The baby just moments after his birth: the tests performed after the birth of baby
Posted on July 31, 2008
Filed Under Baby care |
A baby born at term measure between 45 and 55 cm, 50 cm on average.
It weighs between 2.6 and 4 pounds, averaging 3, 5 kilos.
After delivery, the baby is placed a few moments on its mother’s womb so that it can remain against her mother, and that his skin could be against that of his mother.
The mother can take this moment to touch and caress her baby.
Under the new recommendations of the high health authority, HAS, “care charged for the monitoring of baby should promote contact the mother and her baby while maintaining safety requirements.”A first feeding may be given at this time.
The umbilical cord is cut ligature then within 5 minutes after birth.
About the issue of health insurance: “Around baby: belly of his mother in his first week”
The first gestures made after birth
Depending on the size of motherhood, the course of delivery, and the possible discovery of anomalies baby, the first baby care are made by lla midwife, childcare or pediatrician.
The baby’s temperature is monitored to ensure it has no fever
The size, weight and head circumference of the baby are measured.
An antibiotic eye is instilled in eyes is to avoid the appearance of conjunctivitis caused by germs present in the genital tract of his mother.
A few drops of VIT K is given to the baby in order to allow proper clotting and avoid the outbreak of haemorrhagic disease of the newborn.
The desobstruction: a very fine pipe, installed in the nose, mouth and throat baby can be clearing and aspirate mucus that can clog the airways
All openings are considered
A nasal tube can check good permeability of the nasal cavity
A sensor installed in the stomach helps to verify the absence of malformation of the esophagus
The permeability of the anus is verified
The cord care
The umbilical cord is disinfected.
An umbilical clamp is installed a few days to allow for clotting.
The test AGPAR
This test helps build the overall condition and vitality of the baby and identify the presence of anomalies requiring special care or urgent intervention.
It is done 4 times a minute after birth, followed by 5 minutes, 10 minutes and 15 minutes after birth.
Each element is noted from 0 to 2 according to a grid.
The higher the figure is low and this means that the baby’s condition is worrying.
This test can be verifierLa heart rate
If there is no heartbeat: the score is 0
If the latter is less than 100: the figure is 1
If it is above 100: the figure is 2
Breathing
Sil no breathing: score 0
If the cry is low: the figure is 1
If the cry is frank and vigorous: the figure is 2
Reflexes
If the baby makes grimaces: chiffe east 1
If the baby cries: number is 2
The colour of his skin
If the skin is blue: the score is 0
If the body is pink, but the arms and legs blue: the figure is 1
If the baby is entirely: the figure is 2
The muscle tone
If the baby made some movements of arms and legs: the figure is 1
If the baby is very active: the figure is 2
The score normal APGAR test is 10/10 A score of 10Un score of 10 means that the child has prompted a cry franc few moments after the expulsion:
His heart rate is above 100
His breathing is normal and efficient, around 40 to 60 breaths per minute
It is very tonic
His movements are active
Score APGAR understood between 7 and 10Dans this case, the skin can be baby blue. This anomaly may be caused by a delivery which lasted longer.
This score is improving in most cases after a few minutes.
A score of 3 to 7 indicates a suffering child. The first resuscitation gestures can be considered.
If the score test APGAR east inferieur to 3, a transfer in a neonatal unit is made
The laying of an identification bracelet
The laying of a bracelet around the wrist of the baby on which are inscribed his name and surname, sex and name of his mother can avoid some unfortunate mistakes.
Measures and the first review of baby
The pediatrician evaluates the general condition and tone of the baby. It verifies that the baby relax and let his arms are ballants
The external genitalia are examined
For a boy, the testicles must be located inside the scrotum
For a girl, pediatrician checks that large and small lips are open
The heart rate is monitored again: it must be between 130 and 140 beats per minute
The respiratory rate is controlled and must be between 40 and 60
The abdomen is palpé
The feet and legs are considered
The measure pulse of the femoral artery
Checking the temperature
An examination of the neck and clavicles can verify the presence of hematoma or a fracture of the clavicle can be seen during a difficult childbirth.
The bones of the skull and appearance fontanelles, cartilaginous areas of the skull before the ossification complete, are examined.
The doctor will check the state of his eyes, his ears, his nose and his mouth: he checks his eyesight and his hearing
It verifies the existence of marks that could have been caused after a forceps and disappear after a few days.
The reflex glare is made by placing a bright light in front of the baby who must close its eyes.
A neurological examination is performed to evaluate its tone, its motor and its overall reflexes.
The reflex of the automatic
The reflex agrippement: the baby closes his hand when he tickles the palm of the hand
Reactions of the cardinal points
Lengthening cross
Reflexe of the neck
These reflexes disappear gradually over the months.
The state of the umbilical cord is checked to ensure that no infection and that the umbilical clamp to be removed a few days later, is firmly in place.
The hancheLa dislocation of the spine and hips are examined: An examination of the hips in order to verify the absence of a dislocated hip causing an anomaly nesting of the hip.
0, 5% of children have a dislocated hip at birth occurring during childbirth in the vast majority of situations.
Risk factors for the emergence of a dislocated hip:
A baby whose weight is high and more than 4 kilos
The presence of a narrow basin of the mummy
Presence of a family history of dislocated hip
Birth by headquarters
How to detect this anomaly?
The pediatrician can detect this anomaly by removing the baby’s knees after his legs folded on his thighs and then on his abdomen. The committee heard a noise characteristic reflecting bad nesting of the head of the femur.
An X-ray or ultrasound can be done.
The baby is kept legs apart, in the position of abduction, in a specific language, for approximately one month.
A harness or a cast is sometimes asked if the dislocation is more important or when it was discovered later, unnoticed during the first exam.
To avoid certain child limping then be made after discovering a dislocated at the age of walking, an ultrasound is being systematically practised in children with certain risks (birth weight greater than 4kilos, pelvis too narrow Mum ..)
The test Guthrie
A blood test done to the 3rd or 4th day after the baby was born by taking blood at his heel allows you to search certain rare diseases, as phenylketonuria, hereditary disease causing neurological abnormalities and intellectual, congenital hypothyroidism, cystic fibrosis, an adrenal hyperplasia and sickle cell disease.
The phenylketonuria: it causes neurological abnormalities, a type of mental retardation. A regime without phenylamine can allow a normal brain development.
Cystic fibrosis: genetic disease of the respiratory system.
The congenital hypothyroidism: the disease causes mental retardation that can be avoided with treatment.
The congenital adrenal hyperplasia: This often fatal disease can be prevented by taking medication corticosteroids.
The sickle cell disease: disease that affects hemoglobin children from certain countries as Black Africa or certain regions like the Caribbean or French Guiana, looking for a sickle cell disease. The establishment of prevention can reduce complications of the disease.
Technological advances can now detect about 50 diseases from naissanceMais many ethical problems arise: what used screening if doctors can not treat diseases detected?
Some diseases detected thanks to new processes may be found their place with the screening of 5 diseases prescribed by legislation.
The French Society of Biology has established a working group to consider the problems posed by this type of testing and evaluating the possibilities of carrying out this type of screening all babies. Health authorities will take their decision following this work.
Screening for hearing of the newborn:
Not yet systematic screening of deafness can identify children with hearing problems.
1 baby in 1000 is involved in families not knowing history of deafness
France is lagging behind other European countries, like England, the Netherlands, for example, have established a systematic screening of deafness
In France the average age of diagnosis is late, around 1 year and a half to 2 years, which may lead to a delay in learning language, for example.
In nearly 70% of cases, parents who alerted the doctor noticed some anomalies with their child. Risk factors for disorders of auditionPoids birth less than 1500g
A family history of deafness
Rubella or toxoplasmosis
Prematurity
Signs to alert parents quickly locate the first signs of trouble at the hearing in order to develop treatments nécessairesUn baby very quiet, seemed to be elsewhere, babillant little…
It does not react when heard a noise violation
It sets the faces, as if it did not quite
There is no great effort to speak and present a delay of language
He has repeated ear infections or ear infections that went unnoticed…
The troubles of sight
The baby is coming to see through its eyes 2 to age 4 and a half months.
Sometimes a baby presents his vision disorders that can prevent it from developing smoothly.
90% of what the baby is acquired through his vision.
The number of consultation systematically planned during the first year
Apart from emergencies or requiring medical advice, 9 pediatric examinations are systematically planned
Within 8 days after birth
Before the end of 1 months
During the 2nd, 3rd, 4, 5th and 6th months
During the 9 months
During the 12 months
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