Thinking about having a baby?
Ever wonder what happens in the newborn nursery?
Multiple factors affect the care of a newborn in the first 48 hours. Here are just a small number of scenarios encountered and managed by pediatricians in the nursery:
Small for gestational age (SGA): <10th percentile for weight. If no apparent reason for the small weight (maternal hypertension or tobacco use), the urine is tested for infection (cytomegalovirus) and drugs. If the infant is below 2500 grams (5.5 pounds), a car seat evaluation is performed (to ensure infant can breathe well while in the car seat) and breastfeeding may be supplemented with a high-calorie formula. A blood test is performed to check hemoglobin levels.
Large for gestational age (LGA): >90th percentile for weight. The biggest concern is polycythemia (or too much blood), so a blood test is performed to check the hematocrit.
Preterm: Very premature infants go to the NICU for intensive care. The babies just under 37 weeks, however, can stay in the nursery. There, as with SGA , a car seat evaluation may be performed and breastfeeding may be supplemented with a high-calorie formula. A blood test is performed to check hemoglobin levels.
Meconium-stained amniotic fluid: The infant’s first stool is accidently passed into the amniotic fluid before delivery. The consistency ranges from thin to thick. This can be dangerous if the infant inhales the material during his or her first breath, resulting in respiratory distress known as meconium aspiration syndrome. A resuscitation team will be present in case this happens and will perform deep suctioning to remove it.
Chorioamnionitis: Infection of the amniotic fluid that the fetus lives in. A maternal infection, defined as fever of 100.4 degrees or greater along with other signs, could cause this fluid to get infected, which is potentially deadly for the infant. Blood tests are drawn to check for signs of infection in the baby. Antibiotics are started prophylactically. The tests are repeated at 36 hours of life.
Breastfeeding is always encouraged in infants. Most babies turn out just fine, but it's good to always be prepared.
