Newborn Care

Apgar Score The very first test given to your newborn, the Apgar score occurs right after your baby's birth in the delivery or birthing room. The test was designed to quickly evaluate a newborn's physical condition after delivery and to determine any immediate need for extra medical or emergency care. Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Activity, Pulse, Grimace, Appearance, and Respiration. The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby's condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth.

Apgar Score Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2, with 2 being the best score: activity and muscle tone pulse (heart rate) grimace response (medically known as "reflex irritability") appearance (skin coloration) respiration (breathing rate and effort) Doctors, midwives, or nurses add these five factors together to calculate the Apgar score. Scores obtainable are between 10 and 0, with 10 being the highest possible score.

Apgar Scoring Apgar Sign 2 1 Heart Rate (pulse) Normal (above 100 beats per minute) Below 100 beats per minute Absent (no pulse) Breathing (rate and effort) Normal rate and effort, good cry Slow or irregular breathing, weak cry Absent (no breathing) Grimace (responsiveness or "reflex irritability") Pulls away, sneezes, or coughs with stimulation Facial movement only (grimace) with stimulation Absent (no response to stimulation) Activity (muscle tone) Active, spontaneous movement Arms and legs flexed with little movement No movement, "floppy" tone Appearance (skin coloration) Normal color all over (hands and feet are pink) Normal color (but hands and feet are bluish) Bluish-gray or pale all over

Apgar Score A baby who scores a 7 or above on the test at 1 minute after birth is generally considered in good health. However, a lower score doesn't necessarily mean that your baby is unhealthy or abnormal. But it may mean that your baby simply needs some special immediate care, such as suctioning of the airways or oxygen to help him or her breathe, after which your baby may improve. At 5 minutes after birth, the Apgar score is recalculated, and if your baby's score hasn't improved to 7 or greater, or there are other concerns, the doctors and nurses may continue any necessary medical care and will closely monitor your baby.

Umbilical Cord Care

Umbilical Cord Care When the umbilical cord is cut, it leaves a stump, which then dries, heals, and usually falls off within 1 - 3 weeks. While the cord is healing, keep it as clean and as dry as possible. In order to keep the cord dry, sponge bathe your baby rather than submersing him in a tub of water. Watch the umbilical cord for infection. This does not occur often, but can spread quickly if it does occur. Signs of infection are: Foul-smelling, yellow drainage from the cord Redness and tenderness of the skin around the cord Another uncommon problem is active bleeding. This usually occurs when the cord is pulled off too soon. Allow the cord to fall off naturally, even if it is only hanging on by a thread. In active bleeding, every time you wipe away a drop of blood, another drop appears. If the cord does actively bleed, call your baby’s doctor immediately. The umbilical cord stump should dry up and fall off by the time your baby is 8 weeks old. If your baby's stump remains beyond that time, there may be a problem with the baby's anatomy or immune system. See the baby's doctor if the cord has not dried up and fallen off by the time the baby is 2 months old.

Bathing Baby Your infant doesn't need much bathing if you wash the diaper area thoroughly during diaper changes. Two or three times a week during her first year is plenty. If she is bathed more frequently, it may dry out her skin. Sponge Baths During her first week or two, until the stump of the umbilical cord falls off, your newborn should have only sponge baths.

Bathing Baby Once the umbilical area is healed, you can try placing your baby directly in the water. Her first baths should be as gentle and brief as possible. She will probably protest a little; if she seems miserable, you should go back to sponge baths for a week or two, then try the bath again. She will make it clear when she's ready. Most parents find it easiest to bathe a newborn in a bathinette, sink or plastic tub lined with a clean towel. If you're filling the basin from the tap, turn the cold water on first (and off last) to avoid scalding yourself or your child. In addition, make sure your hot water heater is set no higher than 120 degrees Fahrenheit.

New Born Videos http://www.babycenter.com/2_bathing-your-newborn_1486858.bc

Cradle Cap Your beautiful 1-month-old baby has developed scaliness and redness on his scalp. You're concerned and think maybe you shouldn't shampoo as usual. You also notice some redness in the creases of his neck and armpits and behind his ears. When this rash occurs on the scalp alone, it's known as cradle cap. No one knows the exact cause of this rash; however, it certainly is influenced by the hormonal changes of pregnancy, which stimulate the oil glands. This overproduction of oil may have some relationship to the scales and redness of the skin. Cure-continue to shampoo-if persistent use a medicated shampoo

Jaundice Jaundice is very common in newborn babies.  About 90% of newborn babies will become jaundiced two or three days after birth.  Jaundice reaches its peak at about four days of life and then gradually disappears in most babies by the time they are two weeks old.  Jaundice does not necessarily mean your baby is ill. 

What causes jaundice?  Jaundice is caused by high levels of a chemical called bilirubin in the baby's body. Red blood cells are being made, and being broken down continually in all people, including babies before and after birth. Hemoglobin in the red blood cells breaks down into smaller chemicals including bilirubin. Before birth the bilirubin is carried out of the baby through the placenta, and into the mother's blood.  When a baby is born, the baby's liver suddenly has to take over the work of getting rid of bilirubin and it can take the liver a few days to fully manage this.

Jaundice If the baby is breast fed then quite frequently parents are reassured that it is breast milk jaundice, which is harmless, and will go away with time.  It is important, however, that this diagnosis is made by testing.  The vast majority of babies will have breast milk jaundice but a very few will have liver disease jaundice - or even both.  In these babies it is vital that the following is carried out: -The colour of the stools and urine are checked - -The urine of a newly born baby should be colourless. -The stools of a breast fed baby should be green / daffodil yellow colour. -The stools of a bottle fed baby should be green / English mustard colour

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