KNOWING OUR CHILD
Here we will look at the newly born and some of the special characteristics which draw our attention and may even cause alarm if we do not know about them. You will see how most of these things are perfectly justified and take a perfectly normal course as time goes by.
If you have chosen a natural birth method, as soon as your child is born you will see that he or she is covered with a whitish and greasy substance called
vernix caseosa . This substance can cover the entire body or only the folds (between the legs, under the arms and the neck area). In either case it is quite normal and its function has been to protect the skin of the child while it was immersed in the amniotic fluid. Have no worries about it at this time, simply embrace and feel your child. Later, more at ease in your room, you will have time to know him or her in more detail.
While still in the labor room you may notice that some shots are administered to the child. This is vitamin K to prevent the hemorrhage illness of the newly born. Most probably, the first doses of the vaccine against Hepatitis B will also be administered. Eye drops will be applied to prevent conjunctivitis. Some times, these drops may cause a slight reddening of the eyes which normally goes away in very short time.
Once you are back in your room after labor, relax and take time to observe your child. You may or may not find some of the things that we will describe next. Remember that each child is different from others and it is not a must for each of these features to appear in every newly born.
T
HE HEADIf the fetus spent too much time, just prior to birth, in passing between the pelvic bones of the mother, it is likely that you will notice a slight deformation of the head. The head bones are not yet "soldered" together at this point and have the capacity to shift their position a little in order to "fit through" and facilitate labor.
It is also frequent to observe some areas of edematous and slightly bloated appearance, like "big bumps", specially along the sides of the head. This is called
Caput Succedaneum. It is caused by pressure from the uterus neck over the scalp as it passes through. The pediatrician will follow it up, it normally goes away after a few days
THE FACE
The face of the newly born often appears bloated or swollen, the eyelids edematous and even the chin may be slightly skewed or "off center". This is caused by the strains and stresses of labor.
If we look closely, we may observe little red spots (
stork marks), not very intense, in the skin over the eyelids, the forehead, the upper lip and the back of the head. These spots have nothing to do with labor or the birth itself. Normally they disappear in about two years time with the possible exception of those in the back of the head which may last a little longer.
In many cases we may also observe, specially around the mouth, some small, white pimples about the size of a pinhead. They are called
milium and are the result of fat accumulation in the sweat glands. They go away in a few days.
T
HE CHEST, THE BACK AND THE ABDOMEN
Along the first few days after birth if you observe the breasts of the child, you may notice a small amount of swelling and even the secretion of a whitish fluid ("witch's" milk). It can happen to a male as well as to a female newly born. This interesting phenomenon is known as
breast engorgement. Its origin is this: at the moment of birth, the blood of the mother comes in direct contact with that of the child (the only instance when this happens). The result is that a certain amount of a hormone known as Prolactin, abundantly present in the blood of the mother and responsible for stimulating milk secretion, enters the blood stream of the child thus stimulating his or her own mammary glands to grow.
This episode is quickly overcome as the hormone is progressively eliminated from blood stream of the child. It is very important to point out that YOU SHOULD NEVER SQUEEZE THE BREASTS OF THE CHILD. As we have said, the swelling will progressively disappear and they will go back to normal.
THE NAVEL
Generally, the navel is one of the areas of great concern for the parents. There is no reason for this. It is nothing but the remains of the umbilical cord which has kept mother and fetus united and through which the latter received nourishment. At birth, the cord is cut at about 1 inch from the belly of the child and the stub closed with a clamp. The tissue which constitutes the cord is called Wharton jelly and the stub will progressively dry out by a process medically known as "aseptic necrosis" until it falls off by itself. Therefore, the longer it is kept dry, the sooner it will fall. It is also advisable to disinfect it with 70 proof ethyl alcohol which also helps in speeding the dehydration of the stub until it dries completely. To apply the alcohol, take a piece of sterile gauze and dip it in alcohol, squeeze off the excess alcohol and rap it around the stub. Keep it in place by wrapping a bandage or cloth over it and around the abdomen of the child being careful not to tighten it excessively. There are other methods for the care of the navel, just follow the advise of the people attending you at the maternity hospital or clinic until your first visit to the pediatrician.
An important chapter of this subject is that about the external genitals. Next we will try to explain their particulars for both sexes.
FEMALE GENITALS
The vulva of a recently born girl often appears slightly open with some exposure of the inner lips and the clitoris which can also appear to be a little oversized. Generally, the outer lips appear swollen. A secretion similar to thick mucus can be observed coming out of the vagina, this is completely normal.
Occasionally, and for reasons similar to those of the breast engorgement but due to a different hormone, around the third or forth day after birth, the girl may present a small vaginal hemorrhage which causes great alarm. Have no worries about this, it is entirely normal and should go away after two or three days.
MALE GENITALS
With boys, something similar also happens with regard to the swelling of the external genitals. The testicles and the penis appear slightly swollen. If the child was born by breech delivery, the swelling may be greater. Some times, a little asymmetry is observed in the size of the testicles with one of them appearing to be bigger than the other. This is called a Hydrocele. These are normally benign and return to normal spontaneously. During routine explorations, the pediatrician will check their size and evolution.
THE BACK
In recently born children it is common to observe the presence of fine hair all over their back. It is known as
lanugo and will disappear little by little with time. This lanugo is more abundant and its presence more frequent in children of low weight.
In the low lumbar region and often times reaching as low as the lower portion of the buttocks, a stained area may appear with a blue-ink color and similar to a hematoma. Even though it is known as
mongolian blue spot, It bears no relation with the Down Syndrome or Mongolism. It is quite normal and after a variable time interval, which may even be years, it simply goes away. This spot is the result of an accumulation of MELANIN loaded cells in that area. MELANIN is a pigment of the cells which makes the skin turn darker when exposed to sunlight (namely, we get a tan).
T
HE LIMBSDuring labor, the child is subject to great stresses and compression forces. As a result, during the first 48 hours or so of his or her life the palms of the hands and feet will exhibit a bluish tint or shade known as cyanosis. The cyanosis will disappear progressively with time and this is indicative that the development of the child is progressing well.
Due to the position of the fetus in the womb, the feet of the newly born can some times present abnormal postures known as positional Tálipes. In the immense majority of the cases, these anomalous positions will progressively be corrected and the feet will return to normal.
