产前课程 W.2 - Part II

Is My Baby OKAY ?
During you pregnancy, your baby is cocooned and nourished within the mother's body. We can get fair idea of the baby's condition by monitoring his growth and activity in the mother's womb. However, it is not until the baby actually arrives that we can know his or her condition for sure.

When parents ask their doctor : " Is my Baby OKAY ?", they usually are interested to know whether the baby is normal, and free from any problems.

In this respect, the first few minutes after the delivery are crucial. The baby's first hurdle is to establish breathing quickly, and some babies announce their arrival by screaming at the top of their lungs, thereafter, a quick measurement of weight, lenght and head circumference will tell if the baby's size is within normal limits.

In most instanced, by the time the parents get to see and hold their body, he or she would have been bathed and dressed up. Still, it is not uncommon ( and quite natural ) to find parents gently examining every inch of newborn's features and making sure that there are really 10 fingers and 10 toes.

Appearance
A newborn baby continues to assume a curled-up position ( Foetal Position ) that he or she has been used to inside the mother's womb, he may have a thin layer of fine hair ( Lanugo ) on his body, and many Asia babies also have bluish-gray patches over the side and buttocks ( Mongolian Sports ), which will fade with time.

Many babies' heads will be moulded in an ablonged fashion ( Caput ) which help them negotiate the birth canal. Others may develop a swelling on one or both sides of the scalp ( Cephalhaematoma ) but virtually, all will resume a normal shape with time and without any help.

Sometimes, parents may notice a flattened, diamond=shaped area on top of the baby's head ( Fontanelle ) which may appear to pulsate. This is just a normal gap between the scalp bones, and gradually closes as the bones grow and fuse together.

Over the face, one can often see pink birth marks ( Capillary Hemangiomas ) especially over the eyelids and sometimes at the back of the neck too. Folklore has attributed these marks to stork bites as they carry the baby down from heaven ( Which, incidentally, is where they all come from ! )

These are transient, as are fine yellowish dots on the nose ( Milia ) which represent collections of oily substances, and are, by the way, not to be squeezed please !

Up to 70% of normal babies will develop rashes over the body ( Erythema Toxicum ) which are harmless, and typically bother the parents more than it does the baby.

Interestingly, as a consequence of a sudden drop in the mother's female hormones after birth, a few babies experience secretion of breast milk 9 Galactorrhoea ) and even vaginal bleeding ( Withdraw Bleed ) during the first week. Parents should recognize these possibilities and not be unduly alarmed as the effect of these hormones will pass.

The baby's tummy normally appears prominent, especially after a feed. Unfortunately, this leads many caregivers to label the baby's tummy as being " distended with wind ". A general rule of thumb is : if the bay is happy and contented, the tummy is usually not the problem.

Many parents also worry if the cord clamp will hurt their baby - it does not. Within a week after birth, the cord actually dries up into a dark stump, which drops off by itself.

Behaviour / Activity
Babies need sleep to grow well, and in fact, they can sleep as much as 18 hours in a day, waking up only for absolutely pressing reasons like feeding.

When awake and quite, babies love to study their environment, However, their eyes can focus well only up to 20cm. So it is a good idea to get up close and personal to them, because their idea of a good time is to see faces, especially their parents' faces cooing and taking to them.

Babies do not possess the faculty of adult speech ( and they are still unable to help themselves to the fridge ! ), therefore, nature has provided them with the superb set of lungs, Some adults get extremely agitated or depressed when a baby cries. Yet crying does not mean that the parents are not doing a good job, It is the only way for the baby to let you know that they need something. Address those needs, and the crying will stop.

This begs the question : How does one read the language of a baby's cry ?

Most commonly, babies cry because it is feeding time and they are hungry. Or they have soiled themselves with urine, vomitus or stools. Or they are in some kind of discomfort from heat, rashes, insect bites, or colic. Or perhaps they just want a little cuddle ( remember, you can never cuddle little babies too much ! ) For a start, now parents should look for the above possibilities like a checklist, As you spend more time with the baby, you will become better and better at differentiating the cries.

Newborn babies are also preprogrammed with automatic movements ( Reflexes ) that help them protect themselves and cling on to their mothers. Stroke their palms and they will hold on to your finger tightly ( Grasp Reflex ); A sudden noise like a slamming door will cause them to startle, throw their arms up and possibly cry ( Moro's Reflex ).

Feeding
A common question that vexes parents : How much to feed my Baby ?

One good idea is to follow the baby's cues and feed on demand, The amount needed varies because every baby's stomach capacity, metabolic rate and genetic programme is different. And they grow at a terrific rate too !

Breastfed babies may want to feed every 1-2 hours especially in the beginning. Formula-fed babies seem able to last 3-4 hours between feeds, but only because formula is harder to digest !

Whatever it is, remember to give feeding regularly, and also through the night during the first month. ( If baby seems to have slept pass his feeding time, you must gently remind him or her ).

The baby is getting enough if he passes on adequate amount of urine and stools ( see next section ) and putting on weight at a good rate.

Water is not necessary because milk itself contain abundant water. Moreover, water by itself fills up the stomach but provide zero calories and nutrients. After feeding, many babies hiccup due to distention of the stomach and whether or not you do anything about it, hiccups will disappear once the feed is digested.

On the same note, spiting out feeds ( Regurgitation ) is extremely common due to laxity of the newborn's swallowing tube ( Oesophagus ).

While the problem usually resolves within next few months, we can help by periodically burping the baby during and after feeds, not moving him too suddenly , and putting him down on an incline where the head is always slightly higher than the stomach.

Elimination
In the good old days, a sure sign of a new baby was the sight of rows of rows of clothes diapers hanging out to dry. Tobe sure, babies can generate prodigious amounts of waste !

Most babies pass thick, sticky greenish stools ( Meconium ) within 24 hours. With increasing feeds, the stools change colour to yellow within a few days. Because breast milk is easy to digest, bowel movements are usually regular, sometimes occurring with every feed and the stools may appear slightly watery and golden. On the other hand, formula-fed babies may have firmer, bulkier stools, which is passed less often.

Newborn should also pass urine within first 24 hours, and thence, may wet their diapers about 6 to 12 times in a day.

Summary
Knowing what is normal can put a lot of parental anxieties to rest. The best way is to read about babies before delivery, consult family members and friends who have taken care of babies themselves, asking your paediatrician, and most importantly, to learn from observing and being with your baby a lot.

And in between the hard work and interrupted sleep, remember to enjoy and love the little miracle you hold in your arms !

完！
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