A newborn child differs significantly from an adult not only in basic anthropometric parameters (height and weight), but also has a number of structural features and functioning of various body systems.
The main feature of a newborn is its ability to intensively grow and develop, which is accompanied by morphological and functional improvement at the organ level. At the same time, maturation occurs.
central nervous system
The subcutaneous fatty tissue of a newborn is characterized by the presence of deposits of so-called brown fat, which is used for more effective fat loss.
In addition to morphological features, the skin of a newborn differs from the skin of an adult and is functional. First of all, the high role skin in the breath of a child in the first days of life. Therefore, it is unacceptable to apply excessive amounts of substances impermeable to air and water to the skin.
Besides, functional feature The skin of a newborn is its high ability to regenerate (restoration).
Muscular system
The muscles of a newborn are underdeveloped: their mass is only a quarter of the total weight, while in an adult this figure reaches 45%. The muscle fibers of a newborn are much thinner than those of adults, and their tone and strength are correspondingly weaker.
Skeletal system
At the cellular level skeletal system the newborn is characterized by a high water content with low levels of minerals. A child in the first days of life has elastic, flexible, softer bones than an adult.
By the time of birth, the processes are not completed in all bones of the skeleton.
The head of a newborn is equal to one-fourth of the total length of his body, and the bones of the skull are movable. At the point of convergence of two, a diamond-shaped large fontanel is palpated, normal sizes which is 2.5 by 2.5 cm.
The spinal column of a newborn is represented by cartilage tissue.
The chest has the shape truncated cone. The ribs are placed horizontally, forming a right angle with the spine, which to a certain extent limits its mobility in the act of breathing.
Respiratory system
Considering the respiratory system of a newborn, it should be noted that his nose is characterized by narrow nasal passages, and the nasal mucosa is thin and well supplied with blood vessels.
Nature itself took care of the special sensitivity of the young mother. Otherwise, how can a tiny squeaking lump survive? His mother's hearing, vision and touch are enhanced. Even a woman who has just given birth, who has only heard her baby cry once, can recognize her own voice in a choir of peers. What can we say about how carefully the mother studies, examines, quietly touching her baby’s fingers and ears! Do you know what is the most amazing and unexpected conclusion from such a first “acquaintance”? You will agree with me: “My God, he already has everything, only very tiny things! He real man, only small...” This indescribable feeling persists for long years, popping up in memory every time a child is born.
A newborn is a child from birth to 4 weeks.
In the first days of meeting their baby, young parents have many questions and concerns. This arises, in part, because we do not have sufficient knowledge about what a newborn baby looks like and why certain anatomical and physical indicators are considered normal. I propose to look at the tiny body of a newborn baby, to understand its anatomical and physiological characteristics, so as not to worry in vain and at the same time, to properly care for and care for the baby.
Head of a newborn baby
The baby's head often has irregular shape- this is the result of compression during passage through the birth canal. There may be bluish spots on the skin of the cheeks, on the forehead, and on the scalp due to dilation of the blood vessels in the skin.
Young parents are especially alarmed by the unossified area on the skull - the fontanel (in premature babies, the small fontanel on the back of the head is not closed). Thanks to this incomplete fusion of bones, your baby was able to be born: the shape of the head changed during the birth process, and this helped to move along the birth canal. The fontanel, as the head grows, will gradually close (shrink), this will finally happen by 1-1.5 years.
The baby's scalp is often covered with a yellowish crust, this is the so-called “milky scab”. Believe me, it does not cause any concern to the child. Therefore, there is no need to delete it. When your baby gets older and you decide to get rid of the crust, do it as follows. 30-40 minutes before evening bathing, wipe the baby’s head with a cotton swab soaked in baby oil. Then wash your baby's hair with baby soap or baby shampoo (you should use such baby cosmetics only after 2 months!). Then, using a special children's comb with small teeth, carefully run it at the roots of the hair - the entire crust will remain on the comb. It is not recommended to frequently use a comb with teeth until the fontanel is closed; use children's soft brushes with natural bristles.
Skin of a newborn baby
The baby's skin is soft, pink, and velvety to the touch.
The cheeks and shoulders, as well as the entire body of a newborn baby, are sometimes covered with remnants of vellus hair. Some body hairiness - individual feature, the delicate fluff on the back and arms can last a long time. The density of hair on the head also varies: don’t worry, everything is the norm - a complete absence of hair, and thick, black hair that is just right to be “cut and styled.” Of course, there is no need to do this, because after a while the “extra” hairs will fall out, and the hair color may also change.
Some newborns develop icteric discoloration of the skin of the body on the 2-3rd day after birth. This is physiological jaundice, which lasts no more than 10 days.
Almost all babies experience redness of the skin on the second day after birth, the cause of which is the disappearance of vernix lubrication. This is “simple erythema” and will disappear by the end of the first week of life. It is possible that peeling of the skin will remain after it, especially on the baby’s palms and feet, in the folds, between the fingers and toes. Peeling goes away quite quickly and does not require special treatment. During the day, 1-2 times, such areas can be lubricated with baby oil or cream.
There is also the so-called “toxic erythema”. It is characterized by the appearance of red spots on the skin, sometimes with a bubble in the center. These rashes can appear on different parts of the body and will go away in 2-3 days. Special treatment is required only if the rash bothers the baby greatly.
Sexual (hormonal) crisis of newborns children
The sexual crisis is manifested not only by pimples, spots and “dots” on the skin, but also by engorgement mammary glands both girls and boys. Sometimes the swelling is quite significant. Under no circumstances should you squeeze secretions from the mammary glands, as this can cause infection. Newborn girls often have quite abundant grayish-white discharge from the genital opening or scanty bloody issues, lasting 2-3 days. In both boys and girls, the genitals remain swollen for 2-3 weeks. All of the above symptoms are characteristic of a hormonal crisis in newborns and do not require special treatment, but compliance with basic hygiene standards - wiping or washing the genitals after each bowel movement and at least several times a day after urination.
Specialists and experienced parents It is recommended to use gauze in the first days and weeks - they are soft, comfortable for the baby, and allow the skin to “breathe.” In addition, by counting them, you can make sure that you have enough food: if at least 8-12 diapers or diapers a day become wet, it means. If you use disposable diapers industrial production, “free” the baby from them several times a day - the baby’s skin, even in the “wettest” places, must breathe.
It is necessary to pay attention to the process of urination itself, especially in boys. Normally, urination should be calm, a continuous stream, without painful sensations for the child. By the way, almost all newborn babies have a reddish tint to their urine during the first days. This phenomenon disappears by the end of the first week of the baby’s life.
Eyes and vision of a newborn child
The eyes of almost all babies are slightly swollen, their gaze is vague, squinting. There may be no eyebrows or eyelashes at all yet. Babies don’t cry until they are two months old: look closely, they really cry without tears!
Until very recently, there was a widespread belief that newborn babies see almost nothing and perceive surrounding objects as a blur. The latest research convincingly proves that almost from the moment of birth, a child is able to see the world around him. In addition, babies may be interested in and even express their preference for certain shapes and colors.
Vision develops rapidly during the first 6 months of a baby's life. Somewhat blurry at the beginning, the visual (visual) perception becomes absolutely clear within the first 10-12 weeks. Although a child can focus on an object, one eye “focuses” on an object that is different from the “focus” of the other eye. This happens because the eye muscles are not yet strong enough to keep both eyes “aligned.” By six months they should already be acting in a coordinated manner. If this does not happen, contact your pediatrician or pediatric ophthalmologist. The sooner this problem is detected, the greater the opportunity for correction. By six months, the baby can see contrasting images as well as adults.
A newborn baby can see objects not only close up, but also at a distance, slightly blurry. Large objects are especially interesting for the baby, since he does not yet distinguish details, as well as bright, contrasting colors. Delicate, pastel colors that parents like so much do not attract the attention of a child until 3 months of age. Contrasting toys and images are much more interesting for him. In normal home environment there are a lot of things that stimulate visual development baby. The twigs of a baby's crib, shadows created by light on the ceiling, green house plants against a white wall - all this and much more represent contrasting images that are so interesting to a child.
For a baby over three months old, large objects are no longer very interesting, since he begins to react to small details. The child distinguishes colors well, sometimes even giving preference to certain shades.
By four months, a child has the same color vision as an adult. Of greatest interest to a baby in the first half of life are red and Blue colour, the smallest - yellowish-green tones.
Nose newborn baby
The nose is a wonderful creation of nature that allows us to breathe without thinking about it. And breathing means supplying yourself with the amount of oxygen that is necessary for normal life. In the nasal cavity, the air is warmed, humidified and undergoes several levels of purification. Mechanical cleaning is carried out due to the presence in the nose of specially designed nasal passages, as well as hairs and cilia. Protection against bacteria and toxins occurs through the barrier and immune functions of the nasal mucosa. A newborn baby breathes through his nose. If a child’s nasal breathing is difficult (the child snores or snores) due to increased mucus secretion, this may be a symptom of a disease (rhinitis, ARVI, etc.). In this case, you need to consult a doctor.
A child can distinguish more than three thousand smells; by this smell he will find only one - his mother. This property appears in children until they see, but then disappears, but in animals the sense of smell remains. In general, healthy babies breathe from their stomachs. This type of breathing is called diaphragmatic breathing. But, unfortunately, over the years, as soon as a person takes a vertical position and begins to lead a “sedentary” lifestyle, this natural skill is lost.
The ears of a full-term newborn baby
In full-term babies they are hard, in premature and physiologically immature babies they are soft. But by the end of the first month they harden. Very often, when children are born, their ears stick out, i.e. They can have protruding ears, but this does not mean that they will remain that way, so there is no need to immediately run to a cosmetologist. The auditory, or Eustachian, tube is wider and shorter than in children older in age, which facilitates the penetration of infection and the development of otitis media (inflammation of the middle ear).
Features of the respiratory system in full-term newborns
The mucous membranes of the respiratory tract in infants are delicate, contain a larger number of blood vessels, therefore, during infections, more often viral, swelling quickly develops, secretion a large number of mucus, which makes breathing very difficult. It is also hampered by the anatomical narrowness of the newborn’s nasal passages, as well as his trachea (windpipe) and bronchi. But there is never inflammation of the frontal sinus (frontal sinusitis) and the maxillary or maxillary sinus (sinusitis), because they are still missing. The lungs are underdeveloped, breathing is shallow and is mainly carried out by the diaphragm - a muscle located on the border of the thoracic and abdominal cavities. Therefore, breathing is easily disrupted by the accumulation of gases in the stomach and intestines, constipation, tight swaddling, pushing the diaphragm upward. Hence the wish - to monitor regular bowel movements and not to swaddle the baby too tightly.
Since with his shallow breathing the baby does not receive enough oxygen, he breathes quickly. The norm is 40-60 inhalations and exhalations per minute, but this frequency increases even with a slight load. Therefore, you need to pay attention first of all to shortness of breath, which is accompanied by a feeling of lack of air and may be a sign of illness.
Sense organs of newborn babies
In the first weeks, the olfactory organs feel almost no smell; only an extremely loud sound can wake them up, and only too bright light can disturb them. The child's thoughtless gaze does not linger on anything; many experience physiological strabismus caused by weakness of the eye muscles, involuntary movements of the eyeballs - nystagmus. Up to 2 months, the baby cries without tears - the lacrimal glands do not produce fluid. So far, only the senses of taste, touch and temperature sensitivity help him to understand the world. But you can no longer say about a two-month-old child that he is “blind and deaf.” A sure sign is that he persistently looks at the loud, bright rattle.
Cardiovascular system and hematopoiesis of newborns
When babies are born, changes occur in the circulatory system; first, the functional umbilical vessels and veins cease their activity, and then the anatomical ones - the intrauterine blood flow channels close. With the first breath, the pulmonary circulation is activated, through which the blood is saturated with oxygen in the lung tissue.
The pulse rate is 120-140 beats per minute, when feeding or crying it increases to 160-200 beats. Blood pressure at the beginning of the first month is 66/36 mm Hg, and by the end of it - 80/45 mm Hg.
In newborns, the main site of hematopoiesis is the red bone marrow of all bones, additional sites are the liver, spleen, and lymph nodes. The size of the spleen is approximately equal to the palm of the child himself, its lower edge is located in the projection of the left costal arch (the lowest protruding rib at the border of the chest and abdomen). Lymph nodes, as a rule, cannot be identified during examination; their protective function is reduced.
Endocrine system of full-term newborns
During childbirth, the adrenal glands bear the greatest load of all glands and some of their cells die, which determines the course of some borderline conditions. The thymus gland, which plays a protective role, is relatively large at birth and subsequently decreases in size. The thyroid, parathyroid, and pituitary glands continue to develop after birth. The pancreas, which is involved in digestion and takes part in carbohydrate metabolism (produces the hormone insulin), functions well at the time of birth.
Nervous system of a newborn baby
The nervous system of babies is immature. The convolutions of the brain are barely outlined. They are more strongly developed in those sections where the vital centers responsible for breathing, heart function, digestion, etc. are located. In infancy, they sleep most of the day, waking up only from hunger and discomfort. , such as sucking, swallowing, grasping, blinking, etc., are well expressed, and by the 7-10th day of life the so-called conditioned reflexes, a reaction to the taste of food, a certain posture usually associated with feeding, by the time it’s time, the child soon begins to wake up on his own.
Genitourinary system of full-term newborns
By the time of birth, the kidneys, ureters, and bladder are quite well formed. However, severe stress experienced by a child during childbirth short-term disrupts metabolism. In the areas where urine is formed, uric acid crystals are deposited and the kidney function is slightly reduced for the first few days. The child urinates only 5-6 times a day. From the 2nd week, the metabolism gradually stabilizes, the number of urinations increases to 20-25 times per week. This frequency is normal for the first months, given the relatively small volume and insufficient extensibility of the walls Bladder. The external genitalia are formed. In boys, the testicles most often descend into the scrotum, but if they are in the lower abdomen, they can descend on their own in the first 3 years. In girls, the labia majora cover the labia minora. It is important to take into account the anatomical and physiological differences in the structure of the genital organs when committing.
Immunity of a newborn baby
Some factors that play a protective role in the body are produced in utero. The child receives some of the immune substances from the mother with colostrum, in which their concentration is very high, and with breast milk, where their content is much lower, but in sufficient quantities. But in general the immune system imperfect, the child is vulnerable to infection.
Anatomical and physiological features of the arms and legs of newborn children
The baby's arms and legs may have a somewhat bluish coloration and be cool even in a warm room. This is normal, and just like a rapid pulse, a change in body temperature indicates a temporary imperfection of the circulatory system and the development of metabolism in the body. The movements of the baby's arms and legs are chaotic and unconscious. Prevails - arms bent at the elbows, legs slightly bent and pulled towards the stomach. This is the so-called “fetal position”, which will persist throughout the entire first month of the child’s adaptation to new living conditions. If you try to carefully separate the arms and legs, it is unlikely to succeed, since the muscles prevent extension.
You may have read that you need to swaddle your baby “with hands on”; babies are supposedly scared own hands, become restless, cannot sleep, or wake up frequently. Such statements are true only for children with sufficient neurological abnormalities. It is advisable not to swaddle the baby and give him freedom of movement.
Legs infant always curved in the shape of the letter O, babies cannot yet stretch their hip and knee joints. As a child straightens up, learning to stand or walk, the legs begin to gain weight for the first time. As a result, their shape changes. They stretch out at the joints, the knees move closer together, and the ankles move away from each other. This distance can be a good 7 cm. The X-shaped position of the legs is also temporary. By the age of 6-7 years, the ankles come closer together again, and the legs stretch. Doctor intervention is required only in rare cases, for example when the distance between the ankles is significantly more than 7 cm or only one leg is X-shaped.
Fingernails and toenails newborn hair is dense, reaching to the fingertips and sometimes requires cutting at the end of the first week. You need to trim your nails with special scissors with rounded ends, making an even cut without curves. If you are afraid of hurting your baby with scissors, trim your nails while you sleep. Babies often have hangnails that quickly become inflamed. They need to be lubricated several times a day with iodine. If the inflammation does not go away within a day or two and the abscess develops, then you need to consult a doctor, because there is a danger of a serious inflammatory process.
Digestive system of a newborn baby
The digestive system of infants is functionally immature, and, since newborns have an increased metabolism, it bears a heavy load - minor errors in the diet of a breastfeeding mother and the child’s diet can cause indigestion (). The digestive glands, including the salivary glands, have not yet developed: very little saliva is secreted in the first days. The muscles that block the entrance from the esophagus to the stomach are also underdeveloped - this leads to frequent, light regurgitation - the release of milk from the stomach back through the mouth. Excess milk should be wiped off with soft gauze; always keep something like this on hand. The process of regurgitation is due to the fact that the muscles of the fairly wide esophagus are poorly developed. The communication between the esophagus and the baby's stomach is such that food easily comes back from the stomach. Therefore, after each feeding, you need to hold the baby upright for some time, lightly stroking the back - it is necessary to release the swallowed air and reduce the likelihood of regurgitation. The baby can only “release” air, without milk, this is a little like belching in adults. If regurgitation is too profuse (vomiting like a fountain) and occurs after each feeding, then you need to consult a doctor.
The peculiarity of the metabolism of newborn children is the increased need for carbohydrates, increased absorption of fats and their deposition in tissues. The water-salt balance in infants is easily disturbed. Initially, the stomach holds about 10 ml of liquid, by the end of the first month its capacity increases to 90-100 ml. The intestinal muscles are still poorly trained and the movement of food through it is slow. That is why newborns are so tormented by accumulations of gases formed during the digestion of milk and bloating - flatulence. Constipation and... Feces in the first 1-3 days of life (called “meconium”) have a characteristic viscous consistency dark green, there is practically no smell. Meconium is formed from amniotic fluid, mucus, bile, which enter the stomach and intestines of the fetus. Immediately after birth, by the presence of these secretions, it is judged that the child has no defects in the development of the esophagus, stomach, intestines, or anus. Organ obstruction requires immediate surgical intervention.
During the first 10-20 hours of life, the child’s intestines are almost sterile, then they begin to colonize it with the bacterial flora necessary for digesting food. The type of feces also changes - feces appear - a mass of yellow color.
Babies mouth
The baby's oral cavity is wonderfully adapted for sucking the mother's breast: the tongue is relatively large, the mucous membrane forms folds on the gums, they ensure the tightness of the oral cavity during sucking. Little saliva is produced in the first weeks of life. After breastfeeding, a kind of “sucker” sometimes appears on the baby’s upper lip - a callus. It may disappear between feedings and appear immediately after feeding. The baby does not experience any unpleasant sensations.
Navel of a newborn baby
With the cutting of the umbilical cord after childbirth, the last bodily connection between mother and child disappears. It was through the umbilical cord that the child received necessary nutrition and oxygen. Now the baby can breathe and eat on his own. All that remains of the umbilical cord is a stump three to five centimeters long, which requires (to avoid infections) proper care. So, after childbirth, the umbilical cord is cut at a distance of 3-5 cm from the navel and compressed with a clamp. At proper care the wound heals quickly, the clamp remains in place for another 2-3 days. After 6-10 days, the umbilical cord stump dries out and falls off. Soon after this, the navel already looks beautiful. Generally speaking, the final shape of the navel is determined genetically, but it will only develop with good care.
The navel should attract your attention for the first 10-14 days. 2-3 times a day, preferably in the morning, after sleep, and in the evening, after bathing, it is necessary to treat it. Using a clean pipette, place a few drops of a 3% hydrogen peroxide solution into the navel, removing the excess with a cotton ball. Then cotton swab With brilliant green, lubricate the navel with energetic movements, “drying” it. The navel can become an entry point for infection, so take care of it seriously, but without unnecessary panic. If at first you are afraid to handle the navel yourself, ask a visiting nurse from a children's clinic or an experienced friend whom you trust to teach you. Later you will cope perfectly well with not such medical “tasks”, believe me!
During the healing process, the navel should not come into contact with the diaper, so that bacteria does not enter the wound with urine or feces. Therefore, first swaddle the baby, then wash your hands and only then take care of the belly button. The diaper should fit tightly and not reach the navel.
Image source “Lori Photobank” “http://lori.ru/”
Leather newborn is smooth, velvety, elastic, soft pink in color. The stratum corneum is thin; the epidermis is juicy and loose.
Sweat glands - formed at birth, but the excretory ducts are underdeveloped, closed by epithelial cells, so sweating is not observed until 1 month.
Sebaceous glands - begin to function in utero; their secretion with epidermal cells forms a “curdled lubricant”, which facilitates passage through the birth canal. On the face they can degenerate into cysts, forming white-yellow formations - milia.
Hair - they are distinguished by the absence of a core, so they are light - “fluffy” (lanugo). They are located on the shoulders, back, and head of the newborn; different lengths and colors and do not determine the further splendor of the hair.
Subcutaneous fat - begins to develop in the 5th month of intrauterine life. In a full-term newborn, the fat layer is well developed on the cheeks, thighs, legs, forearms and weakly on the abdomen.
Umbilical wound - remains after the umbilical remnant falls off on the 3-4th day. Heals by 7-10 days of life, epithelializes by 3-4 weeks. It is the main entry point for infection and requires careful care.
Musculoskeletal system.
Scull . The sutures of the skull are wide and not completely closed. At the junction of the bones there are fontanelles covered with a connective tissue membrane. Between the frontal and parietal bones, at the junction of the coronal and sagittal sutures, there is a rhomboid large fontanelle . Its size (distance between sides) is from 3 to 1.5-2 cm. By birth, all children are open. Small fontanel located between the parietal and occipital bones, open in premature infants and in 15% of full-term infants. Closes no later than 4-8 weeks after birth. The sagittal, coronal and occipital sutures are open and begin to close from 3-4 months of age.
The function of the fontanelle is to help adapt the fetal head to the size and shape of the mother’s birth canal through configuration (by placing bones on top of one another), thereby protecting the child’s brain from injury.
Spine a newborn has no physiological curves.
Muscles Up to 3-4 months, physiological hypertonicity of the flexor muscles is characteristic, therefore a flexion pose (embryonic position) occurs: the head is slightly brought to the chest, the arms are bent at the elbow joints and pressed to the lateral surface chest, hands clenched into fists, legs bent at the knees and hip joints.
Movements are chaotic and uncoordinated. As a child grows, large muscles develop faster than small ones.
Respiratory system - imperfect.
Nasal passages narrow, the lower nasal passage is absent, which leads to rapid disruption of nasal breathing even with minor inflammation. Breathing through the mouth in a newborn is impossible due to the fact that the large tongue pushes the epiglottis posteriorly.
The paranasal sinuses are poorly developed or absent, so sinusitis practically does not occur in newborns. Pharynx narrow and small. The lymphopharyngeal ring is poorly developed. But the auditory (Eustachian) tube, which connects it to the middle ear, is short and wide, which contributes to the frequent development of complications such as otitis media. Larynx wide, short, funnel-shaped with a distinct narrowing in the area of the subglottic space. The vocal cords above the larynx are short, the glottis between them is narrow. These features contribute rapid development laryngeal stenosis with laryngitis. Trachea narrow, the cartilage is soft, pliable, can collapse and cause the so-called “congenital stridor” - rough snoring breathing and expiratory shortness of breath. Bronchi formed, the cartilages are soft and prone to collapse. The right bronchus is a continuation of the trachea, shorter and wider than the left, therefore foreign bodies come here more often. Lungs rich in loose connective tissue, low-elastic, low-air, rich in blood vessels, therefore prone to the development of edema, atelectasis (collapse of the alveoli) and emphysema (overstretching of the alveoli).
A newborn is characterized by a diaphragmatic type of breathing: shallow, frequent, arrhythmic. Respiration rate 40-60 per minute; the ratio of respiratory rate and pulse (RR: HR) = 1: 2.5-3-3.5.
TICKET No. 16
Convulsive syndrome. Urgent Care.
4. The purpose of the State Program “Health Development”.
Primary health care reform at modern stage. Priority of primary health care elements in the work of a medical assistant, medical assistant, medical assistant.
Reforming the primary health care system for the population:
– changing the system of providing assistance to the rural population;
– modernization of existing institutions and their divisions;
– building patient flows with the formation of unified routing principles;
– development of new forms of provision medical care– in-patient substitute and mobile methods of work;
– development of emergency care on the basis of outpatient departments;
Improving the principles of interaction with inpatient facilities and emergency medical services
Increasing the efficiency of specialized care:
– implementation of innovative treatment methods,
Development of infrastructure and resource provision for healthcare, including financial, material, technical and technological equipment of treatment and preventive institutions based on innovative approaches and the principle of standardization,
Federal law“On Compulsory Health Insurance” provides for the inclusion of high-tech medical care in the compulsory health insurance system from 2015.
Increasing the efficiency of maternity and childhood services:
* Development of the “Birth certificate” program;
* Development of a network of perinatal centers;
* Prenatal diagnosis child development disorders;
*Early detection of hereditary and congenital diseases immediately after the birth of the child;
*Development of specialized medical care for children
AFO newborn. Caring for it.
After the separation of the fetus from the mother, the first four weeks are called the neonatal period. At this time, the body begins to adapt to the environment.
Indicators physical development the birth of a newborn depends on many reasons: the state of health of the mother, her nutrition, the course of pregnancy, the gender of the child. Therefore, the weight and length of a child’s body have wide limits: from 2500 g and above (on average 3200 g) and from 45 to 58-60 cm (on average 52 cm). The head circumference (34-36 cm) is slightly larger than the chest circumference (32-34 cm).
Leather in a newborn it is smooth, elastic, hyperemic and covered with a layer of curdled butter. The connective tissue is poorly developed, the number of muscle fibers is insignificant, and is very vascularized. The sebaceous glands are well developed and the sweat glands are poorly developed. The skin has increased vulnerability and reduced protective function. It is a respiratory organ with well-expressed excretory properties.
Subcutaneous fat full-term children are well developed. Contains a large amount of dense fatty acids.
Muscular system underdeveloped, especially on the limbs. The tone of the flexors predominates, providing the child with a characteristic posture.
Nervous system still immature, but under the influence of external conditions it is constantly being improved. This affects the growth and development of the child.
Brain The baby is relatively large and heavy. Its mass is 350-400 g. The cerebral cortex is thin, the grooves are shallow, and not always clearly defined. The gray matter of the brain is not sufficiently limited from the white matter. The spinal cord, compared to other parts of the central nervous system, has a perfect structure and is functionally mature.
Sense organs in newborns are imperfect. However, they distinguish taste well. Sweets calm the child down and make swallowing movements; bitter, salty and sour foods make him restless. The sense of smell is poorly developed. The child feels touch well. Uncoordinated eye movements cause physiological strabismus. Bright light causes protective reflex blinking. The hearing is reduced, but it reacts to strong sounds, the facial muscles contract, the frequency and depth of breathing changes. The pain has eased somewhat.
Respiratory system. The nose of newborns is small, the cartilage is soft, and the passages are narrowed. The mucous membrane is delicate, well vascularized, vulnerable and swells quickly. The paranasal sinuses are underdeveloped. The auditory tube is short and wide, located horizontally. The throat, larynx, trachea and bronchi are narrow, with soft cartilage, their mucous membrane is delicate, and has a good blood supply.
The chest is barrel-shaped, the ribs are soft, supple, and placed horizontally. The trachea at the level of III-IV thoracic vertebrae is bifurcated. The lungs have a dense capillary network and little elastic tissue. Their lower border is located higher than in children infancy, due to the high location of the diaphragm
The volume of each breath is 15-20 cm. Blood oxygen saturation on the first day of life is 64-92%, on the 7th day it increases to 87-97%.
The cardiovascular system. After the birth of the child and ligation of the umbilical cord, the function of cardio-vascular system changes significantly. The placental circulation stops and the pulmonary circulation begins to function.
Blood circulation in newborns occurs twice as fast as in adults, and lasts 11-12 seconds. The heart is placed high, and its size relative to the chest is much larger than in adults. The pulse in the first days after birth is 140-160 per 1 minute. By the 4th week of life it gradually slows down, reaching 125-140 per minute. It is characterized by arrhythmia.
Blood and hematopoietic organs. During the embryonic period, it occurs mainly in the liver, the hematopoietic function of which increases until the 5th month, and then weakens and almost stops at the birth of the child. From 4th month intrauterine development Along with the liver, the hematopoietic organs are the bone marrow, spleen and lymphatic tissue. In a newborn, the main hematopoietic organ is the red bone marrow.
The liver of newborns is large, full of blood, and poor in connective tissue. On palpation, its lower edge protrudes from under the costal arch by 1-2 cm.
Digestive system. The oral cavity is small. It has a delicate and well-vascularized mucosa, the protective function of which is reduced. The salivary glands are underdeveloped, the amount of saliva is reduced. The enzymes amylase and ptyalin, which break down polysaccharides, and maltase, break down disaccharides into monosaccharides, are released with saliva.
There are hard ridges on the lips that promote a tight grip on the nipple. Fatty formations (Bish's lumps) are located in the thickness of the cheeks and improve the act of sucking.
The esophagus is 10-11 cm long. Its mucous membrane has many vessels and few mucous glands. The mucous membrane is dry and vulnerable.
The stomach contents in the first days of life are 30-34 ml, on the 10th day - 70-80 ml. Newborns spit up and vomit easily.
The intestinal mucosa has increased permeability to microorganisms and toxins. Immediately after birth, the contents of the intestines are sterile, but after a few hours saprophytic microflora (bifidobacteria, non-pathogenic Escherichia coli, etc.) enters them. Under the condition of natural feeding, bifidobacteria predominate, while artificial ones - E. coli.
Gastric juice in newborns is characterized by low acidity and enzymatic activity, which causes its insufficient protective function. In the first 2-3 days after birth, meconium passes during bowel movements, later - transitional stool, which subsequently becomes golden yellow. The frequency of stool in newborns is up to 3 times a day. If there is no meconium in the first days of life, one should suspect fusion (atresia) of the rectum.
Urinary organs. Compared to body weight, the kidneys in newborns are larger than in adults; they can be palpated. The kidneys function from the first days of life, although they still have an embryonic structure (underdeveloped medulla and renal cortex).
In the first 2-4 days, physiological oliguria (little urine) is observed, due to insufficient intake of fluid into the body. Therefore, urination increases up to 20-25 times per day, 10-15 ml of urine is released.
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