a few cotton balls in wet water and then squeeze them dry. Wipe each closed eye with a new cotton ball, rubbing from the inner corner of the eye to the outer corner. Nose and ear care: The nose and ears are self-purifying organs, so you should not try to stuff anything into them or disturb them in any way. Stuffing something the size of a cotton ball into your nostrils or ears will only push what was already there further in. It is far better to let what is inside fall out naturally. Never put medicine in an infant’s ear or nose unless you have a doctor’s instructions. Even if you see it, don’t try to pull earwax out of your baby’s ear. Earwax is a natural secretion from the skin in the outer ear canal. This stuff is antibacterial, and it also keeps dust and fine grit away from the ear drum. Some babies have more earwax than others, but pulling it out only causes the ear to secrete more earwax. Ear wax can inflame the ear, so leave it alone. If you are a little concerned about this, then you can consult your doctor. Belly button care The umbilical cord is clamped and immediately cut as soon as the baby is born, leaving only 5-8 cm of the root. After a few days, the umbilical cord dries up and then it will fall off. Your doctor may advise you to rub the umbilical cord area lightly with sterile alcohol and sterile cotton balls every day and then cover it with sterile gauze. Try to ventilate the area as much as possible, as this will help speed up the contraction and healing. If you notice any redness, fluid flow or other signs of infection, please consult your health consultant or doctor. It is not necessary to wait for the umbilical cord to heal before giving the baby a bath, just wipe it thoroughly afterwards. Some babies have umbilical hernias, but they usually heal within a year. If your child has an umbilical hernia and it is growing or not healing, see your doctor. Newborn skin eczema care Eczema is a common, complex skin inflammation and is one of the most common skin conditions of infancy. It is divided into acute, subacute and chronic phases. The etiology is generally considered to be related to genetics, allergies, neurological function and physical factors. Inappropriate care, such as excessive use of strong alkaline soap, excess nutrition, and abnormal intestinal fermentation, can also cause the disease. Maternal androgens are transmitted to the fat child through the fetal pelvis, resulting in increased sebum in the newborn, which can also lead to seborrheic eczema. The top of the newborn’s head “fetal scale” treatment Some newborns soon after birth, in the top of the head before the chimney door area that gradually appear black scaly fusion together hard demented, not easy to remove, called “fetal scale”. This is due to the accumulation of sebaceous material secreted by the sebaceous glands, generally not itchy, no impact on the child’s health, but looks very dirty, and the newborn may also feel uncomfortable, therefore, it should be removed. The best way to remove it is to wipe it with sterilized vegetable oil or paraffin oil and then wrap it well, so that the dirt is fully softened. Newborn skin prickly heat care In the hot summer, due to the heat and children cry, sweating more, coupled with the newborn skin is tender, often prickly heat, as prickly heat can form small pustules, and even sepsis and life-threatening, so the occurrence of prickly heat should be prevented. 1, hot summer should avoid newborns cry, put the child in the shade to prevent sweating. 2, use warm water and special soap for children to give the baby a bath. After the skin is dried, then put on a little baby powder to keep the skin dry. 3.If the head is prickly, shave off all the head hair to reduce sweating. The cranial hematoma is formed when the fetus is in the womb during delivery and the cranial roof and maternal pelvis are indirectly rubbing against each other, or when the fetal head is pressed because of the strong birth canal, resulting in the rupture of the blood vessels under the skull membrane and the accumulation of blood in the affected area. The cranial hematoma generally does not require treatment, and the skin must be protected from infection. Blood should not be drawn by puncture, because semi-coagulated blood is not easy to draw out, but also easy to induce infection, which is extremely dangerous. If occasionally septic infection occurs in the hematoma, the infection should be controlled as soon as possible by incision and drainage of pus, along with the use of effective antibiotics to prevent septic meningitis and sepsis. When the cranial hematoma is large, there is a possibility of complication of hyperbilirubinemia or nuclear jaundice, which should be treated with 20-3Oml of fresh blood transfusion and vitamin K1 at the same time. Care of neonatal sclerosis Neonatal sclerosis is mainly caused by various factors such as cold, prematurity, infection, asphyxia and hypoxia, and often occurs in the cold season. However, it can also be seen in summer if it is caused by premature birth or infection. The main manifestations are low body temperature of 31℃~35℃ or even about 26℃, low or no crying, inability to suckle, little movement, cold extremities, dark red skin or with yellow gangrene. In severe cases, the skin and subcutaneous tissue become hard like hard rubber. Children with mild cases can be treated and cared for at home. The following are a few key points of care. 1, rewarming to take a gradual rewarming way, do not add temperature too quickly resulting in death of the sick child pulmonary hemorrhage. The general light can be wrapped in warm cotton swaddling, placed in 24 ℃ ~ 26 ℃ room temperature, plus the placement of hot water bags, hot water bags, the temperature is generally about 50 ℃ gradually increased to about 70 ℃ is appropriate, gradually re-stable. Every hour to measure the body temperature once; heavy can be placed in 26 ℃ ~ 28 ℃ room temperature, an hour later, together with the cotton swaddle placed in 27 ℃ ~ 28 ℃ warm box, every hour to raise the box temperature 1 ℃, gradually rise to 30 ℃ “~ 32 ℃, so that the sick child skin humidity to 35 C ~ 36 ℃, every 4 hours to measure the body temperature once. Generally required in 12 to 24 hours so that the body temperature gradually return to normal, and maintain the body temperature between 36 ℃ ~ 37 ℃. 2.Feeding When the temperature resumes to 34℃, in order to supply the baby with enough heat, breastfeeding should be started. If the sick child is weak and has poor sucking power, use a drip feeding or nasal feeding, and use a small spoon to try to feed breast milk after swallowing function is restored, or let the baby suck breast milk by himself. If the general condition improves, the amount of milk can be gradually increased. 3. The limbs of children with hard swelling are often restricted in movement, so they should be turned over regularly to prevent local pressure injury or local ischemia that may lead to tissue necrosis. 4.Severe cases can be transfused with blood or plasma as appropriate to increase the body’s ability to resist disease. 5. Pay attention to the hygiene of the environment and disinfection of supplies to prevent secondary infections and complications. Promote the early recovery of the sick child. Neonatal umbilical cord bleeding care Neonatal umbilical cord bleeding is often divided into two cases. 1. Blood oozing from the local granulation tissue after the umbilical cord is shed is more common, often secondary to infection and accompanied by a small amount of purulent secretions. The granulation tissue can be cauterized with 1% silver nitrate, or disinfected with 1% iodine. If necessary, antibiotics and vitamin K can be used to facilitate recovery as soon as possible. 2. Umbilical artery bleeding is rare, because the umbilical cord is thick and the knot is loosened after dry shrinkage, which can easily cause bleeding, and such bleeding occurs mostly within 24 hours after birth. Sometimes the umbilical cord is cut off too much and the knot loosens and falls off on its own, but it can also bleed because the cord is too thin and too tight and the blood vessel is broken. This kind of bleeding should be re-treated at the umbilical hollow by ligating the umbilical cord and suturing the broken blood vessels to prevent excessive bleeding and anemia. Blood transfusion may be given for severe bleeding. Newborn umbilical corditis is called umbiliculitis when there is mucus or purulent discharge from the umbilicus with a foul odor and the skin around the umbilical fossa is red. Since umbiliculitis can cause serious diseases such as abdominal wall cellulitis, peritonitis, sepsis and liver abscess, it is more important to prevent umbilical inflammation. If the umbilicus is already inflamed, it should be washed with hydrogen peroxide, disinfected with 75% alcohol, and treated with appropriate antibiotics. If there is no improvement after home treatment and the child appears depressed, refuses milk and has a fever, he should be hospitalized immediately for examination and treatment. Neonatal fever care Neonatal body temperature is generally below 37.5℃, if more than this temperature means that the newborn is feverish, there are many reasons for neonatal fever, but it is common in the following areas. 1, the ambient temperature is too high and the fever caused by hot water bags, indoor fireplace and room temperature is too high. Due to the incomplete thermoregulatory function of newborns, they cannot maintain the balance of heat production and heat dissipation and fever, this kind of fever only requires adjustment of the environmental temperature and does not require treatment. 2, dehydration fever born in the hot summer newborns, due to sweating, less milk and other factors and dehydration, followed by an increase in body temperature up to 38 ℃ ~ 40 ℃, but the general condition of the newborn, the normal mental response, given water or rehydration will rapidly decline in body temperature, fever rarely more than a day, known as “dehydration cooked”. This kind of fever only needs to be replenished with enough fluids. No other special treatment is needed. 3, infectious diseases caused by the fever is often divided into prenatal infection, infection at the time of delivery and postpartum infection. Prenatal infection (unclean examination, premature rupture of amniotic fluid, prolongation of the second stage of labor) and infection at the time of delivery usually start fever 1 to 2 days after delivery; postpartum infection usually occurs about 1 week after delivery, often caused by respiratory tract infection, sepsis, abscess, skin pustules and other factors that cause fever. The main thing for this type of fever is to find out the cause of the fever and then treat it symptomatically. When the fever exceeds 39°C, physical methods of cooling (such as warm water baths) are more effective, and if necessary, antipyretic drugs may not be used under the guidance of a doctor. Neonatal pneumonia care Neonatal pneumonia is one of the most common respiratory infectious diseases in the neonatal period, often without typical signs and symptoms, mainly manifested by poor general condition, low crying, little or no crying, little or no milk intake, depression or irritability, choking, coughing, vomiting or foaming at the mouth, shallow or irregular breathing, double inspiration, even apnea, and difficult to hear small wet rales and twisted sounds. The following are the key points of care. 1. Newborns with pneumonia should be kept in an environment with fresh air, plenty of sunlight, and a room temperature of about 22°C to 24°C. Water should be sprinkled on the ground frequently to maintain a certain level of humidity in the room. Since choking is easy to occur when pneumonia occurs, the teat should be pulled out every 4 to 5 sips during breastfeeding so that the sick child can rest for a while before eating milk, which will reduce the incidence of choking. As the sick child eats less milk, coupled with asthma and fever, the body often consumes more water, so the number of feedings should be increased and the sick child should eat as much milk as possible to increase the intake of water and prevent dehydration. If dehydration has occurred and cannot be corrected by increasing breastfeeding, intravenous rehydration should be given to correct dehydration. 2. If the body temperature exceeds 39℃, give antipyretic drugs along with physical cooling (warm water bath), but prevent excessive sweating or dehydration fever due to the use of antipyretic drugs. For malnourished or wasted children, physical cooling alone is also very effective. In addition, the sick child should wear moderate clothes, not too thick and affect the heat dissipation. 3. Feeding the sick child should be done about half an hour before breastfeeding and not immediately afterwards to prevent vomiting. Neonatal anuric care Neonatal anuria can be due to congenital renal agenesis or urinary tract malformation, or due to late renal urination. Generally, 99% of newborns urinate for the first time within 36 hours after birth, but if they have not urinated for more than 36 hours, they can be given oral sugar water or intravenous 5% grape broth solution, and if they are discharged favorably after the above treatment. Then it may be late kidney urinary teaching, if still no urine, then it may be renal agenesis or urinary tract malformation, further examination is required. Neonatal white eye red care Neonatal blood vessels are fragile, at birth, due to the extrusion of the birth canal, resulting in the rupture of small blood vessels of the sclera bleeding, so the newborn sclera (white eye) after birth is bright red small pieces of bleeding foci, this bleeding generally does not require any special treatment, a few days later can be self-absorption disappeared. Newborn care – newborns suddenly hold their breath is what happens Newborns often appear to suddenly hold their breath within 2 to 20 days after birth. This is especially true for premature or full-term infants. The main manifestation is sudden breathing stop, purple face, limbs weakness. If the breath-holding time exceeds 15 to 30 seconds, it is medically called “apnea”. The reason is mainly due to the immaturity of the brain development of newborns, when encountering cold stimulation or pneumonia and other diseases, the phenomenon of breath-holding can occur. Due to breath-holding when the exchange of blood oxygen in the lungs stops, resulting in lack of oxygen in the body, such as lack of oxygen for too long, may occur life-threatening. Therefore, once this phenomenon is detected, if no medical personnel are present, parents should immediately take artificially assisted breathing (put your hand on the child’s back, then lightly support, lightly put the child or pat the child’s soles at a frequency of about 40 times per minute to stimulate breathing, and pay attention to keep the room temperature at 26℃～28℃. If there is still no improvement after the above treatment or if the phenomenon of breath-holding occurs frequently and annoyingly, the baby should be sent to hospital immediately for treatment. Care of newborn red buttocks Red buttocks are mainly caused by the stimulation of the newborn’s tender skin by urine, which can cause rupture of the buttocks in severe cases. Therefore, the diapers used by newborns should be clean, soft and absorbent, and you should not put plastic cloth or rubber cloth under the diapers, because plastic cloth and rubber cloth are not breathable and can make the child’s buttocks always in a hot and humid environment after use, which makes it easier for red buttocks to occur. Wash the diapers with soap or alkaline ingredients, scald them with boiling water and then dry them in the sun for reuse. In addition to changing diapers regularly and washing the skin of the buttocks with warm water after each diaper change, you should also apply red buttocks cream (an ointment prepared by mixing cod liver oil drops with petroleum jelly) or disinfected vegetable oil to treat red buttocks. You can also use a light bulb or hairdryer to bake locally to dry the skin of the red buttocks, promote local blood supply and speed up the healing of the red buttocks, 2 to 4 times a day for 10 to 15 minutes each time. However, it should be noted that the baking should be done at a certain distance from the skin of the buttocks to prevent burns. What’s wrong with cryptorchidism in male infants The testicles begin to form when the embryo is two months old and gradually descend when it is three months old, and the testicles can descend into the scrotum when the embryo is about seven to nine months old. However, due to certain factors, a few fetuses are still not descended into the scrotum at birth, but remain in the abdominal cavity or in some part of the groin, which is called cryptorchidism or incomplete testicular descent. The reasons that prevent testicular descent include short spermatic cords, retroperitoneal fibrous adhesions, pituitary insufficiency, abnormal termination of the testicular lead or abnormal inguinal development. A small number of testes with incomplete descent can descend into the scrotum on their own before the age of 5-6 years, while the majority cannot descend on their own. How to deal with cryptorchidism in infants and boys Cryptorchidism still has the possibility of descending, so it can be temporarily observed, and if it still cannot descend before the age of 5 to 6, it needs to be treated. Unilateral cryptorchidism mostly has local factors, and most of them need surgery. For bilateral cryptorchidism, try chorionic gonadotropin, 500 units each time, inject twice a week, the dosage for a course of treatment is 4000~5000 units; if necessary, repeat 1~2 courses of treatment, most of them can have good effect. If the effect is not satisfactory, surgery is feasible. The age of surgery is generally 6 to 7 years old. If the surgery is delayed until adolescence, the atrophy of varicocele may cause the loss of sperm production ability. Therefore, for cryptorchid children, dynamic changes should be closely observed in order to grasp the timing of treatment. What’s wrong with large scrotum in baby boys There are obvious individual differences in the size of scrotum in boys. However, if it is too large, it may be pathological and is generally related to the following three factors. 1. Scrotal syringomyelia is more common in newborns and is generally self-absorbing within 1 week of age and does not require surgical treatment. If it is still not absorbed in adulthood, but if it does not affect life and work, it does not need surgery. If the syringomyelia is large and causes symptoms that affect life and work, sheath reversal or resection is required. 2, inguinal hernia inguinal hernia has a sense of impact when the infant coughs, a negative transillumination test, and no wave rate. If the infant lies flat and does not cry the swelling can be returned into the abdominal cavity and the scrotum returns to normal. If the swelling is embedded in the scrotum and cannot be returned to the abdominal cavity, emergency surgery is needed to prevent complications such as intestinal necrosis. Testicular tumor is less common, it is solid and hard, with a heavy feeling when supported by hand and negative transillumination test. If this happens, you should go to hospital for further examination in time.