What a new-born baby can do

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Starting evaluation of skills, and accordingly - state of health of a new-born baby is carried out by doctors right in maternity ward


 

Starting evaluation of skills, and accordingly - state of health of a new-born
baby is carried out by doctors right in maternity ward. Each parent can find out
the result of this evaluation in documents, received while discharge from maternity
hospital, where he will read, for example: “a baby was born 8-9 APGAR scores”.
Not everybody knows what`s Apgar score, many are assured that this is some abbreviation
and try to decode it without success. We`ll explain: Apgar - is a surname, it
belongs to a woman, an American anaesthetist. Apgar offered a score, which rates
a baby’s appearance, pulse, responsiveness, muscle activity, and breathing with
a number between zero and 2 (2 being the strongest rating). The numbers are totaled,
and 10 is considered a perfect score.
 
A score is given for each sign at one minute and five minutes after the birth.
If there are problems with the baby an additional score is given at 10 minutes.
A score of 7-10 is considered normal, while 4-7 might require some resuscitative
measures, and a baby with apgars of 3 and below requires immediate resuscitation.
 
 
Sign
0 Points
1 Point
2 Points

A

Activity (Muscle Tone)
Absent
Arms and Legs Flexed
Active Movement
 

P

Pulse
Absent
Below 100 bpm
Above 100 bpm
 

G

Grimace (Reflex Irritability)
No Response
Grimace
Sneeze, cough, pulls away
 

A

Appearance (Skin Color)
Blue-gray, pale all over
Normal, except for extremities
Normal over entire body
 

R

Respiration
Absent
Slow, irregular
Good, crying
 
 
However, these are doctors, who calculate your baby`s Apgar score to see how
he’s doing. What shall an average parent do? Here you come back home from maternity
house, here you take council with your family. You`ve got a newborn. Doctors said
he`s ok. But you are in some doubt. He`s red, his eyes are looking to and fro,
he`s waving his hands in some strange manner, jerking his legs, puffing out his
lips, turns his head and crying… Relatives offer various distressing ideas,
plunging young parents into dejection and not contributing to a mother`s normal
lactation.
 
Taking into account the above-mentioned and quite typical situation, we will
try to tell you about the way it should be, as the most effective method to avoid
stresses - is to gain information in time. There`s also another method - to ask
relatives refraining from making remarks, in order not to create unnecessary stresses,
but this task can hardly be fulfilled.
 
Let`s start with organs of sense. In fact, according to old rules, doctor usually
finishes a baby examination with evaluation of work of these organs, but parents
are worried by this most of all - what their baby sees, hears and feels.
 
Eyesight. Both ophthalmic and muslces, moving an eyeball, are not completely formed in
a newborn. A baby can only sense light, i.e. he can distinguish day from night,
but he cannot recognize people yet. Mentioned unripeness of oculomotor muscle
forms a physiological (i.e. absolitely normal for newborns) squint.
 
Specificity of a newborn - is a blink reflex. The essence: an eye won`t blink
when you are dangling with objects in front of it, but it reacts to a bright and
sudden beam of light.
 
Hearing. It`s somehow lowered right after childbirth (ear mirror is filling up with
air little by little), but by the moment, when your baby is home, he hears almost
like adult people. But he doesn`t understand and as a result doesn`t react. If
a sound is quite loud - he starts, depth and respiration rate can change, facial
muscles react. But a baby often calms down, when he hears his mother`s voice.
 
Smell - is a feeling, which is sifnificantly developed in newborns since first days
of life, as due to smell a baby can distinguish his mother from other relatives
and close people, feeling smell of milk. He clearly reacts to strong scents (as
a rule, his respiration rate changes or he starts worrying), but he cannot distinguish
a father`s cologne from mother`s perfume.
 
Taste. Everything is ok with a baby`s taste already. Sweet food has a sedative effect:
a baby licks his lips, swallows. He doesn`t like salted and bitter food. He stops
sucking, pulls a grimace and cries.
As his taste and smell are well developed, then negative reactions to “tasteless”
medicines and hygienic remedies a nursing mother uses are quite possible (and
it should be definitely considered).
 
Sense of touch. It is well developed, but irregular, as nerve terminals are distributed unevenly.
A baby accepts touches to his face and extremities more actively, than stroke
of his back. And he reacts to them quite wisely - cries because of cold and firm,
calms down because of soft and warm.
 
Well, we already know about organs of sense. Now let`s learn a little about all
the rest, also very important.
 
Skin. It is provided with blood greatly, the smallest vessels (capillaries) are wider,
than adults` (of course, relatively). Sweat-glands are quite underdeveloped. Significant
sensitiveness to disturbing factors, especially to overheating, is connected with
these two factors. But there`s also a marked advantage - very high regenerative
ability: everything heals up very quickly - of course, in case, when disturbing factor
is removed.
 
Muscles. A peculiar feature - is increase of muscle tone, but muscles themselves are
underdeveloped, especially muscles of extremities. And in general muscular mass
differs from adult`s person one significantly and is only 22-25% from body weight,
whereas parents` one is at least 40%.
 
Respiratory system. As it is known, fetus doesn`t have lung respiration, gaseous exchange is carried
out due to so-called placental circulation. Right after birth a baby makes the
fist breath, upper air passages and lings are filled up with air: a baby starts
breathing like a human being. An important peculiarity of a newborn - narrowness
of nasal passages, larynx and trachea, and mucous membranes coveting them from
inside are very delicate and actively supplied with blood. Mucous membranes of
upper air passages can be easily damaged while picking at nose, they can be easily
overdried. A protective mucus is produced while dryness and dustiness, and as
all passages are narrow, problems often appear, when mucus is accumulated in respiratory
tract. A newborn can sneeze, but he cannot blow his nose. It`s important to know
this, because a baby can breathe well, but only in case, if loving relatives create
good conditions for him - there should be little dust, not hot, and nursery should
be ventilated in time.
 
Normal respiration rate for a newborn is 40-60 respiratory movements per minute.
 
Cardio-vascular system. Right after birth placental circulation stops. Work of heart and vessels changes
significantly. Lungs are filled up with blood, some vessels and openings in heart
stop functioning and are closed. A newborn`s heart - is one of the healthiest
organs, it`s quite steady to loads and lack of oxygen. Frequency of heart contractions
is from 110 to 140 beats per minute, and these fluctuations happen constantly
- almost any external influence changes pulse rate seriously.
 
Digestion. A baby is born with well developed masticatory muscles and relatively big tongue.
This makes long and active sucking possible. However, salivary glands are still
unripe, and there`s little saliva. Organs of digestion are growing very quickly.
Thus, in the first day of life a stomach can store about 20 ml of milk, in a week
- 50 ml already, and by the end of neonatal period - more than 100. As a baby`s
organism is oriented on milk, ferments of stomach and bowels are meant for successful
digestion of milk (according to their qualitative and quantitative structure).
During first 10-20 hours of life intestinal tract is practically sterile, but
it`s filled up with microbes very quickly. Bacteria, reproducing in bowels, change
the look of excrement: firstly it is brown, then sulphureous, several days later
- light-yellow, pappy with sourish smell.
 
Excretory system. There`s already some urine in bladder while birth. During first 3 days urinations
are quite infrequent - 4-5 times per day and night. It`s quite normal. But their
quantity increases sweepingly and on the second week of life is from 15 to 25
times. Volume of a newborn`s bladder is from 50 to 80 ml, but a baby cannot accumulate
such quantity of urine: 10 - 15 ml are enough - it`s time to change diapers. As
for kidneys themselves, although they can fulfil their functions quite successfully,
but they are underdeveloped by the moment of birth. In connection with this, characteristics
of a newborn`s urine (specific gravity, reaction, albumen content) differ from
adult person`s norms.
 
A newborn`s nervous system has a number of peculiarities. Probably, this is the
system of organism, which undergoes the most serious changes right during first
months of life. Reflexes, excitability and reactions to surroundings are constantly
changing. Muscle tone is more expressed in muscles, bending arms and legs. Some
signs that are absolutely abnormal for adults are quite natural for newborns.
Thus, for example, trembling of muscles of extremities (so-called tremor) is quite
undesirable to agitated grannies, but is normal for a newborn. Tendon jerks (the
ones, which a neuropathologist determines with help of reflex hammer) are not
steady in newborns, only a knee-jerk is fixed almost always in everybody.
 
But there`re also absolutely peculiar reflexes; they are called - “physiologic reflexes
of newborns”. Mentioned reflexes are caused by unripeness of brain, all healthy
newborns have them, but as brain “ripens”, they fade away and dissapear by 4-5
months. Any parent can find out these reflexes in his baby independently.
 
Grasping reflex. If you touch a baby`s palm with your finger, he will catch it and hold strongly.
So strongly, that it`s easy to raise a baby above the table.
 
Embrace effect. It appears while blowing on the table, where a baby`s lying, while a sudden
loud sound, pat on buttocks or hips. This reflex consists of two phases. During
first one a baby leans back, his shoulders are straightened and arms are stretched
aside. During second phase arms meet on chest.
 
Crawling reflex. If you put a baby on his belly and place your palms to his feet, a baby pushes
away.
Reflexes of support and automatic walk. In vertical position a baby sets his
feet against a swaddling table. And if you bend him forward a little, then you
will see motions, resembling walking.
 
This list is not limited only by mentioned reflexes, but it`s quite sufficient
for parental experiments.
All above-mentioned allows us composing quite definite impression of a newborn`s
skills. A baby can do a lot of things, although he seems to be so weak and helpless.
 
The main of his skills - is ability to distinguish good from bad and inform relatives
about it. He can cry and call for help, when he`s hungry, feels discomfort or
some pain; calm down and behave quite decent, when he`s pleased with everything.
He can suck and swallow, evacuate, distinguish day from night, silence from noise,
tasty from bitter, soft from hard - this is quite good for a person, who is only
several days old.

 



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