Newborn and maternal health and survival are closely linked; therefore, it is important to treat mothers and their child as a dyad through all phases of pregnancy and delivery. Healthy mothers who have access to proper nutrition and health care throughout the continuum of pregnancy and postpartum care are less likely to suffer from ill health or death, and their babies face a lower risk of disease and premature death. Newborns themselves require special attention separate from that of their mothers to assure a healthy start to life.
Being a new parent means facing new challenges and sometimes you'll sail through, while at other times the responsibility may seem daunting.One of the most important things you can do as a new parent is accept the support and help family and friends have to offer.
Physiologic leukorrhea often appears in the 6 months preceding menarche. By the time menarche occurs, growth velocity is decelerating rapidly, although some growth usually continues until an average skeletal age of 15 years. By this time, pubertal development usually is complete.
While in the womb, a baby is exposed to many chemicals (hormones) present in the mother's blood stream. After birth, the infants are no longer exposed to these hormones. This may cause temporary conditions in a newborn.
PLACENTAL HORMONES contains:
1. Estrogen which
* stimulates endometrium to thicken
* breast enlargement
* fluid retention
* growth of uterine muscles and blood vessels
* NEONATES also may have a sterile mucoid discharge secondary to maternal estrogen (subsides in 2 wks).
2. Progesterone which
* relaxes smooth muscle
* relaxes ligaments
* increases mucous secretion
Effect on newborn baby (female and male infants)
BREAST ENGORGEMENT
Swollen breasts are present during the first week of life in many female and male babies. They are caused by the passage of female hormones across the mother's placenta. Breasts are generally swollen for 2 to 4 weeks, but they may stay swollen longer in breast-fed and female babies. The breast swelling should go away by the second week after birth as the hormones leaves from the newborn's body. One breast may lose its swelling before the other one by a month or more. Never squeeze the breast because this can cause infection. Be sure to call your physician if a swollen breast develops any redness, streaking, or tenderness. The hormones may also cause some fluid to leak from the infant's nipples. This is called witch's milk. It is common and usually goes away within 2 weeks.
GIRLS
1. Swollen labia
The labia minora can be quite swollen in newborn girls because of the passage of female hormones across the placenta. The swelling will resolve in 2 to 4 weeks.
2. Hymenal tags
The hymen can also be swollen due to maternal estrogen and have smooth 1/2-inch projections of pink tissue. These normal tags occur in 10% of newborn girls and slowly shrink over 2 to 4 weeks.
3. Vaginal discharge
As the maternal hormones decline in the baby's blood, a clear or white discharge can flow from the vagina during the latter part of the first week of life.
This fluid is called physiologic leukorrhea. There may also be slightly bleeding from the vagina. These changes are common and should slowly go away over the first 2 months of life. Occasionally the discharge will become pink or blood-tinged (false menstruation). This normal discharge should not last more than 2 to 3 days.
BOYS
1. Hydrocele
The newborn scrotum can be filled with clear fluid. The fluid is squeezed into the scrotum during the birth process. This painless collection of clear fluid is called a "hydrocele." It is common in newborn males. A hydrocele may take 6 to 12 months to clear completely. It is harmless but can be rechecked during regular visits. If the swelling frequently changes size, a hernia may also be present and you should call your physician during office hours for an appointment.
2. Undescended testicle
The testicle is not in the scrotum in about 4% of full-term newborn boys. Many of these testicles gradually descend into the normal position during the following months. In 1-year-old boys only 0.7% of all testicles are undescended; these need to be brought down surgically.
3. Tight foreskin
Most uncircumcised infant boys have a tight foreskin that doesn't allow you to see the head of the penis. This is normal and the foreskin should not be retracted.
4. Erections
Erections occur commonly in a newborn boy, as they do at all ages. They are usually triggered by a full bladder. Erections demonstrate that the nerves to the penis are normal.
Physiologic leukorrhea of adolescents: many girls develop a vaginal discharge 3 to 6 months before the onset of menstruation. Aside from the discharge, other symptoms are generally absent. The mucosal surface of the vagina also changes in response to increasing levels of estrogen, becoming thicker and a duller pink in color (in contrast to the brighter red of the prepubertal vaginal mucosa).It is usually described as copious, whitish mucoid discharge with no odor or irritation. This happens because the lining of the vagina and cervix (part of the uterus) mature due to the increase in female hormones (estrogen). This does not cause pain with urination, burning with urination, vaginal pain or any other symptoms.
The diagnosis of Physiologic leukorrhea can be confirmed by a wet mount examination, which reveals only normal epithelial cells without leukocytes, clue cells or other abnormalities. Menstruation usually begins around age 11, but it may happen as early as age 8, or as late as age 16. The beginning of menstruation is called "Menarche".
Recognize that physiologic leukorrhea commonly precedes menses by 3 to 6 months and this physiologic leukorrhea in girls may be misinterpreted as a sign of disease. It is important to be known that girls' heights will rarely increase more than 2" after menarche has occurred. Treatment consists of adolescent gynecology symptomatic care. If there is visible blood or leukorrhea present on the cervix it should be wiped off with a cotton swab before proceeding.
Counseling should have been done parentally on role of partner in helping with the newborn, and how much disruption the baby will cause to the household etc. If mother is a single parent, appropriate social services can be alerted, or mother given information
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