How to observe the baby's stool

Baby stool frequency and color shapes are closely related to the daily diet.

1, normal stool

1. The first few days after birth baby have meconium. Meconium is characterized by no odor, and viscosity, color, dark green, generally after three days the meconium will fully cleared.

2. Breast-fed baby’s stool is golden yellow, like cream, have a acidic odor, but no obvious smell, generally 3-4 times a day.

3. Cow-milk fed baby’s stool is yellow or gray, as hard-paste, slightly smell, neutral or alkaline reaction, l-2 times a day

4. The baby having rice flour; children's faeces is more soft, a little bit Gampsocleis color, odor significantly. If having vegetables, children's stools may be dishes, and all these are normal.

2, abnormal stool

If the baby's stool is green, like the thin, like water or egg soup, but uneven, with small white clots, daily bowel movement several times, is often a reflection of indigestion. If stool sour smell, foam, there may be a carbohydrate indigestion; stool has soap block or fat particles, indicating that fat indigestion; if the stool has obvious foul smell may be the protein indigestion; stool is bright red or tar-like, suggesting that gastrointestinal bleeding; stool is white is even more dangerous signal, it could be hepatitis or biliary obstruction.

Baby's head care?

1, sparse hair,

A lot of baby's hair grows slowly. There is almost no long hair. Some babies got sparse hair. Some babies got bald on the back of the head. Is there any problem with this? Is there any lack of nutrition? In fact, this phenomena is normal for most of the time. The amount of baby’s hair is related to the level of detachment of lanugo. The more detachment of lanugo, the less the baby’s hair, and seem to be growing very slow. Newborn baby is in fetal hair replacement cycle, hair growth slow is normal. And bald on back of head is because of friction.

Tips:

A calcium deficiency can also cause hair loss. Therefore, if the bald is not because of friction, you should see the doctor.

2, hair split at ends

The hair dryer can cause your baby's hair bifurcation. Baby’s hair is fragile and can not take the hair dryer; often using hair dryer often easily makes your baby's hair to be withered, bifurcation. So, it is better to use a soft, dry towel for drying baby hair, do not use hair dryer.

Tips:

If baby has anemia, the hair will be dry, lack luster. Baby with anemia can be pale or chlorosis, easy fatigue, low resistance to the virus.

3, head length swollen package

Some baby after birth will have a swollen package in the left or right top of the head. When give a soft touch, the press will not make babies crying, it seems that there is no pain, but it will not disappear, and slowly turn to harden, resulting eventually in a "corner"-shaped bulge, so that many new dad, new mother can remember it very clearly. In fact, this is just scalp hematoma, which results from the excessive pressures and pelvic friction during delivery. This caused rupture of subperiosteal vessels, the blood accumulate in the periosteum. When the pressure stops the bleeding, hematoma will no longer continue to increase. Followed by the hematoma can be absorbed and calcium, approximately after 2 ~ 3 months later (and some baby's hematoma may last longer, even up to a few months), tumor becomes smaller, hardened, and eventually looks as a "corner". Once this time, hematoma basically was cured.

Tips:

Some mom will use syringes for taking baby hematoma, which is not desirable. Because the hematoma has been extracted, the cavity pressure has eased, will lead to continued bleeding. The bacteria enter the hematoma can lead to bacterial infections, wounds and other serious consequences. Under normal circumstances 1 ~ 2 months hematoma will naturally eliminate.

4, fontanelle

There is a soft cover with no bones on baby’s head. This is fontanelle. Tthere are two fontanelles: one is the front fontanel, at the front of heads, which consists from the parietal bone with the frontal phase; the other is a rear-fontanelle, the transition from the parietal bone and occipital bone.

Deal with infants eczema

Eczema is a common disease of infancy, medically known as allergic skin disease. Cause of this disease is complex, internal factors mainly related to the stratum corneum is thinner, and capillary network is developed, skin is rich in water and chloride endothelium, skin is sensitive to stimuli. When the baby touch the woolen goods or obtained mechanical friction, inhalation of dust or eat milk, eggs, fish, shrimp, beef and mutton and other allergenic substances, or use a strong alkaline soap lotion to wash, they will get sick.

Rush often starts from 2nd month. Most eczema appears in the cheek, zygomatic, eyebrows and forehead. In severe cases the trunk and limbs will appear. Initially, two cheek start itching and flushing, children often turn his head or clutch friction and scratch, and soon there are erythema, small grain-like papules, then into a herpes, blister broken out with yellow liquid, formed dry yellow crusts; eczema have also dry type, on small papules there is a small amount of white bran-like desquamation. Either way, eczema, there is intense itching, therefore, children are often irritable and crying, anxiety, appetite and sleep were affected. Excessive scratching can also cause skin infection and local lymph nodes, in these cases parents should promptly bring the child to the hospital. If there is no secondary infection, eczema is not danger, but often due to sunlight, ultraviolet light, heat and humidity, and other physical factors that would lead to sicker. But because the symptoms often recurrent, parents often very worried, in fact, the majority of infants with eczema may be self-healing, and only a small number of unhealed and protracted delays in the early childhood or childhood. Therefore, parents of infants with eczema do not have to be too worried, as long as the home-based care to learn how to help children through such a period.

1. Try to find out and to avoid touch allergens. You can check whether your children is food allergies, especially milk, breast milk or egg and other animal protein; and check whether the mother’s breast-feeding after having fish, shrimp, crab and other animal foods leads to baby eczema increase, if so, will have to try to avoid eating these foods.

2. Avoid to touch irritating substances, do not use alkaline soap to wash the skin, do not use cosmetics, perfumes, do not wash affected area with hot water, bath should not be too frequent.

3. Room temperature should not be too high, do not let the eczema directly exposed under sunlight, otherwise it will aggravate eczema itching. Baby’s clothes should be more lenient, not too thick too tight, 100% cotton clothing is best.

4. The room to keep the air and keep clean and avoid dust to stimulate the skin.

5. Infantile eczema treatment should be under the guidance of a dermatologist, parents must not misuse of antibiotics. Can take medicine such as chlorpheniramine, and calcium gluconate to reduce skin allergy.

6. During eczema period, do not to do immunization and BCG vaccination, avoid contact with patients with herpes simplex in order to avoid eczema herpeticum.

Learn how to correctly hold your baby

When the nurse sent the newborn baby to your arms, the young mum with great joy, watching this round and soft flesh soft flesh, and does not know how to "hold" the baby.

There are two correct postures to hold newborns: hand lift and wrist hold

Hand lift: Using To jack up the baby's back, neck, head with left hand, to jack up his small buttocks and waist with right hand. This method is more used to pick up the baby from the bed and lay down.

Wrist hold: put the baby's head on the left crook of the arm, the elbow protects baby's head, left wrist and left hand protect back and waist, right arm over the baby's legs, right hand care the baby's buttocks and waist. This approach is more commonly used.

1. Communicate with baby

When parents hold baby, they should interact with baby such as talk, sing, watch your baby with your eyes gently, gently touching, physical contact with your baby. It can stimulate your baby’s brain development. This is the first step to establish emotional, physical and mental development. It is very important for your baby.

Generally, you should hold your baby when she is weak up, and put her on the bed when she is sleeping. Newborns sleep about 20 ~ 22 hours a day. Holding at sleep can interrupt baby’s sleep.

2. Should be close to their parents left chest

Parents hold baby should put baby’s head to close to left chest to allow baby hear the parents heartbeat, which baby has been familiar with. It can make baby easy to calm down.

3. Not vertical hold

When you pick up the baby upright, you will find your baby's neck is weak, head bowed, not vertical. Because the newborn's head takes ¼ of entire length. Vertical holding baby, the baby's head weight gives pressure in the cervical spine. The baby in the ~ 2 months, cervical muscle has not been fully developed, neck muscle weakness, should be prevented the embrace of the incorrect posture of the spinal cord damage. These injuries were not easy to find, but may affect the child's future growth and development.

Newborn screening in the United States

The following tests are mandated (required to be performed on every newborn born in the state) in most of the United States. According to the U.S. Centers for Disease Control, approximately 3,000 babies with severe disorders are identified in the United States each year using newborn screening programs at current testing rates. States vary, and not all tests are required in every state, and a few states mandate more than this. The first test to be universally mandated across the U.S. was the Guthrie test for phenylketonuria (PKU), and in many areas and hospitals, the newborn blood test is often erroneously referred to as a "PKU test", even though all states now universally test for congenital hypothyroidism, galactosemia, and increasing numbers of other diseases as well.

Endocrine disorders: Congenital adrenal hyperplasia (CAH), Congenital hypothyroidism

Blood cell disorders: sickle-cell disease (SS)

Inborn errors of carbohydrate metabolism: Galactosemia

Inborn errors of amino acid metabolism: Phenylketonuria (PKU), Maple syrup urine disease (MSUD), Homocystinuria

Inborn errors of organic acid metabolism: Biotinidase deficiency

For a recent state-by-state list, see U.S. National Newborn Screening and Genetics Resource Center. According to this resource, the only tests mandated in every state are the following:

CH - Congenital hypothyroidism

H-HPE - Benign hyperphenylalaninemia

PKU -- Phenylketonuria/hyperphenylalaninemia

HEAR - Hearing

GALT - Transferase deficient galactosemia

Usual procedures and responses to positive results

Heel blood on a filter paper card for the newborn screeningIn nearly all of the United States, the newborn screening program is a division of the state health department. State law mandates collecting a sample by pricking the heel of a newborn baby to get enough blood (typically, two to three drops) to fill a few circles on filter paper labeled with names of infant, parent, hospital, and primary physician. It is usually specified that the sample be obtained on the second or third day of life, after protein-containing feedings (i.e., breast milk or formula) have started, and the postnatal TSH surge subsided. Every hospital in the state as well as independent midwives supervising home deliveries are required to collect the papers and mail each batch each day to the central laboratory.

The state health department agency in charge of screening will either run a laboratory or contract with a laboratory to run the mandated screening tests on the filter paper samples. The goal is to report the results within a short period of time. If screens are normal, a paper report is sent to the submitting hospital and parents rarely hear about it.

If an abnormality occurs, employees of the agency, usually nurses, begin to try to reach the physician, hospital, and/or nursery by telephone. They are persistent until they can arrange an evaluation of the infant by an appropriate specialist physician (depending on the disease). The specialist will attempt to confirm the diagnosis by repeating the tests by a different method or laboratory, or by performing other corroboratory or disproving tests. Depending on the likelihood of the diagnosis and the risk of delay, the specialist will initiate treatment and provide information to the family. Performance of the program is reviewed regularly and strenuous efforts are made to maintain a system that catches every infant with these diagnoses. Guidelines for newborn screening and follow up have been published by the American Academy of Pediatrics.

Recommended target conditions and disorders

The following list includes most of the disorders detected by the expanded or supplemental newborn screening by mass spectrometry. This expanded screening is not yet universally mandated by most states, but may be privated purchased by parents or hospitals at a cost of approximately US$80. Perhaps one in 5,000 infants will be positive for one of the metabolic tests below (excluding the congenital infections).

Core panel

The following conditions and disorders were recommended as "core panel" by the 2005 report of the American College of Medical Genetics (ACMG). The incidences reported below are from their report, pages 143-307, though the rates may vary in different populations. (WARNING: The file is a very large PDF.)

Blood cell disorders

Sickle cell anemia (Hb SS) > 1 in 5,000; among African-Americans 1 in 400

Sickle-cell disease (Hb S/C) > 1 in 25,000

Hb S/Beta-Thalassemia (Hb S/Th) > 1 in 50,000

Inborn errors of amino acid metabolism

Tyrosinemia I (TYR I) < 1 in 100,000

Argininosuccinic aciduria (ASA) < 1 in 100,000

Citrullinemia (CIT) < 1 in 100,000

Phenylketonuria (PKU) > 1 in 25,000

Maple syrup urine disease (MSUD) < 1 in 100,000

Homocystinuria (HCY) < 1 in 100,000

Inborn errors of organic acid metabolism

Glutaric acidemia type I (GA I) > 1 in 75,000

Hydroxymethylglutaryl lyase deficiency (HMG) < 1 in 100,000

Isovaleric acidemia (IVA) < 1 in 100,000

3-Methylcrotonyl-CoA carboxylase deficiency (3MCC) > 1 in 75,000

Methylmalonyl-CoA mutase deficiency (MUT) > 1 in 75,000

Methylmalonic aciduria, cblA and cblB forms (MMA, Cbl A,B) < 1 in 100,000

Beta-ketothiolase deficiency (BKT) < 1 in 100,000

Propionic acidemia (PROP) > 1 in 75,000

Multiple-CoA carboxylase deficiency (MCD) < 1 in 100,000

Inborn errors of fatty acid metabolism

Long-chain hydroxyacyl-CoA dehydrogenase deficiency (LCHAD) > 1 in 75,000

Medium-chain acyl-CoA dehydrogenase deficiency (MCAD) > 1 in 25,000

Very-long-chain acyl-CoA dehydrogenase deficiency (VLCAD) > 1 in 75,000

Trifunctional protein deficiency (TFP) < 1 in 100,000

Carnitine uptake defect (CUD) < 1 in 100,000

Miscellaneous multisystem diseases

Cystic fibrosis (CF) > 1 in 5,000

Congenital hypothyroidism (CH) > 1 in 5,000

Biotinidase deficiency (BIOT) > 1 in 75,000

Congenital adrenal hyperplasia (CAH) > 1 in 25,000

Classical galactosemia (GALT) > 1 in 50,000

Newborn screening by other methods than blood testing

Congenital deafness (HEAR) > 1 in 5,000

Secondary targets

The following disorders are additional conditions that may be detected by screening. Many are listed as "secondary targets" by the 2005 report ACMG. Some states are now screening for more than 50 congenital conditions. Many of these are rare and unfamiliar to pediatricians and other primary health care professionals.

Blood cell disorders

Variant hemoglobinopathies (including Hb E)

Glucose-6-phosphate dehydrogenase deficiency (G6PD)

Inborn errors of amino acid metabolism

Tyrosinemia II

Argininemia

Benign hyperphenylalaninemia

Defects of biopterin cofactor biosynthesis

Defects of biopterin cofactor regeneration

Tyrosinemia III

Hypermethioninemia

Citrullinemia type II

Inborn errors of organic acid metabolism

Methylmalonic acidemia (Cbl C,D)

Malonic acidemia

2-Methyl 3-hydroxy butyric aciduria

Isobutyryl-CoA dehydrogenase deficiency

2-Methylbutyryl-CoA dehydrogenase deficiency

3-Methylglutaconyl-CoA hydratase deficiency

Glutaric acidemia type II

HHH syndrome (Hyperammonemia, hyperornithinemia, homocitrullinuria syndrome)

Beta-methyl crotonyl carboxylase deficiency

Adenosylcobalamin synthesis defects

Inborn errors of fatty acid metabolism

Medium/short-chain L-3-hydroxy acyl-CoA dehydrogenase deficiency

Medium-chain ketoacyl-CoA thiolase deficiency

Dienoyl-CoA reductase deficiency

Glutaric acidemia type II

Carnitine palmityl transferase deficiency type 1

Carnitine palmityl transferase deficiency type 2

Short-chain acyl-CoA dehydrogenase deficiency (SCAD)

Carnitine/acylcarnitine Translocase Deficiency (Translocase)

Short-chain hydroxy Acyl-CoA dehydrogenase deficiency (SCHAD)

Long-chain acyl-CoA dehydrogenase deficiency (LCAD)

Multiple acyl-CoA dehydrogenase deficiency (MADD)

Congenital infections

TORCH complex (Toxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex, Syphilis etc.), if there are indicative symptoms or mothers who may have been exposed

HIV

Miscellaneous multisystem diseases

Galactokinase deficiency

Galactose epimerase deficiency

Maternal vitamin B12 deficiency

Expanded screening and controversies

With the development of tandem mass spectrometry in the early 1990s, the number of detectable diseases quickly grew, especially in the categories of fatty acid oxidation disorders and organic acidoses. Screening tests for the disorders listed below (and an increasing number of others) are now available, though not universally mandated. There is considerable variability from state to state, and sometimes from hospital to hospital within a state, on disease that are screened. To make matters more confusing, some hospitals routinely obtain supplemental screening (most of the tests below) on all infants even if not mandated by the state or requested by parents. In recent years in the United States, expanded newborn screening with tandem mass spectrometry has become a profitable commercial venture.

Newborn screening tests have become a subject of political controversy in the last decade. Two California babies, Zachary Wyvill and Zachary Black, were both born with Glutaric acidemia type I. Wyvill's birth hospital only tested for the four diseases mandated by state law, while Black was born at a hospital that was participating in an expanded testing pilot program. Black's disease was treated with diet and vitamins; Wyvill's disease went undetected for over six months, and during that time the damage from the enzyme deficiency became irreversible. Birth-defects lobbyists pushing for broader and more universal standards for newborn testing cite this as an example of how much of an impact testing can have.

Instituting MS/MS screening often requires a sizable up front expenditure. When states choose to run their own programs the initial costs for equipment, training and new staff can be significant. To avoid at least a portion of the up front costs, some states such as Mississippi have chosen to contract with private labs for expanded screening. Others have chosen to form Regional Partnerships sharing both costs and resources. But for many states, screening is an integrated part of the department of health which can not or will not be easily replaced. Thus the initial expenditures can be difficult for states with tight budgets to justify. Screening fees have also increased in recent years as healthcare costs rise and more states add MS/MS screening to their programs. (See Report of Summation of Fees Charged for Newborn Screening, 2001–2005) Dollars spent for these programs may reduce resources available to other potentially lifesaving programs. It has been recommended that one disorder, Short Chain Acyl-coenzyme A Dehydrogenase Deficiency, or SCAD, be eliminated from screening programs, due to a "spurious association between SCAD and symptoms. However, recent studies suggest that expanded screening is cost effective (see ACMG report page 94-95 and articles published in Pediatrics ' . Advocates are quick to point out studies such as these when trying to convince state legislatures to mandate expanded screening.

Expanded newborn screening is also opposed by among some health care providers who are concerned that effective follow-up and treatment may not be available, that false positive screening tests may cause harm, and issues of informed consent

Hernia and its treatment

A hernia is present at the site of the umbilicus (commonly called a navel, or belly button) in the newborn; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 5 years. Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia of the newborn. The size of the base of the herniated tissued is inversely correlated with risk of strangulation (i.e. narrow base is more likely to strangulate).

Babies are prone to this malformation because of the process during fetal development by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus

Importantly this type of hernia must be distinguished from a paraumbilical hernia, which occurs in adults and involves a defect in the midline near to the umbilicus, and from omphalocele.

When the orifice is large (< 1 or 2 cm), 90% close within 3 years (some sources state 85% of all umbilical hernias, regardless of size), and if these hernias are asymptomatic, reducible, and don't enlarge, no surgery is needed (and in other cases it must be considered). In some communities mothers routinely push the small bulge back in and tape a coin over the palpable hernia hole until closure occurs. This practice is not medically recommended as there is a small risk of trapping a loop of bowel under part of the coin resulting in a small area of ischemic bowel. The use of bandages or other articles to continuously reduce the hernia is not evidence-based.

An umbilical hernia can be fixed 2 different ways. The surgeon can opt to stitch the walls of the abdominal or he/she can place mesh over the opening and stitch it to the abdominal walls. The latter is of a stronger hold and is commonly used for larger tears in the abdominal wall. Most surgeons will repair the hernia 6 weeks after the baby is born.

Deal with annoying hernia

Hernia can not be ignored

Hernia, not a serious illness, but was ignored, there will be adverse effects on the baby.

1. Hernia will first affect the baby's digestive system, prone to the lower abdomen bulge, abdominal distention gas, abdominal pain, constipation, poor nutrient absorption, fatigue and physical decline and so on.

2. As the groin and adjacent to the urogenital system, male baby may be affected by herniated disc, squeezing the normal development of testes.

3. As the bowel within the hernia sac or omentum vulnerable to compression or collision caused by inflammatory swelling, resulting in a hernia can not return to its original place, leading to hernia incarcerated (stuck in there, affecting blood flow), and occurred bowel obstruction, intestinal necrosis, abdominal pain and other dangerous situations.

There are two types of Hernia, occurred in the umbilical is called umbilical gas, occurred in the groin called the inguinal hernia. Main reason for the emergence of hernia is due to defects in embryonic development. In other words, the human body has a layer of film to wrap around a variety of organs. However, if this layer of film development is incomplete, large intestine and the like softer stuff is easy to come out from this gap when baby cry or cough

Inguinal hernia

What is inguinal hernia?

Inguinal hernia is a relatively common pediatric diseases, the incidence is about 3%. Boys have about 5-10 times than girls do. The children with intra-abdominal pressure or premature babies are more likely to have inguinal hernia, such as frequent constipation baby. If the elevated mass was found at belly stocks, and some may even be swollen to the scrotum. Most of these lumps are crying, coughing, sneezing, or vigorous exercise after a long stand up suddenly, but after lying down or rest will disappear naturally, sometimes hand it to press back. A simple pain caused by hernia, usually not very obvious, but if persistent groin pain took place, while mass can not be pressed back, and the duration of symptoms lasts for 2-3 days, there may be due to fall into the intestines, fallopian tubes and other necrosis . This is a very serious complication, there may be life-threatening danger.

1. Hernia occurs, allowing your baby lying down immediately and appropriate booster lower body, generally for a hernia will disappear; or hand gently pushed back to intra-abdominal mass.

2. If the "balloon" is very hard and they can not back on the abdominal cavity, have vomiting, abdominal pain, fever, should immediately see doctor for surgical treatment, to avoid intestinal necrosis leading to life-threatening sepsis.

Umbilical gas

What is the umbilical gas?

Umbilical gas usually occurs in infancy. Umbilical gas is very small, only accommodate a small finger, umbilical hernia caused from the fetal abdominal wall development incomplete, while the remaining latch is rather poor, but also did not close well. Such a hernia, low birth weight and premature children are more likely to occur.

1. Do not use tape or copper pressure. There are many people think that using a copper or tape to press down and paste up can help it get better. In fact this approach simply ineffective in many cases may also cause skin allergic reaction to the tape.

2. Umbilical gas will be self-limiting, before age of 1 it will be better. With increasing age, the opportunity o fself-limiting will reduce, but still some of the larger hernia until we go up 5 to 6 years of age.

3. If the umbilical gas does not get better, it is recommended to wait until 3-4 years of age to see a doctor, follow medical treatment.