From birth to age one month, the baby is medically known as a neonate. The Newborn From birth to age one month, the baby is medically known as a neonate.

Medical Care and Testing

Apgar Test Test used to check the physical condition of a newborn, determining likelihood of survival. Checks for baby’s pulse, breathing, muscle tone, responsiveness, and skin color. Babies are given either a 0, 1, or a 2 in each category. Heart beat and breathing are the most important Skin color (a sign of circulation) is the least important. Test is given 1 minute and 5 minutes after delivery. Umbilical cord is usually attached for 1st test, but not 2nd. 2nd score should be higher than 1st.

Most healthy babies score 6 or 7 at 1 minute, then 8-10 at 5 minutes. If a baby scores 7 or less at 5 minutes, he/she is tested again at 10 minutes after birth. A low score means the baby needs special medical care.

After Apgar test, the nurses put antibiotic drops in eyes, a thermometer is attached to baby’s chest, and the baby wears a snug hat. Most babies receive a vitamin K shot to help clot blood. A sample of blood is taken from the umbilical cord. Injections of penicillin may be given if possible strep infection. Footprints are made and wrist/ankle bands are placed for identification

Neonatal Behavioral Assessment Scale Aka Brazelton scale: helps doctors spot any problems as early as possible. This tests for: Alertness, attention to sound, light, tendency to cuddle Baby’s general activity level and reflex behavior Levels of excitement and irritability Response to stress

Other Screening Tests Screening can be done for 55 disorders (29 of which are treatable) Anemia- a condition that occurs when the level of healthy red blood cells, which carry oxygen to all parts of the body, becomes too low. This can result in fatigue and shortness of breath Pediatricians test for this in infants Phenylketonuria- a disease that can cause mental retardation if untreated by diet. Hearing tests are done to make sure speech and language will not be delayed.

Hypothyroidism: leads to slow growth & brain development Galactosemia: the inability to convert a sugar in milk into glucose. If untreated can cause blindness, mental retardation, and death. Sickle cell anemia: can cause anemia, pain, damage to vital organs, and death. Early and consistent treatment reduces the problems Jaundice: a buildup in the blood of a yellow pigment called bilirubin. Baby is placed under bright lights to help reduce yellowing. If untreated, a severe case can lead to cerebral palsy, hearing loss, and mental retardation.

Care for Premature Babies +12% of babies are born premature, some with congenital problems involving heart, digestive tract, spine, or brain. These babies are placed in an intensive care nursery (ICN) Newborns who need intensive care live in neonatal intensive care units (NICUs). These consist of heated, completely enclosed beds. Neonatology: is a branch of medicine concerned with the care, development, and diseases of newborns.

Circumcision About 65% of newborn boys are circumcised. A surgical procedure in which the skin (foreskin) is removed from the end of the penis. Slight risk of infection.

Well-Baby Checkup A routine medical visit in which the doctor examines a baby for signs of good health and proper growth, done within 3 to 5 days after birth.

Reflexes The absence or weakness of a reflex may result from prematurity or congenital problems. Withdrawal reflex: when soles of feet are pricked, newborns jerk or withdraw their legs Some reflexes will disappear with time. Rooting reflex: When you touch a newborn’s cheeks, lips, or skin around the mouth, the baby searches for food. After finding an object, the baby begins to suck.

Reflexes Cont… Palmar (grasping) Reflex Newborns’ fingers tighten around any object placed in the palm. Grasp is strong enough to lift them into a sitting position. Plantar (grasping) Reflex Newborns’ toes tighten around any object when the ball of the foot is stroked. This reflex disappears between 8-15 months of age. Babinski Reflex Newborns’ toes fat out if the outside of the sole is stroked from heel to toe. Reflex ends at about one year of age. Moro (startle) Reflex The reflex consists of two movements. Newborns fling arms and legs out and pull them back again when they are startled. Walking Reflex When babies’ feet touch a solid surface, alternation steps are taken as in walking. This reflex disappears in three or four months.

Meeting the Newborn’s Physical Needs

Breast-feeding vs. formula feeding Mother’s need to: Talk to dr. about which formula to use Powdered, liquid concentrate, ready-to feed. Cow’s milk base vs. soy milk base Throw away unused formula or store in refrigerator Mother’s need to: Eat a balanced diet Drink at least 8 oz. of fluid a day Realize certain foods you eat may upset the baby Talk to doctor before taking any over-the- counter drugs Rest and avoid stress Best 1st food for newborns

Diapering Disposable vs. cloth diapers Must consider cost and convenience Daycares require disposable diapers Consider how much time it will take to wash diapers Diaper services are sometime available- drop of soiled diapers and clean one are delivered.

Bathing Newborns don’t get too dirty except for their faces, necks, and diaper areas. Sponge baths are recommended until the navel has completely healed-up to three weeks after birth.

Sleeping Newborns average about 17 hours of sleep per day. Baby should sleep on firm mattress in a crib. Pillows, stuffed toys, flat sheets, and blankets should only be used after baby is 1 year old. Babies should be placed on their backs for sleeping. Doing this along with giving baby a clean pacifier will reduce the risk of SIDS Baby dies without warning while sleeping.

Exercising Exercise is important for muscle development, coordination, and even relaxation.

Scheduling After a few weeks, most babies begin to develop eating- sleeping patterns. These change as baby’s needs change. Parents can help shape how these schedules look by planning feeding times every two hours for newborns.

Meeting the Newborn’s Intellectual Needs

What Newborns Can Do Recognized the human voice and look in that directions Move arms and legs rhythmically to human speech Imitation: copying the actions of another person Newborns can imitate facial and hand gestures

Helping Babies Learn For the first 3-4 weeks, newborns vision is limited, so mobiles hung above the beds this early are almost useless. They can however see things safely attached in the corner or sides of their cribs. Objects should be rotated to keep infant interested.

Meeting the Newborn’s Social-Emotional Needs

Alertness of Newborns Babies learn best when they are in an alert-inactive state. calm and quiet state of mind. Babies differ in length of time they are alert. With each passing week, newborns spend more time in the alert-inactive state.

Soothing a Fussy Baby Some babies cry 1/6 to ¼ of the day! The only way a newborn can communicate is through crying. Colic: a condition (not a disease) in which the baby has intense abdominal pain. Allergies, tension, swallowing air, and hunger are all causes. How to soothe: Rock the baby in an over-the-shoulder position Carry the baby around the house/yard Sing and play music Take baby for car or stroller ride

Meeting the Parents’ Needs

The Need for Rest Being tired can lead to illness, irritability, and depression. Parents of newborns should sleep or rest when the baby is sleeping. Parents should avoid unnecessary chores or cooking complicated meals. Parents can take turns getting up with baby at night.

Taking Care of New Business While in the hospital, parents should apply for their baby’s birth certificate and social security number. Parents will need to add child as a beneficiary to life insurance policies, investment accounts, and their will. Parents will need to add the baby to their health insurance as well.

Time to Be with Adults Spending time with adults each day restores energy. Getting out even for a short walk can restore physical and mental energy. This can help make both babies and parents feel better It is best to rely on experienced friends, along with the grandparents of the new baby for advice.