Signs of a cold in a baby, symptoms and safe treatment. Diseases of newborns What diseases do babies have?

One of the pressing problems of pediatrics is the pathology of newborns. According to statistical data, the leading place in the structure of child mortality is given to this group of diseases. Various disorders in children's body may manifest themselves during intrauterine development or the pathological course of childbirth. Any of the diseases inherent in newborns requires detailed study and competent treatment, which involves timeliness, as well as mutual work of doctors and new parents.

Which child is considered a newborn?

A baby is considered a newborn from the moment it is born and during the first month of life. At this time, babies need special care and attention from parents and doctors.

It is completely irrational to avoid the help of a pediatrician in the first weeks of a baby’s life, since some serious diseases may elude the untrained eye of the mother, but will certainly attract the attention of a specialist.

Photo: Newborn baby

Can a child's crying indicate an illness?

In some cases, it is crying that becomes the impetus for studying the health of a newborn child. We all know that babies can cry and be excessively moody for several reasons:

• uncomfortable room temperature;
• fatigue;
• wet diaper;

If parents are doing everything possible to eliminate these causes of baby crying, but the newborn still shows increased anxiety, it is worth being vigilant.

Why does the disease occur?

There are a number of reasons why a newborn baby may encounter various pathologies. Doctors highlight the following:

• Failure of the expectant mother to comply with medical recommendations during pregnancy
• Severe toxicosis and other problems during pregnancy
• Malnutrition of the expectant mother
• Birth injuries
• Rhesus conflict between mother and child
• Poor baby hygiene
• Infection of a newborn in the maternity ward

Photo: Severe toxicosis

Premature babies are more prone to pathologies in the first month of life than those born with normal weight.

Bacteria and viruses attack the child's body during its intrauterine development. , rubella, herpes and mumps are most often observed. Manifestations of infections are varied: delayed weight gain, pallor of the skin, enlarged liver, breathing problems, abnormal bowel movements, and others. Symptoms may develop immediately after the birth of the child or after discharge from the parental home.

Photo: Intrauterine infections

Treatment of intrauterine infections is based on the pathogen that attacked the baby’s body. As a rule, therapy is symptomatic.

Asphyxia

The disease is a circulatory disorder in a newborn and the resulting difficulty breathing. Pathology is observed immediately after the baby is born. The disease is fraught with oxygen deficiency.

Photo: Oxygen deficiency

Experts distinguish between congenital and acquired asphyxia. The first occurs due to impaired placental circulation and entanglement of the fetus with the umbilical cord. In this case, the baby is born with a clearly slow heartbeat. Possible weak muscle tone and bluish skin. Acquired asphyxia is the result of a difficult birth, in which there is a spasm of the mother's birth canal.

It should be noted that most newborns face this diagnosis. As a rule, the pathology is successfully suppressed. However, in other cases, urgent resuscitation procedures are required, which are aimed at suppressing possible neurological problems in the future.

Photo: Newborn resuscitation

Pemphigus

A rather dangerous disease that occurs when a newborn’s body is infected with staphylococcus or streptococcus. Appears in the form of small blisters on the body. The rash may involve the trunk and limbs, but never occurs on the palms or soles of the feet. Sometimes the blisters have purulent contents. In this case, the rashes quickly spread, and the bubbles themselves rapidly increase in size.

Symptoms of the disease are as follows:

• elevated temperature bodies;
• lack of weight.

Photo: Pemphigus of the newborn

As a rule, the disease occurs due to the banal lack of hygiene of the baby. Excessive insulation of the child, infrequent bathing and the mother’s reluctance to wash her hands before contact with the child are the reasons that increase the risk of infection.

The disease is eliminated with the help of antibiotics and treatment of rashes with medications prescribed by the doctor.

Photo: Treatment of rashes

With this disease, red blood cells are destroyed in the child’s body, which leads to anemia. Rhesus conflict can give impetus to the development of pathology. When the child is ill, anemia and pallor of the mucous membranes are noted.

The disease can be avoided, and for this, the expectant mother, if a Rh conflict with the fetus is established, should regularly visit the antenatal clinic and take iron supplements. Vitamins, especially group E, are also recommended.

Photo: Hemolytic disease

If there is a suspicion of a risk of hemolytic disease in the unborn child, the woman should be in the clinic in the last few weeks before the expected date of birth.

If you do not pay attention to hemolytic disease in a newborn in time, irreparable things can happen: the child stops showing the desire to breastfeed, there is a rapid decrease in hemoglobin levels, and the spleen and liver enlarge.

Physiological jaundice

The disease develops in the first days after birth and is characterized by discoloration of stool and yellowness of the skin. Jaundice is caused by the liver's inability to properly remove bilirubin from the body. There is another reason - the replacement of hemoglobin during intrauterine development with adult hemoglobin.

The disease goes away in the first month of the child’s life, which is facilitated by placement under an ultraviolet lamp. Under the influence of the lamp, bilirubin is converted into substances that are easily removed from the body naturally.

At home, you can fight jaundice by placing your child in the sun. A decoction of rosehip helps well, which can be consumed by a nursing mother.

Thrush

Susceptibility to thrush (candidiasis) in infants is extremely high, which is caused by the tenderness of the mucous membranes and epidermis. The causative agent is fungi of the genus Candida, which live in the body of every person. Their activity is usually observed during the period of weakened immunity and immediately after birth. A child can become infected from medical personnel and mothers whose hands are not clean enough.

To do this, every time after feeding, the mother should wipe the baby’s mouth with a cotton swab soaked in soda solution.

Thrush is not an extreme dangerous diseases for newborns, but must be treated in a timely manner!

"Weeping" umbilical wound

In the first few weeks after the baby is born, the umbilical wound should be cleaned daily and covered with a sterile bandage. This protects the wound from infection. Sometimes the latter cannot be avoided, and then purulent discharge occurs. People usually call the problem a “wet” navel. At the same time, it comes from the wound bad smell. The fight against infection consists of maintaining complete sterility and lubricating the wound with brilliant green or iodine (as prescribed by a doctor).

Photo: “Weeping” umbilical wound

Untimely treatment of an infected umbilical wound can result in umbilical sepsis!

With the birth of a child, parents have new problems and experiences associated with the slightest anxiety of the baby or with any, even mild, illness of the baby. What diseases are most common among children in the first year of life? Unfortunately, there are not so few of them, and some of them develop already in the first days of a baby’s life. Let's talk about the most common diseases in children under 1 year of age.

Unhealed umbilical wound and omphalitis

If the skin around the umbilical wound turns red or purulent discharge appears from it, then the child should be urgently shown to a doctor.

An umbilical wound is formed in a baby around the 3-5th day of life at the site of the fallen umbilical cord. Until the umbilical wound is completely healed (by 10-14 days of life), it is necessary to bathe the baby in boiled water with the addition of potassium permanganate until it turns slightly pink. After bathing, the wound is treated with cleanly washed hands and a clean diaper:

• use a cotton swab dipped in 3% hydrogen peroxide solution to remove discharge from the wound;
• Use a new stick to remove any remaining hydrogen peroxide;
• lubricate the wound with 2% alcohol solution of brilliant green.

Baby's underwear (vests, diapers, rompers), ironed on both sides after washing, must be changed several times a day, without covering the wound with a diaper.

If the umbilical wound becomes wet, blood or pus comes out of it, or the skin around the wound becomes red, you should notify your pediatrician or visiting nurse. In this case, we can talk about omphalitis - bacterial (caused by streptococci or staphylococci) inflammation of the bottom of the umbilical fossa. A weeping navel and omphalitis develop when the rules of hygienic treatment of the umbilical wound are violated.

At the same time, the general condition of the baby may suffer:

• the child shows anxiety, cries or, conversely, becomes lethargic;
• poor breastfeeding;
• loses weight;
• The temperature may rise.

Treatment consists of treating the navel up to 4 times a day. In more severe cases, the doctor prescribes antibiotics.

Umbilical hernia

An umbilical hernia is called an exit internal organs(most often intestinal loops) through the large umbilical ring - weakness on the anterior abdominal wall of an infant. It is diagnosed quite often in the infant period of life. A hernial protrusion, visible to the naked eye, is formed when the baby strains or screams due to increased intra-abdominal pressure.

If an umbilical hernia is detected, the child must be shown to a surgeon. After repairing the hernia, the doctor will apply a plaster for 10 days. Such treatment sessions are used several times. In addition, they are appointed physiotherapy and massage (they should be performed by a specialist).

When the baby can hold his head, he should be placed on a hard surface on his tummy. This will help not only to move the organs back into place, but also to normalize stool, which will eliminate the need to strain.

If the hernia does not disappear by the age of one, the child will need surgery as planned. Usually the operation is performed from the age of 3, and sometimes earlier if the hernia occurs frequently. This is done to avoid strangulation of the hernia.

Jaundice of newborns

Jaundice of newborns can be physiological and pathological.

Most cases of icteric staining of the skin and mucous membranes in a newborn are a manifestation of physiological processes in his body during the adaptation period after birth.

Jaundice appears on the 2-3rd day of life and is associated with the fact that the liver has not yet formed sufficient quantity enzymes in order to neutralize toxic bilirubin, which is formed during the massive destruction of hemoglobin in a baby after birth.

Normally, bilirubin, neutralized in the liver cells, is released after a series of transformations from the body in feces and urine. In an infant, the liver does not have time to neutralize all bilirubin; its level in the blood rises and quickly turns the skin and mucous membranes a bright yellow color. Such physiological jaundice does not pose a threat to the baby. It develops in 60% of full-term and about 90% of premature babies and goes away spontaneously in 2-3 weeks.

In some newborns, physiological jaundice persists for more than 3 weeks. This may be due to the transition of physiological jaundice to breastfeeding jaundice. Mother's milk contains a substance that inhibits or blocks the formation of liver enzymes. The reason for this phenomenon is not clear, but such jaundice is also not dangerous for the baby.

But still, if the jaundice has not disappeared within 3 weeks, it is necessary to conduct research to determine the causes of such jaundice, which may pose a danger to the baby.

This jaundice may be:

• , that is, developed during the ongoing massive destruction of red blood cells, for example, due to a Rh conflict (mismatch) between the blood of the child and the mother;
• hepatic – when the function of liver cells is impaired, for example, with congenital hepatitis;
• – caused by obstruction biliary tract in a baby (requires surgical treatment).

Any of the above pathological jaundice requires monitoring bilirubin levels and possibly treatment. If the bilirubin level is slightly higher than normal, but does not rise any further, then the child continues to be monitored. If its level is 10 times higher than normal and continues to increase, this situation is fraught with a toxic effect on brain cells and requires urgent treatment.

The treatment used is a safe method, phototherapy: the child is placed (protecting the eyes) special glasses) under a bright lamp for several hours or days. In extremely severe cases, a replacement blood transfusion is used.

Skin problems

The skin of newborns is very vulnerable and permeable to infections. This is due to the characteristics of the baby’s skin:

• she is gentle and easily vulnerable;
• blood vessels are located superficially;
• When overheated, moisture evaporates intensely.

Therefore, the baby’s skin requires special care, otherwise serious problems may arise.

1. Diaper rash

Diaper rash is an inflammation of areas of the skin caused by prolonged exposure to moisture or friction. Most often they occur in the inguinal, axillary, intergluteal, cervical folds or behind the ears.

Depending on the manifestations, there are 3 degrees of diaper rash:

• I Art. – slight redness, the integrity of the skin is not compromised;
• II Art. – bright redness, microcracks, erosion;
• III Art. – severe redness, cracks, erosions, pustules on the skin, weeping, ulcers.

Diaper rash causes a burning sensation, pain, and itching. The child is restless and capricious.

The cause of diaper rash may be increased moisture in the skin, which removes natural lubrication. This contributes to the disruption of the skin's protective barrier and the penetration of microbes. The risk group includes children with excess body weight.

Contribute to the occurrence of diaper rash:

• violation of the rules of caring for the baby, skin irritation under the influence of urine, hiccups;
• poor drying of the skin after bathing or washing;
• overheating due to excessive wrapping or high ambient temperature;
• friction with synthetic clothing;
• skin reaction to the diaper material.

Bepanten cream is the leader in the market for diaper rash remedies

It is unacceptable to leave diaper rash unattended; it can cover a large surface and become infected. The temperature in the room where the child is located should not be higher than 21 0 C. We should not forget about air baths.

At stage I Diaper rash usually does not require treatment, it is enough to scrupulously follow the rules of skin care, change diapers in a timely manner (at least every 3 hours), carry out air baths, and treat folds with a special protective cream. If you have not been able to get rid of diaper rash within a day, you should consult a pediatrician; perhaps the doctor will recommend the use of ointments (Bepanten, Drapolen).

At II Art. In addition to these measures, “talkers” are used (they are prepared in a pharmacy according to a doctor’s prescription). The doctor may also prescribe the use of ointments (methyluracil, tannin) on the affected area. If there are pustules, they are treated aqueous solutions brilliant green or methylene blue.

You need to bathe your child in a weak pink solution of potassium permanganate (first, about 5 crystals of it are dissolved in a jar of water, and then be sure to filter through 4 layers of gauze to prevent skin burns from the undissolved crystal). If you are not allergic to herbs, then you can use sitz baths by adding a decoction of oak bark to the water for 5-7 minutes.

III Art. Diaper rash is difficult to treat; we must try to prevent the disease from becoming so severe. When it gets wet, it is not recommended to use ointments and oils: by covering the diaper rash with a film, parents prevent it from healing. It is also undesirable to use starch to treat folds: firstly, its lumps injure the skin, and secondly, it is a breeding ground for the growth of bacteria. You should consult a dermatologist and follow treatment recommendations

2. Heat rash

Miliaria is a disease that affects the baby's skin in areas with increased sweating. Miliaria usually occurs when the baby is overheated or under a thick layer of fat-based cream.

Miliaria appears as a pink, pinpoint rash. Some elements of the rash may have a white tip. It usually appears in natural skin folds and folds, on the back and buttocks (under diapers). As a rule, none unpleasant sensations For a child, prickly heat is not accompanied.

Most cases of prickly heat go away without treatment if the rules for caring for your baby’s skin and hygiene procedures are strictly followed. You can lubricate the affected area with Bepanten cream.

To prevent the recurrence of prickly heat, the following preventive measures are necessary:

• The child’s underwear and bedding should be made from natural fabrics;
• maintain a comfortable temperature in the room for the child (20-21 0 C);
• dress your baby for walks in accordance with weather conditions, do not bundle him up;
• use water-based cream;
• for bathing, use (if there is no allergy) infusions of chamomile, nettle, oak bark or light pink permanganate solution potassium

3. Diaper dermatitis

Diaper dermatitis is an inflammation of the skin that most often occurs in bottle-fed girls and in allergy-prone children receiving treatment with antibacterial drugs.

Possible causes of diaper dermatitis:

• rare changes of onesies or diapers;
• improper use of baby creams and powders;
• low-quality cosmetics and detergents.

The disease is manifested by the appearance of redness and swelling, peeling or a group of small blisters in a clearly limited area of ​​skin (in contact with rompers or diapers). These phenomena are accompanied by burning and itching.

If treatment is not carried out, cracks, erosions, and pustules will appear. Then the surface layer of skin is torn off, and ulcers form. Bacterial (streptococcal, staphylococcal) or fungal infection.

Treatment is carried out as prescribed by the doctor. In addition to strict adherence to hygiene rules, ointments and creams are used (Desitin, Bepanten, Panthenol, etc.). They are applied in a thin layer when changing a diaper and washing.

4. Pemphigus of newborns

Pemphigus of newborns is a purulent contagious skin disease, most often caused by. Occurs in the first weeks of life. Infection occurs from persons caring for a child with a pustular infection on their hands.

A sign of the disease is the appearance on the baby’s skin of fairly large blisters with yellowish color cloudy liquid. They can open on their own, leaving an eroded surface. The leaking liquid contributes to infection of neighboring areas of the skin. The baby's general condition suffers and the temperature rises.

Complications of the disease can be abscesses and a septic condition. Treatment is carried out only as prescribed by a doctor. In addition to high-quality skin care, antibiotics are used (taking into account the sensitivity of the pathogen), erosions are treated with a 2% solution of silver nitrate, and rash elements are treated with aniline dyes.

Hormonal crisis

A hormonal crisis (the second name of which is a sexual crisis) develops in full-term infants of any sex as a result of exposure to maternal hormones that reach the child through the placenta during childbirth or through milk during breastfeeding.

The manifestations of this crisis are:

• mastopathy (engorgement mammary glands);
• white discharge similar to colostrum from the mammary glands;
• vulvovaginitis in girls: discharge from the genital tract is bloody or mucous, gray-white in color, swelling of the labia;
• pronounced pigmentation in boys around the scrotum and nipples;
• milia are small yellow-white dots on the face (in the area of ​​the bridge of the nose, chin, forehead, wings of the nose).

These changes appear on the 3-4th day of life and gradually decrease over the course of a month. Usually no treatment is required. It is forbidden to squeeze out discharge from the mammary glands or massage them, as this can provoke the development of mastitis, for the treatment of which it is necessary surgical intervention.

In case of severe engorgement of the glands, a compress of camphor oil may be prescribed. Girls should be washed frequently (from front to back), and then treat the external genitalia by moistening a napkin with a weak solution of potassium permanganate. In case heavy bleeding You should consult a doctor for a correct diagnosis.

Thrush

A sign of thrush is the appearance of white spots on the baby’s tongue and cheek mucosa, resembling pieces of curdled milk. This is one of the forms of candidiasis infection, it is caused by yeast-like fungi.

Plaques are not washed off between feedings, but are removed with a spatula when mild form diseases. With moderate severity, spots appear on the roof of the mouth and on the lips and are not completely removed.

Severe thrush is characterized by the spread of plaque tightly fused with the oral mucosa to the gums, the back wall of the pharynx, and the soft sky. Similar cheesy deposits can also appear on the mucous membrane of the genital organs and in the area of ​​skin folds.

The rash is sharply painful. The baby is capricious, sleeps poorly, takes less time at the breast, and may even refuse to breastfeed altogether.

Both internal and external factors play a role in the occurrence of thrush.

TO internal factors relate:

• prematurity;
• developmental anomalies;
• artificial feeding (especially in the early stages);
• regurgitation and vomiting;
• malnutrition;
• anemia;
• metabolic and endocrine disorders;
• acute and chronic infections.

External factors:

• microtrauma of the mucous membrane (mechanical or chemical);
• treatment with antibiotics (causes dysbacteriosis);
• a course of hormone therapy, cytostatics (significant reduction in the body’s defenses);
• vulvovaginal candidiasis in the mother during pregnancy;
• candidiasis or carriage of fungi in persons caring for a child;
• poor quality processing of pacifiers, toys, etc.

It is important to eliminate the factors leading to the child’s illness. At initial manifestations, local treatment is carried out - treatment of the oral mucosa with a sterile cotton swab moistened with a light pink solution of potassium permanganate or 2% solution of baking soda (1 tsp per 200 ml of warm boiled water), or 1% solution hydrogen peroxide.

After such wiping, you need to lubricate the mucous membranes every 3 hours for 5 days with 1-2% aqueous solution of methylene blue or 0.25% solution of silver nitrate, or Lugol's solution diluted with warm boiled water in a ratio of 1:3.

To treat thrush, drugs containing Nystatin and Levorin are used. A suspension of these drugs can be easily prepared at home by mixing a tablet (250 mg) crushed into powder with 5 ml of distilled or boiled water. Treatment with the suspension is alternated with a 5% solution of baking soda and carried out after 6 hours.

Can be used for widespread lesions, 1% solution of Canestin or Clotrimazole. It is not advisable to carry out the treatment after feeding, so as not to cause vomiting. Manipulations should be carried out without harsh pressure.

During the entire treatment period, a nursing mother needs to treat her nipples before feeding with 2% soda solution. Bottles, pacifiers, and toys should be boiled. Duration treatment course determined by the doctor (usually it is carried out for at least 2 weeks).

At the discretion of the physician, internal antifungal medications may also be used. Appointed single dose medications are mixed with a small amount of water or milk. A severe form of candidiasis is treated in a hospital.

Rickets

Rickets is still a common disease in infants. It develops when there is a lack of vitamin D in the baby’s body, which regulates phosphorus-calcium metabolism.

The child receives calciferol or vitamin D from food. It is also synthesized in the skin when exposed to ultraviolet rays. Therefore, rickets often develops in children in winter, when there is little sun.

In addition to a deficiency of vitamin D, phosphorus and calcium, with rickets there is a lack of vitamins A, B and C, trace elements of iron, magnesium, copper, etc. Because of this, children with rickets are whiny, capricious, have poor sleep, and often suffer from colds.

The first signs of rickets may appear even in one month old crumbs, and in the absence of treatment there will be more and more of them.

Signs of rickets in infants are:

• increased sweating, especially on the palms and head;
• baldness on the back of the head;
• indigestion;
• pronounced smell of urine;
• decreased muscle tone (flat stomach, loose joints);
• softening of the bones, resulting in soft edges of the fontanelles, flattening of the back of the head, formation of frontal bumps, deformation of the chest;
• curvature of the limbs (X- or O-shaped legs);
• thickenings on the metacarpal bones of the fingers and on the ribs;
• late teething;
• enlarged liver and spleen;
• anemia, frequent intestinal and respiratory infections;
• in the absence of treatment, a narrowing of the pelvis, curvature of the spine with the formation of a hump, is possible.

Vitamin D3 for the prevention of rickets

The development of rickets can be easily prevented with the help of a preventive course of vitamin D, so you should not neglect it. Considering the development of irreparable changes due to rickets, its slightest manifestations cannot be ignored.

A timely started and completed course of treatment allows you to stop the process and prevent the development of serious consequences. Currently, severe manifestations of the disease are observed only in children from disadvantaged families.

Treatment of rickets involves a variety of measures:

• mandatory long walks for the child in the fresh air;
• a diet that allows you to provide the child with vitamins and microelements; if the child is breastfed, the mother’s diet should be carefully reviewed;
• therapeutic exercises, swimming and massage;
• pharmaceutical preparations (vitamin D, vitamin-mineral complexes, etc.).

Digestive tract problems

Intestinal colic

A fairly common disease in infants is severe pain in the baby’s intestines, which may be accompanied by bloating. The child twists his legs, draws them in, and cries loudly. The cause of colic may be poor nutrition of the mother during natural feeding or the baby swallowing air during feeding.

To prevent the occurrence of colic and gas accumulation in the intestines, it is necessary:

• bring the mother’s diet into line with the recommendations of specialists, exclude foods that cause increased gas formation;
• after feeding, the baby should be held upright until he burps air;
• give the child dill water, fennel decoction or Espumisan;
• place the baby on his stomach more often;
• If the child is restless, apply a warm diaper to the belly and lightly massage the belly (clockwise).

By 3-4 months, as the organs mature digestive tract, colic usually goes away.

Constipation

Not every daily absence of stool in a child is constipation: mother's milk is almost completely absorbed. The main thing is the child’s well-being and behavior, as well as the consistency of the stool.

We can talk about constipation if the baby is restless, cries, tries to push, but cannot empty the intestines. With constipation, the baby's stool is hard, pea-shaped or plug-shaped.

The cause of constipation in a baby is most often the non-compliance with the diet by the nursing mother or the nature of the baby’s diet (early introduced complementary foods or incorrectly selected milk formula). The mother's passion for protein foods, flour products, and coffee can contribute to constipation in a child. The amount of liquid the baby consumes also matters.

But sometimes constipation is associated with diseases:

• dolichosigma (congenital elongation of the large intestine);
• Hirschsprung's disease (disturbance of intestinal innervation, leading to spasm of its parts);
• Lactase (enzyme) deficiency causes alternating constipation and diarrhea.

Parents should contact their pediatrician to find out the possible cause of their baby's constipation and get the necessary recommendations (and in some cases, conduct an examination).

In the absence of this pathology, the simplest measures can help a child with constipation:

• when breastfeeding, pay serious attention to the mother’s diet, increasing her consumption of vegetables and fruits rich in fiber;
• Give your baby a decoction of dried fruits and raisins as a drink;
• massage the child’s abdomen daily (directing massage movements clockwise);
• The choice of formula and complementary foods should be agreed with the pediatrician.

If these measures do not give effect, you can use:

• glycerin suppositories;
• irritation of the rectum with the tip of the gas tube;
• Lactulose preparations can be used as prescribed by a doctor.

An enema should only be used as a last resort.

Attention! Under no circumstances should pieces of soap be inserted into the rectum, as this can cause a burn from the mucous alkali contained in it!

Diarrhea

A child up to one year old can have a bowel movement after each feeding. But if his general condition does not suffer, he is calm, eats well and gains weight normally, then this is not a pathology. The main importance is not the frequency of stool, but its consistency, color and the presence of mucus or blood.

The liquid consistency of stool is dangerous for infants because the loss of fluid can lead to dehydration.

The causes of loose stools are of great importance. They can be different:

• errors in the nutrition of the nursing mother or the baby itself;
• intolerance to certain products, including cow's (and even mother's) milk and gluten from cereals in the absence of the lactase enzyme;
• acute surgical pathology (appendicitis), when diarrhea is accompanied by severe abdominal pain and fever;
• acute intestinal infection of a bacterial or viral nature: there is stool, the baby’s general condition suffers, the temperature rises, there is abdominal pain, and vomiting may occur;
• dysbiosis (imbalance of microflora in the intestine).

If you have diarrhea (especially if it starts suddenly), you should immediately contact your pediatrician. If the stool is watery, profuse, and accompanied by vomiting, then you need to call an ambulance, since dehydration develops very quickly in young children. Before the ambulance arrives or the doctor arrives, the child should drink plenty of fluids. Treatment should be carried out only under the supervision of a pediatrician (or infectious disease specialist) and as prescribed.

Regurgitation

Regurgitation in a child may be caused by swallowing air during feeding.

Quite often, infants experience regurgitation, which causes concern among parents. After feeding, part of the stomach contents is “thrown out” through the mouth. Depending on the causes of occurrence, physiological and pathological (organic) regurgitation are distinguished.

Physiological ones are often associated with underdevelopment of the digestive system:

• relatively short or narrowed esophagus;
• funnel-shaped esophagus;
• underdeveloped sphincter (sphincter) of the entrance to the stomach, causing gastroesophageal reflux (GER);
• highly sensitive gastric mucosa, reacting to any irritant, etc.

Physiological regurgitation is especially common in premature babies; it disappears by about 8-9 months. If the baby’s condition is not disturbed, and regurgitation is infrequent and not abundant, then there is no need to worry too much - such regurgitation can be regarded as physiological.

The exception is GER, which can lead to profuse and frequent regurgitation. aspiration pneumonia(inflammation of the lungs when vomit enters the lungs) and even asphyxia (death from suffocation).

Physiological also includes functional regurgitation when the child is not properly fed or cared for:

• regular overeating (more often in children receiving artificial feeding);
• swallowing air with milk due to improper attachment to the breast;
• increased gas formation in the baby (when straining, food is squeezed out of the stomach);
• laying on the tummy or swaddling too tightly after feeding.

With physiological regurgitation, the following measures can help:

• do not overfeed the baby;
• During feeding, it is advisable to keep the baby in a semi-upright position;
• before feeding, you can place the baby on his stomach on a hard surface to allow gases to pass naturally;
• when artificially feeding, use a special anti-colic bottle or pacifier to prevent air from being swallowed;
• if there is excessive regurgitation and the absence of organic lesions, anti-reflux mixtures can be used: the natural substances in their composition swell in the stomach and prevent food from escaping;
• When breastfeeding, mothers should avoid eating foods that cause increased gas formation;
• After feeding, you need to hold the baby in an upright position for some time (until the gases pass).

Organic causes of regurgitation:

• pyloric stenosis (developmental anomaly, narrowing of the inlet of the stomach) - manifests itself already from 4-5 weeks of life, frequent regurgitation, leading to weight loss;
• defeat nervous system during fetal development or childbirth;
• hereditary disorders of food absorption or metabolism (phenylketonuria, galactosemia);
• infections (bacterial and viral);
• pathologies of internal organs (damage to the kidneys).

Pathological regurgitation is characterized by a large volume of vomit. They require urgent medical care, and sometimes surgical treatment.

Conjunctivitis

It is called inflammation of the mucous membrane covering the front surface of the eyes and the inner surface of the eyelid. Most often, it is caused by microorganisms (bacteria, viruses, fungi), but it can also be a manifestation. Infectious conjunctivitis is a contagious (infectious) disease.

The manifestation of the disease is redness of the mucous membrane, itching, discharge of pus from conjunctival sac. After sleep, the eyelashes stuck together with purulent discharge do not allow the child to open his eyes. Due to burning and itching, the baby constantly rubs his eyes.

If you notice signs of the disease, you should contact an ophthalmologist, who will select treatment depending on the nature of the inflammation (eye drops, ointment). To make the child feel better, it is necessary to wash the eyes with decoctions and infusions of herbs with anti-inflammatory, disinfectant and healing effects (calendula, chamomile).

Washing can also be carried out with a solution of furatsilin or weak tea leaves. For rinsing, sterile cotton swabs are used, and there are separate ones for each eye. Rubbing should be done from the outer corner of the eye to the inner. The procedure is carried out not only after sleep, but also before each instillation of medicine into the eyes. Drops should also be instilled at the outer corner of the eye, first pulling the lower eyelid down.

ARVI

A group of diseases, the causative agents of which can be various viruses (over 200 of them are known), transmitted by airborne droplets and having similar manifestations, are the most common childhood diseases at any age. The infant period is no exception.

The most common manifestations of ARVI are caused by rhinoviruses, parainfluenza viruses, adenoviruses, rhinosyncytial virus (RSV), etc. Clinical manifestations respiratory viral infections are a runny nose, cough, fever, symptoms of general intoxication (restlessness or lethargy, loss of appetite, sleep disturbance, etc.), purulent discharge from the eyes during adenovirus infection.

You should call a doctor at home to start correct treatment and prevent the development of complications. The child should be provided with plenty of fluids in small, frequent portions (up to 6 months, give warm boiled water, and from the second half of the year - a decoction of raisins, rose hips, chamomile infusion, cranberry juice, dried fruit compote).

Large portions of liquid and forcefully eaten food can cause vomiting. During illness, you should ensure that the room is frequently ventilated, refraining from walking at high temperatures.

When the temperature rises, there is no need to wrap the baby up; you can wipe his body with vinegar or vodka diluted with water in a ratio of 1:3 and place a heating pad with ice near his head. The temperature should not be lowered below 38 0 C. If it is higher, then you need to give an antipyretic drug in an age-appropriate dosage. If there is vomiting, medication is used in the form of rectal suppositories.

But the use of antipyretics for each child is determined individually. Some children easily tolerate fever up to 38.5 0. If the baby is prone to seizures, reduce the temperature that has risen above 37.7 0. If, during treatment, the high temperature persists for more than 3 days, a repeat examination by the pediatrician is necessary to rule out a complication.

Despite the high temperature, the baby may have cold legs and arms. This is due to vasospasm. In such cases, you can put warm socks on your feet or use vasodilators as prescribed by your pediatrician.

A high fever may cause the child to experience seizures. At the same time, the baby’s body stretches, limbs tremble or twitch, and eyes roll back. Parents need to immediately undress the child, give an antipyretic, wipe the body and call an ambulance.

You should clean your child's nose more often to ensure free nasal breathing. To do this, you can use cotton swabs or suck out the discharge from the nasal passages with a small bulb. Use vasoconstrictor drops only as prescribed by a doctor. Cough remedies should also be selected only by a pediatrician.

The pediatrician may prescribe antiviral drugs on the first day of illness. Antibiotics have no effect on viruses. They are used in the event of a bacterial infection and the development of complications.

Hip dysplasia

With the help of massage and orthopedic devices, this problem can be eliminated.

This diagnosis is established in the case of intrauterine underdevelopment of the hip joint, as a result of which the femoral head has increased mobility within the joint, and development connective tissue is violated. Pathology can be unilateral or bilateral.

If femur can come out of the joint and return, then they talk about subluxation of the femoral head. With complete dislocation, the head is completely out of the joint. Subluxation and dislocation are more severe pathologies.

Hip dysplasia most often occurs when the fetus is breech. It is important to diagnose the disease as early as possible, so examinations by an orthopedist should be carried out at 1-3-6-12 months. If a deviation from the norm is suspected, the doctor prescribes an ultrasound or X-ray examination (after 6 months).

Clinical symptoms of hip dysplasia are:

• asymmetry of the femoral and gluteal skin folds;
• additional folds on one leg;
• unequal length of legs;
• restlessness or crying of the child when trying to spread the legs bent in hip joints at right angles;
• clicking sounds when spreading the legs.

At the slightest suspicion of pathology, an urgent consultation with a pediatric orthopedist is necessary, since only early treatment can be effective and have a chance to do without surgery. Due to the fact that the joint continues to form after the baby is born, a complete cure is possible if certain conditions are created.

Depending on the severity of the disease, the following may be prescribed:

• massage;
• physiotherapy;
• Pavlik stirrups;
• Freika tire.

With the help of orthopedic devices, the child’s legs are constantly spread and bent, which creates conditions for correct formation joints. Initially, the baby must wear these spacers 24 hours a day. The doctor determines the duration of their use individually (from several months to a year).

Parents should not remove them prematurely on their own or put the child on his feet without the consent of the doctor, as this can nullify the results achieved.

Torticollis

Torticollis is understood as an incorrect (deviated to one side) position of the head. The manifestations of this developmental defect depend on the age of the child.

Signs of torticollis in the first year of life:

• in the first 2 months: when the baby is laid on his stomach, there is an increase in the tone of the muscles of the back and neck and asymmetry of the skin folds on the legs;
• at 3-5 months there is a slowdown in growth and a decrease in response to sound stimuli;
• at 6-7 months. there is squint and the child stands on his toes, and on the entire foot; teeth erupt late;
• from 7 to 12 months. the asymmetry of the folds on the buttocks and hips, the asymmetry of the shoulders, the curvature of the spine are clearly visible; the child is developmentally delayed (starts to walk later).

The reasons for the development of torticollis can be different:

• damage to the neck muscles caused by incorrect position of the fetus;
• vertebral malformations;
• intrauterine muscle inflammation with scarring and shortening;
• developmental abnormalities of the nervous and muscular systems;
• umbilical cord entwined around the neck;
• muscle injury (tear) or cervical vertebrae during childbirth.

When torticollis is detected, it is necessary to show the baby not only to a pediatrician, but also to an orthopedist and neurologist in order to determine the cause of the pathology and receive the correct treatment. Treatment should not be delayed to prevent deformation of the face and spine. Treatment for torticollis depends on the cause and severity.

Can be used to treat:

• massage and physical therapy;
• physiotherapy (magnetic therapy, electrophoresis, etc.);
• positional treatment (correct position in the crib and on the arms to stretch the affected muscle);
• exercises in the bath or in the pool;
• application of a special collar (Shants collar).

There are also surgical methods treatment.

Summary for parents

In the first year of life, children are especially vulnerable, because many organs and systems have not yet fully matured, and the immune system cannot provide protection for the baby’s body. There are a number of diseases that can occur in infants.

The parents' task is to have an understanding of possible diseases baby, be able to prevent many of them, recognize them initial stage and promptly seek help from a doctor. Many developmental disorders are best corrected during this period.

Modern children have a hard time: as soon as they are born, they fall into the hands of neonatologists, and then pediatricians, orthopedists and speech therapists. And everyone tries to find some abnormality in the child, to make a diagnosis according to the principle: “A healthy patient is a poorly examined patient.” As a result physiological norm they begin to treat. In addition, since doctors are accustomed to dealing with bottle-fed babies, their problems begin to transfer to infants. For example, the stool of a child who is only breastfed is always different from the stool of an “artificial” baby, and doctors are already sounding the alarm: “You have lactase deficiency”...

Lactase deficiency

Lactase deficiency is manifested primarily by foamy, watery and frequent stools with a sour odor, mucus, greens and undigested lumps, as well as irritation around the anus. The baby may be worried during feeding, and there is active seething in his stomach.

At the same time, the child may gain weight well, but the mother still begins to blame herself for the fact that she ate something wrong or became infected with something, which is why her milk “became bad.”

Doctor unfamiliar with physiology breastfeeding, only confirms her doubts. “Your baby probably has lactase deficiency, or maybe dysbiosis,” he says. “We need to check your milk for professional suitability and sterility.”

And endless expensive and unnecessary tests begin (stool for dysbacteriosis, carbohydrates, coprogram, milk culture, etc.). Some kind of staphylococcus is found in mother's milk, most often epidermal (like other microbes, it has the right to exist in the harmonious local system). After which the child, and sometimes the mother, begin to be treated. At the same time, the baby is transferred to a lactose-free formula. The stool becomes denser and everyone breathes a sigh of relief. The myth that mother's milk can be bad is strengthened in the mind.

Let's figure out what's really going on?

Nine months of intrauterine life are not enough for a newborn child’s organs and systems to fully mature. Mother's milk gives him this opportunity. The composition of milk changes as the baby grows.

In the first 3-4 days of life, the child receives colostrum. It contains more proteins and less fat and lactose than “ripe” milk. Colostrum provides local protection to the mucous membrane of the gastrointestinal tract of infants, preparing it to accept “mature” milk, which is heavier in composition. If, instead of colostrum, the baby first receives a mixture or water with glucose plus antibiotics, then the intestinal mucosa is damaged and the prerequisites for the development of lactase deficiency become greater.

The milk becomes “mature” 2-3 weeks after birth, and that’s when the baby’s problems begin. After all, as you already know, milk is conventionally divided into “front” and “hind”. In the “front” there are more carbohydrates (namely, lactose), in the “back” there are fats that help absorb lactose. If the baby does not receive enough hindmilk as a result of improperly organized breastfeeding, he may develop secondary lactase deficiency.

For this reason, if you notice characteristic frequent loose stools in your baby, anxiety soon after the start of feeding, then first of all try to follow four simple rules.

1. Make sure your baby is latching onto the breast correctly.
2. Offer the breast at least 10-12 times a day (do not hoard milk).
3. Feed with one breast at one feeding (accordingly, do not feed with both breasts at one feeding) so that the baby gets to the “hind” milk. He should suck on one breast several times and always for about 1.5-2 hours before falling asleep.
4. Do not pump additionally (pumping is allowed only in case of large fullness of the breast before feeding).

If you do all this, but the symptoms remain, it means that, most likely, the baby actually has temporary (transient) lactase deficiency, but it also goes away on its own.

An infant under 3 months of age has a physiological deficiency (or low activity) of the lactase enzyme, under the influence of which lactose is digested in the small intestine, and therefore part of this undigested lactose ends up in the large intestine. But this is as it should be, because there, under the influence of bacteria, lactose is converted into lactate and short-chain fatty acids, and these are a source of energy for nerve cells and the large intestine.

In addition, the acidity of the intestinal contents increases, creating an unfavorable environment for pathogenic microbes and promoting the growth of digestive lactobacilli. The absorption of calcium, iron, zinc and phosphorus also improves. Gases are a by-product of fermentation.

The abundance of gases in infants is normal and is determined by the intensity of fermentation processes.

Congenital primary lactase deficiency is very rare and is treated with additional administration of the lactase enzyme before each feeding. Typically, such children gain little weight and look completely unhealthy. Therefore, if your child continues to suffer from pain and lose weight after all the measures you have taken to improve the organization of breastfeeding, be sure to contact your pediatrician. Preferably someone who understands the importance of breastfeeding for your baby.

Question answer

“My son is 2.5 months old, he has significant lactose deficiency, carbohydrates in stool are 1.6%. I only breastfeed. I drink lactose with meals about 5 times a day, and the child was prescribed normoflarin and that’s it. Are we being treated correctly? "I'm very interested in what can and cannot be eaten to help my baby's tummy. Can I eat cheese and drink tea with milk? What is healthy to eat for this disease?" Alena, Minsk.

Your treatment is not entirely correct. How does the baby gain weight? How do you breastfeed? Do you keep one breast on duty for 1.5-2 hours? Unfortunately, pediatricians quite often diagnose infants with your diagnosis. However, in most cases we are talking only about temporary lactase deficiency, since primary lactase deficiency occurs in only one out of 20,000 children! The results of the analysis may be completely uninformative, since in infants sugar will always be elevated due to the large amount of carbohydrates in the “foremilk”. If lactase treatment is indicated, it is not for you, but for the child. There is no use for you to drink it.

Dysbacteriosis

For some reason this diagnosis is extremely popular among our doctors. Everyone knows that a child is born with a sterile intestine. , which, in theory, should be the first to enter the mouth, contains elements that promote the growth of normal microflora and suppress pathogenic ones. In the case of pre-breastfeeding with formula, colonization of the intestines is, to put it mildly, imperfect. However, if later the baby is still put to the breast, mother’s milk will help cope with the problems.

The most interesting thing happens when a child appears at home.

Local pediatricians call normal children's stool diarrhea or constipation and send the mother to take a stool test for disobacteriosis. This does not take into account at all the fact that the baby has the right to dysbiosis in his intestines for the first six months of life and to any stool, if at the same time he gains weight well, grows and develops. Then treatment begins, one of the main points of which is to transfer the child, for example, to fermented milk or lactose-free formula. Why is this happening? Pediatricians are not to blame. They are accustomed to the stool of a bottle-fed baby, which is thicker and more monotonous. And stool retention or increased frequency is equated to pathology. Because if this happens to an “artificial” one, his health may suffer greatly.

An even more interesting situation occurs further when, despite drinking, for example, various biological products, microorganisms that are not suitable for his intestines continue to be detected in the child. In this case, the mother is told that it’s all about her milk and is offered to complete breastfeeding. If the mother succumbs to this and stops breastfeeding, the baby begins to get sick often, but the analysis still remains the same.

Question answer

"The baby is 10 months old. From about 3 months old, streaks and mucus appeared in her stool. I went to the institute ***. I did all the suggested tests ~ dysbacteriosis, carbohydrates, etc. - they diagnosed “lactase deficiency.” Long and very painful for the baby’s psyche, treatment with a bunch of all sorts of nasty things that she had to swallow. With daily morning pumping in order to dilute lactose in this milk, and with the use of both breasts all day in a semi-starved state (I realized this only after - when I began introducing complementary foods) .. This is probably where the decline in milk began. And so on, and so on...

But it turns out that I just fed her wrong! I always gave the second breast to help the baby stop hiccupping, and almost always she did not reach my “hind” milk. I foolishly fed her with formula in the maternity hospital...

And our deficiency is clearly not congenital: at first my gain was very great! By now everything has more or less returned to normal. Carbohydrates - 0. Dysbacteriosis shows excess E. coli (according to the norm it should be 0, but we have it). Naturally, now there is increased vigilance regarding the baby's stool. And just recently I had to worry again - again there was mucus and a couple of veins. There are suspicions of semolina porridge, additional lactobacilli from glass (without a special education as a molecular biologist, in my opinion, it is completely impossible to determine their suitability for treatment) and, paradoxically, my milk. I read somewhere that a baby can have diarrhea from milk when the mother is supposed to have her period. Could my baby have mucus for this reason? And should I breastfeed at this time or is it better to express? And another question: how to wean a child from sucking his fingers and scratching his gums with them? After all, crawling on the floor, he thus puts all sorts of rubbish into his mouth..." Irina, Moscow.

Menstruation can only affect hormonally: there may be less milk, and the mother may become more irritable. The baby may react to this, but diarrhea is an “old wives’ tale.” So breastfeed, of course. Thumb sucking may be due to insufficient communication with the breast; on the other hand, babies often hold their hands in their mouths when they have breastfeeding. Let's nibble on more stumps and crackers. “Crawling on the floor and picking up all sorts of “rubbish””, your child builds his immunity. And it is very unreasonable for parents to prohibit this. Well, about this: your baby has normal stools during. You are just tormenting yourself and your child with worries in vain.

My daughter now has all the symptoms of lactase deficiency described in this article: “foamy, loose stools, with a sour smell.” The sour smell, to be honest, I thought was due to the multivitamins we take. We breastfeed accordingly. We're having trouble latching on to the chest. She may have a strong suction, but upper lip Well, it doesn’t want to stick out like a tube; on the contrary, it curls inward. And now she has generally found a new activity for herself, she will suck two or three sips and take it off the breast, then again, in this way she swallows air, but then burps. Usually we also have problems with belching. Stools are not frequent, although what is meant by “frequent stools” here is that we are three months old, so we have stools every day, sometimes two or three times a day, sometimes every other day, or even twice. The stool is also different, with particles of undigested milk, and sometimes even with mucus and lumps, as if the stool had become fixed, but then it still came out liquid, sometimes stringy, the colors are also different, yellow and green. My doctor doesn’t want to do anything about this, maybe it’s for the best if you say it will pass. Since our tummy is constantly rumbling, and before, apparently there were wild contractions, as the child writhed and twisted, and simply burst into sobs. I couldn’t and still can’t understand what’s wrong with us. It seems that I even stopped consuming dairy products, I thought that I was allergic to them, but apparently not, because I’ve been eating a little cheese for a couple of days now, and there’s no particular reaction. But last week, she was a martyr again, she had a very smelly fart, and apparently these same gases completely exhausted her, there was no way to calm the child down:(((

A child is considered a newborn from the moment of birth until he reaches 4 weeks (28 days). There are:

• full-term children who were born on time, that is, from 38 to 42 weeks of pregnancy;
• (28-38 weeks);
• post-term, born at 42 weeks and later.

Full-term babies, as a rule, can physiologically live outside the mother’s body, their height is 48-56 cm, they are active, suckle well, and scream loudly.

Diseases of newborn children may have light form and not threaten anything in the future. But there are also diseases (if left untreated) that can seriously affect the child’s health in the future or even lead to irreversible consequences.

important A newborn requires maximum attention, and at the first signs of illness you should immediately consult a doctor.

Most common diseases

Asphyxia of newborns

Presents with difficulty breathing and varying degrees poor blood circulation in the baby, which manifests itself immediately after birth, leading to oxygen deficiency.

Asphyxia is distinguished between congenital and acquired.

• Congenital occurs due to impaired placental circulation, gestosis, entanglement of the fetus with the umbilical cord. A child is born with a slow heartbeat, weak muscle tone, and bluish skin color.
• Acquired asphyxia is the result of difficult childbirth, entanglement in the umbilical cord, and spasm of the muscles of the birth canal of the woman in labor.

Almost every fifth baby is born with this diagnosis and most of them cope with this problem themselves. There are times when resuscitation procedures cannot be avoided. In any case, the maternity hospital doctors do everything possible for the child so that he does not have neurological problems in the future.

Hemolytic disease

It is anemia, in which the red blood cells in the newborn's body are destroyed.

This is a serious disease caused by incompatibility between the blood of the fetus and mother. If the mother’s Rh factor is negative, and the unborn child’s is positive, then there is a possibility of Rh conflict, since antibodies can be formed in the mother’s body that can destroy them in the blood of the fetus.

Pregnant women with a negative Rh factor should take medications containing iron, visit antenatal clinics more often and go to the maternity ward 3-4 weeks before giving birth.

One of the decisive factors in this sense is the health of the mother during pregnancy and the successful outcome of childbirth. If parents, after being discharged from the hospital, notice unusual behavior of the child or uncharacteristic changes in appearance, they should immediately consult a doctor.

Newborn period begins with the child’s first breath and ligation of the umbilical cord and lasts 3-4 weeks. This period is characterized by the immaturity of all organs and systems, especially the central nervous system, as well as a number of functional, biochemical and morphological changes caused by the transition from the intrauterine development of the fetus to the extrauterine life of the child.

The body of a newborn is characterized by great lability of water metabolism. The average water requirement is 160-200 g/kg of a child’s weight per day. All the main functions of the body are in a state unstable equilibrium; even minor violation environmental conditions can lead to serious changes in the body and some physiological processes easily turn into pathological ones. All this requires special hygienic conditions and careful special care for the newborn, and proper organization of feeding.

The neonatal period is characterized by special conditions bordering between physiology and pathology, for example, erythema of newborns, physiological jaundice, physiological mastitis, transient fever, physiological loss of body weight, albuminuria, uric acid infarction of the kidneys, sexual crises.

Diseases of the newborn period also have fundamental features. During this period, you may experience:

1) congenital diseases that developed in a child in utero (toxoplasmosis, congenital viral hepatitis, cytomegaly, listeriosis, congenital malaria, tuberculosis, syphilis);

2) diseases caused by congenital malformations of organs and systems (congenital defects of the heart, lungs, gastrointestinal tract, etc.);

3) diseases associated with childbirth, birth injuries (damage to the skeleton, peripheral and central nervous system - cerebral circulatory disorders, consequences of intrauterine asphyxia, cerebral hemorrhages, paresis and paralysis); 4) hemolytic disease of newborns, hemorrhagic disease of newborns and other blood diseases;

5) diseases caused by an infectious beginning and, above all, coccal flora, to which the newborn is defenseless, and infection can occur in utero, during childbirth and after childbirth. There is a tendency to rapid generalization of the process with the development of severe septic and toxic-septic conditions, pneumonia.

Newborns are not susceptible to some diseases (measles, rubella), since the mother, while still in utero, passes specific antibodies to the child through breast milk.

Physiological (borderline) conditions of children

In the neonatal period, newborns are short-lived and never recur in the future, but under unfavorable conditions they can develop into pathological process.

Albuminuria- increased protein content in urine up to 0.25 g/l: observed in almost all newborns during the first week of life and is due to increased capillary permeability and increased breakdown of red blood cells, as well as congestion in the kidneys during childbirth. No treatment required.

Uric acid kidney infarction. In the first 2-4 days of life, a newborn has 4-5 urinations per day (due to limited fluid intake), by the end of the first week it already happens 15-20 times a day. Uric acid infarctions are observed in the first days of a child’s life and are caused by increased formation uric acid due to the increased breakdown of cellular elements and the characteristics of protein metabolism, as well as a small amount and high concentration urine with a high content of urates.

The urine is colored reddish color and leaves reddish-brown stains on diapers. With an increase in the amount of fluid drunk and urine excreted during the first 10-15 days, the heart attack goes away without a trace. No treatment required.

Sexual crises. Regardless of the sex of the child, enlargement of the mammary glands, usually bilateral, may be observed in the first days of life. When pressed (which is contraindicated), a liquid resembling colostrum is released from the nipples. The condition is caused by the transfer of estrogen hormones from the mother in utero to the fetus. As the child's body frees itself from maternal hormones, the swelling of the mammary glands disappears. In girls, also as a result of the presence of maternal sex hormones in the body, mucous and bloody discharge from the genital opening may appear. In addition, swelling of the genital organs may occur. All this usually happens on the 5-7th day of life and persists for several days. Treatment for sexual crisis is not required. Only with very large enlarged mammary glands is it recommended dry heat in the form of a cotton bandage and for vaginal discharge - toilet with a weak solution of potassium permanganate (1: 5000-8000).

Transient fever observed more often in children born with large mass body, during the period of maximum loss of body weight - on the 3-6th day of life. Body temperature can rise to 38 1 -39 ° C and higher, persisting for several hours, less often 1-2 days. Usually the general condition is not disturbed, but in some cases, agitation, anxiety, and temporary refusal to eat appear. Treatment and prevention of transient fever consists of timely administration of fluid (boiled water, isotonic sodium chloride solution, Ringer's solution, 5% glucose solution) at a rate of up to 200 g per day, but not more than 10% of body weight. The baby is swaddled lightly and dressed lightly.

Physiological jaundice observed in 60-70% of newborns, appears on the 3rd day of life and, gradually fading, disappears on the 7-10th day, and in some cases (birth asphyxia, prematurity, birth trauma) persists for up to 2-3 weeks. There is an icteric discoloration of the skin, mucous membranes, and sclera while the normal color of urine and stool remains. Jaundice is caused by the relative immaturity of the liver and the rapid breakdown of red blood cells in the first days of a child’s life. No treatment required. For severe jaundice, drinking a 5-10% glucose solution is prescribed.

Physiological weight loss ranges from 3 to 8% of body weight at birth, maximum observed on the 3-4th day of life. Most children regain their original weight by 7-10 days. The reason for weight loss is due to relative malnutrition in the first days, a discrepancy between the fluid received and excreted, regurgitation of amniotic fluid, etc. Weight loss of more than 8% requires clarification of the cause.

Physiological erythema. Hyperemia of the skin, sometimes with a cyanotic tint, caused by a significant expansion of the surface capillaries, persists for 2-3 days, then peeling occurs, more on the palms and soles. It is observed in all newborns, and if it is absent in the first days of life, it is necessary to find out the cause (maternal pathology during pregnancy, birth trauma, pulmonary atelectasis). In case of excessive peeling, the skin is lubricated with sterile fish oil and sunflower oil. Some newborns may have erythema toxicum in the form of a slightly infiltrated rash. Simultaneously with the bright spotty rash, whitish, yellowish nodules appear, surrounded by a halo of hyperemia. After 2-3 days, the rash disappears without a trace.

Principles of care and hygiene of a newborn at home

The discharge of a newborn from the maternity hospital is reported to the clinic by telephone message. Primary patronage is carried out by a paramedic on the first day after discharge, by a doctor within 3 days. Currently, paramedic patronage is carried out daily during the first 2 weeks of the child’s stay at home. Systematic and high-quality patronage helps reduce morbidity and mortality in newborns.

The room in which the newborn lives must be kept clean and tidy and well ventilated. The crib should be closer to the window. The mattress is hard, covered with oilcloth and then a sheet. Place a flat small pillow (not down!) under your head. Bedding is aired daily, and oilcloth is washed with soap. After washing, children's underwear must be ironed with a hot iron on both sides.

A newborn is bathed daily in boiled water at 37 °C, followed by dousing with water whose temperature is 1 °C lower. The temperature in the room where the child is bathed should be 22-23 °C. It is better to bathe your baby in the evening, before feeding; You can use “Children’s” soap. The child should be washed every time after bowel movements, preferably with running water at a temperature of 36 ° C, from front to back from the genitals to the anus, so as not to introduce infection into the genitals. Fingernails and toenails are carefully trimmed with small scissors once every 7-10 days.

Considering the high susceptibility of a newborn to infection, it is necessary to protect him from contact with strangers and observe strict hygiene of those caring for the child; If pacifiers and pacifiers are used, they must be boiled before use.

Diseases of the newborn period

ATELECTASIS OF THE PULMONARY most often occurs in children who are weakened, premature, or born with asphyxia. Revealed when x-ray examination. Clinically expressed phenomena respiratory failure, pneumonia easily follows.

Treatment. If there is no pneumonia, oxygen, cardiac medications, cordiamine, and caffeine are prescribed.

ESOPHAGAL ATRESIA is a developmental defect. There may be complete obstruction of the esophagus, but more often there is a combination of esophageal atresia with a fistula into the trachea.

The symptoms are typical: at the first feeding or taking liquid, after 2-3 sips, all the food taken is poured back out, a painful cough occurs, the child suffocates and turns blue. All symptoms recur with any attempt to feed. Aspiration pneumonia can develop very quickly. The diagnosis is confirmed by X-ray examination with lipiodol. Barium mass should not be used, since in case of a fistula it easily penetrates into the lungs and causes severe pneumonia.

Treatment. Urgent surgery (on the first day of life). The prognosis is very serious and depends on the timing of diagnosis and the addition of aspiration pneumonia.

BILIAL TRACT ATRESIA is a developmental defect with possible complete absence bile ducts or partial atresia (obstruction) both inside and outside the liver.

Symptoms: the appearance of jaundice from the first days of life or somewhat later with a gradual increase in its intensity. Feces are discolored or remain slightly yellow, urine is intensely colored and contains bile pigments. The general condition of the child is not disturbed at first, but liver cirrhosis gradually develops, dystrophy increases, the liver increases in size, becomes dense and lumpy. The level of prothrombin in the blood decreases, hemorrhages appear.

Treatment is only surgical. The prognosis is very serious.

HEMOLYTIC DISEASE OF NEWBORN. The disease develops in utero and is caused by incompatibility of the blood of mother and fetus, either according to the Rh factor (mother is Rh negative, child is Rh positive) or according to ABO blood groups.

When there is a Rh conflict, the mother's body produces Rh antibodies, which, once through the placental barrier into the baby's blood, cause hemolysis of red blood cells containing the Rh factor. The intensity of hemolysis usually depends on the titer of Rh antibodies in the mother (in some cases, such strict parallelism may not be observed). More often, hemolytic disease in newborns appears after the second and especially after the third pregnancy. Thus, the first child, as a rule, is born healthy, the second - with mild signs of anemia, and only the third - with obvious signs of illness. If a woman was sensitized by transfusions of Rh-positive blood before pregnancy, then even the first pregnancy can end in miscarriage, stillbirth child or child with severe manifestations of hemolytic disease. With ABO blood incompatibility, milder clinical variants of hemolytic disease are more often observed, but they can appear after the first pregnancy.

Clinically, hemolytic disease of newborns can manifest itself in three forms - edematous, icteric and anemic.

The edematous form is the most severe; Often children are born still, macerated, or die in the first hours after birth. The appearance of a newborn is characteristic: severe pallor of the skin and mucous membranes, generalized swelling of the subcutaneous tissue, accumulation of fluid in the pleural and abdominal cavities. Severe anemia, the number of red blood cells drops to 1-1.5 million, hemoglobin to 32-48 g/l.

Severe jaundice of newborns is one of the most common hemolytic disease syndromes. The baby is usually born full-term with yellow skin or jaundice develops on the first or second day and increases progressively. The skin becomes yellow-green or yellow-brown. Amniotic fluid and vernix lubrication may also be yellow in color. The liver and spleen are enlarged. Children are lethargic, apathetic, and do not suck well. Heart sounds are muffled. The urine is dark in color, the color of the stool is normal. Anemia in the blood high content indirect bilirubin in umbilical cord blood (from 51.3 to 171 µmol/l and higher with a norm of up to 25.6 µmol/l). A further rapid increase in the level of bilirubin in the blood becomes toxic to the central nervous system and a clinical picture of kernicterus may develop - convulsions, stiff neck and opisthotonus, oculomotor disturbances, and the “setting sun” symptom appear. The duration of jaundice is up to 3 weeks or more. At severe forms ah, especially with kernicterus, death may occur within the first week; if the child remains alive, serious consequences are possible in the form of mental and physical development retardation.

Anemia- the mildest form of hemolytic disease of newborns. It usually appears at the end of the first week of life, the number of red blood cells decreases to 2-3 million. The liver and spleen may be enlarged. The diagnosis is made based on determining the blood group of the mother and child and studying the Rh factor. The prognosis is good.

Treatment. In severe forms of hemolytic disease, early replacement transfusion of Rh-negative blood is necessary. Blood is administered at the rate of 150 ml/kg of the child’s weight (maximum 160-170 ml/kg, and in extreme cases of jaundice - up to 250 ml/kg of weight). If indicated, exchange transfusions can be repeated. Intravenous drip administration of a 10-20% glucose solution, plasma transfusion (10 ml/kg of the child’s weight), administration of B vitamins and hormonal drugs are recommended; in case of damage to the nervous system - glutamic acid, vitamins B6, B12.

In anemic forms, fractional repeated transfusions of Rh-negative, preferably single-group blood, 30-50 ml each. For 2 weeks, the baby is not put to the breast; he is fed donor milk (due to the presence of Rh antibodies in the mother’s milk).

Prevention. All pregnant women undergo a blood test for Rh factor and blood group. In case of Rh-negative blood, antibodies to the Rh factor are determined. With a significant increase in antibody titer, the pregnant woman is hospitalized, specific and nonspecific desensitization and premature delivery are performed. If necessary, the child is given a replacement blood transfusion.

HEMORRHAGIC DISEASE OF NEWBORNS develops due to physiological deficiency in the blood of certain blood clotting factors.

Symptoms arise various localizations and the intensity of hemorrhage and bleeding (bloody vomiting, bloody stools, bleeding from the umbilical wound, from the nose, bloody urine, there may be intracranial hemorrhages, in the adrenal glands, etc.). Sometimes true melena develops (bloody vomiting and profuse bloody stools, general pallor) on the 2-4th day of life, which goes away after 1-3 days. With major bleeding, severe anemia may develop, the child becomes lethargic and dystrophic.

Treatment. Early administration of vitamin K 0.002 g 3 times a day orally for 3 days or vikasol intramuscularly 0.2 ml. Ascorbic acid, vitamins B1, B12, R. 5% calcium chloride solution, 1 teaspoon 3-5 times a day. In case of severe bleeding - transfusion of same-group blood and plasma at the rate of 5-10 ml/kg of body weight, administration of aminocaproic acid. With timely treatment, the prognosis is usually favorable; only in particularly severe cases can death occur due to massive bleeding.

HYALINE MEMBRANES OF THE LUNG - homogeneous protein formations that accumulate in the alveoli, line their walls, alveolar ducts and lead to a sharp disruption of gas exchange. More often observed in premature infants or children born with asphyxia when using caesarean section, from mothers with diabetes, with placenta previa or premature placental abruption. It is assumed that, as a result of increased permeability of the pulmonary capillaries, high-molecular-weight blood plasma protein penetrates into the lumen of the alveoli, which undergoes coagulation and becomes the basis for the formation of hyaline membranes.

Symptoms In the immediate postpartum period, shortness of breath and bouts of cyanosis gradually or suddenly appear, which progress rapidly. Dyspnea takes on an inspiratory nature with retraction of the compliant areas of the chest. At first, the child is very restless, and later, as respiratory failure increases, he becomes lethargic, adynamic, and cannot suck. The skin takes on an earthy gray color. There is weakened breathing in the lungs, no cough. Fluoroscopy reveals diffuse darkening of the lung fields or a reticular granular pattern of the lungs. It is necessary to differentiate from atelectasis, diaphragmatic hernia, intracranial hemorrhages, lung cysts. The prognosis is poor; children usually die within the first 2 days.

Treatment is ineffective. Antibiotics, oxygen, cardiac medications, glucose, and vitamins are prescribed.

RITTER'S EXFOLIATIVE DERMATITIS. One of the severe forms of pyoderma in newborns. Caused by staphylococcus.

Symptoms More often, at the end of the first week of life, widespread areas of redness of the skin with abundant blisters are observed, which quickly burst and expose a burnt surface. The child's general condition is serious.

Treatment. Children need individual care; diapers must be sterile. The erosive surfaces are covered with sterile gauze moistened with sterile sunflower oil. Penicillin is prescribed

100,000 units/kg of child's weight per day intramuscularly or semisynthetic antibiotics - methicillin and others, 100,000 units/kg of body weight per day for 7-8 days, blood transfusion, plasma, gamma globulin, vitamin complex.

CEPHALOHEMATOMA (blood tumor of the head). Hemorrhage occurs between the periosteum and the outer surface of the cranial bones. The tumor fluctuates, is strictly delimited by the edges of one or another bone of the skull, usually the parietal, less often the occipital. Cephalohematoma disappears after 3-8 weeks.

Treatment is usually not required: with suppuration - surgery, antibiotics.

INTRACRANIAL HEMORRHAGES. In complicated pregnancies, in intrauterine asphyxia of the fetus, in the pathological course of labor, under the influence of physical factors (improper application of forceps, vacuum extractor) and in some other cases, favorable conditions are created for increased vascular permeability, and sometimes for rupture cerebral vessels, which leads to intracranial hemorrhage.

Depending on the location of the hemorrhage, it can be:

1) epidural - between the bone and the dura mater; occur when the bones of the skull are damaged;

2) subdural - more often occur during pathological childbirth;

3) subarachnoid - hemorrhages into the pia mater (the most common form);

4) hemorrhages in the brain substance and

5) intraventricular hemorrhages. The last two are less common.

Symptoms depend on the intensity and location of the hemorrhage and are very diverse. With minor hemorrhage, the child is lethargic, drowsy, sucking and swallowing are impaired. Sometimes the clinical picture of intracranial birth injury appears 2-3 days after birth, which indicates an initial minimal hemorrhage, which gradually continued and increased. In severe cases, the child is pale, movements are constrained, eyes are wide open with a gaze directed into the distance, the cry is monotonous, quiet, convulsive twitching of the muscles of the face and limbs, bradycardia, groaning rapid breathing, impaired thermoregulation. Local neurological symptoms depend on the location and size of the hemorrhage.

Treatment. Strict rest after birth. Do not put it on your breast! Feed only with a spoon. Use the toilet carefully. Cold to the head, oxygen. Inside, vitamin K up to 5-10 mg per day for 3 days, ascorbic acid, calcium chloride. According to indications, cardiac drugs, for attacks of asphyxia - drugs that stimulate the respiratory center (cytiton 0.2 ml of 0.15% solution under the skin, lobeline 0.2 ml of 1% solution), glutamic acid. In severe conditions, aminazine (0.001 g/day per day) has a calming effect.

1 kg of child’s weight) in a 0.25% solution (1 ml of a 2.5% solution of chlorpromazine is dissolved in 9 ml of bidistilled water). To combat cerebral edema and increased intracranial pressure, intravenous plasma infusion of 10 ml/kg of the child’s weight every 1–2 days (3–4 times), as well as diuretics, are indicated.

The prognosis depends on the location and intensity of the hemorrhage. With extensive damage, especially in the area of ​​vital centers, death occurs soon after birth with symptoms of progressive asphyxia. With extensive brain damage, the child may remain disabled in the form of hemiparesis and monoparesis, hydrocephalus, a tendency to convulsive states, intellectual impairment, and speech impairment. With timely, consistent therapy and moderate brain damage, recovery is possible without serious consequences.

LISTERIOSIS is an acute infectious disease; The causative agent of the disease Listeria is transmitted from domestic animals and birds. A child becomes infected in utero, transplacentally, or by swallowing amniotic fluid.

Symptoms From the first hours of life, abundant small rash(roseola and papules), on the mucous membrane of the mouth, pharynx, and esophagus there are often rashes in the form of small grayish-white granulomas. Fever, respiratory distress, bouts of cyanosis, and tachycardia are noted. In the lungs there are symptoms of pneumonia. Enlarged liver and spleen. The general condition resembles sepsis. In the blood there is leukocytosis with a neutrophilic shift to the left. When the nervous system is damaged, the clinic resembles a picture purulent meningitis.

The diagnosis can be confirmed by an agglutination reaction with an increasing titer in the mother and infection of experimental animals by injecting urine or cerebrospinal fluid obtained from a sick child. It is necessary to differentiate from toxoplasmosis, cytomegaly, purulent meningitis of other etiologies. The earlier the fetus becomes infected, the more serious prognosis; children die in the first days after birth. With late infection and early complex treatment recovery is possible.

Treatment. Penicillin is combined with tetracycline in an age-specific dose; Duration of treatment - until complete recovery.

Thrush (moniliasis) is a fungal infection of the mucous membranes of the mouth, pharynx, and less often the genitals in the form of white dotted rashes, sometimes draining in nature, difficult to remove. More often the disease occurs in premature or weakened children, malnourished children, during treatment with antibiotics, especially wide range actions. In some cases, moniliasis becomes severe, spreading to the upper respiratory tract, esophagus, and stomach. With further spread of the infection, fungal sepsis may develop.

Treatment. For mild forms of treatment, no treatment is required; you can moisten your mouth (without removing plaque) with a 2% solution of sodium bicarbonate or a 20% solution of borax with glycerin. In severe cases, nystatin is prescribed orally at a dose of 125,000 units 3 times a day for 3-4 days. It is advisable to provide the child with mother's milk. The prognosis is favorable, but the development of thrush against the background of another disease usually worsens the course of the main process.

NECROSIS OF SUBCUTANEOUS FIBER ASEPTICA. Children born with a large weight during a difficult birth may develop foci of subcutaneous tissue necrosis, which is associated with trauma.

Symptoms At 1-2 weeks of life, compactions of subcutaneous tissue of various sizes and locations appear. The usual localization is the back, buttocks, shoulders, limbs, and less commonly, the cheeks. The skin over the induration is either of normal color or of a violet-reddish hue. Within 2-3 months, the infiltrate resolves without a trace. In some cases, secondary infection or calcification of necrotic areas may occur.

Treatment is usually not required; dry heat can be used.

INTERTRIGO. If the child is poorly cared for, the integrity of the epidermis may be compromised on the skin of the buttocks, inguinal folds, axillary and cervical folds. Most often, diaper rash occurs due to maceration of the skin by urine and feces. In mild cases, skin hyperemia is noted; with more severe diaper rash, individual erosions appear against the general hyperemic background of the skin; in severe cases, extensive erosive surfaces appear against the background of severe erythema. The erosive surface serves as a gateway for secondary infection.

Treatment. Child care needs to be improved; with mild diaper rash, a regular hygienic bath and timely change of diapers, and mandatory washing after each bowel movement, help. The skin is lubricated with sterile sunflower, peach oil, and fish oil. For severe diaper rash, treatment of erosions with a 1-2% solution of silver nitrate followed by lubrication with oil is indicated. The baby should be swaddled without oilcloth. The prognosis with timely treatment is favorable.

PEMFIGUS (pemphigus) of newborns - superficial purulent inflammation of the skin caused by staphylo- or streptococcal infection; the disease is very contagious.

Symptoms Blisters of various locations and sizes with cloudy serous-purulent contents form on the skin. The bubbles open on their own, exposing the erosive surface. In a widespread process, the child’s general condition is severe and there is severe fever.

Treatment. Bubbles must be opened without waiting for spontaneous opening; Treat the wound surface with a 2% solution of silver nitrate or a 1% alcohol solution of brilliant green. Use only sterile diapers. Antibiotics are prescribed, and in severe cases, blood transfusions, plasma transfusions, gamma globulin, and vitamins.

The prognosis is favorable; in some cases, sepsis may develop.

Pylorospasm - spasms of the pylorus due to imperfect nervous regulation of the motor function of the stomach.

Symptoms: spitting up and vomiting are typical from the first days of a child’s life. It occurs more often in children with increased excitability of the nervous system. Vomiting is inconsistent, not very profuse; the vomit usually contains unchanged milk, sometimes with an admixture of bile. The child's weight gain may be slow or stop.

Treatment. Feeding is prescribed more often, after 2-2"/2 hours, with smaller portions of milk. In severe cases, they are temporarily weaned and fed with expressed milk; before feeding, it is recommended to give 1 - 2 teaspoons of 5-10% semolina porridge cooked at the breast milk. After feeding, keep the child in an upright position for 8-10 minutes. Place a warm heating pad on the abdominal area. In persistent cases, aminazine is prescribed at the rate of 0.001-0.002 g/kg body weight per day intramuscularly or orally; 2-3 drops 0. 1% atropine solution 2-3 times a day; vitamin therapy is indicated - ascorbic acid, vitamins B1 and B2. Usually, within 2-3 months, the symptoms of spasm disappear, if there is no combination with pyloric stenosis.

PYLOROSTENOSIS—congenital narrowing of the pylorus due to hypertrophy of the circular muscles of the pyloric part of the stomach; happens more often in boys.

Symptoms The disease manifests itself in the 2-4th week of a child’s life and is characterized by profuse vomiting (“fountain”); the amount of vomit exceeds the amount of food eaten. The child loses weight, becomes dehydrated, and has impaired electrolyte balance. On examination, gastric peristalsis is noticeable. An X-ray examination of the stomach with barium sulfate reveals its retention in the stomach for more than 24 hours; in the intestine, barium is found in small portions, while with pylorospasm, all the barium taken ends up in the intestine after 4-6 hours.

Treatment is only surgical. With timely intervention, the prognosis is good.

PNEUMONIA OF NEWBORNS develops in utero and after birth. They can be primary and secondary (for example, in sepsis). The frequency of pneumonia at this age is due to the anatomical and physiological characteristics of the respiratory system, low body resistance to infection, ease of development of atelectasis, aspiration of amniotic fluid during childbirth, aspiration of milk during feeding, immaturity respiratory center and some other points. The cause may be microbial and viral factors, fungal infection and protozoa.

Focal bronchopneumonia often begins with catarrhal symptoms; gradually the child’s condition worsens, sucking activity and weight gain decrease, slight shortness of breath, tension of the wings of the nose, foamy discharge from the mouth, cyanosis of the nasolabial triangle appear, breathing rhythm is disturbed, apnea becomes more frequent; the temperature reaction is insignificant. Can be heard in the lungs hard breathing, there may be isolated moist rales. If focal pneumonia is caused by an adenoviral infection, then the clinical picture of the disease may be more acute and vivid (sharply swollen chest, an abundance of fine bubble moist rales, dull heart sounds, decreased body weight, decreased tissue turgor).

Acute interstitial pneumonia is caused primarily by a viral infection.

Symptoms High fever, severe anxiety followed by lethargy, breast refusal, weight loss, regurgitation, vomiting. There may be meningeal syndrome (tension of the fontanelle, stiff neck, convulsions). Catarrhal symptoms are insignificant or absent. Breathing is “groaning”, moaning, arrhythmic, with apnea, flaring of the wings of the nose; respiratory rate up to 80-100 per minute, cyanosis. The chest is sharply swollen, breathing is harsh, wheezing may not be heard or there are single dry and wet wheezes. Heart sounds are muffled, the rhythm is disturbed up to embryocardia. The size of the liver is increased. Diaper rash may appear on the skin and thrush on the mucous membrane of the mouth. The course of pneumonia is protracted - up to 3-4 weeks, sometimes up to 1-2 months. The disease can recur and be complicated by otitis, pyoderma, and pleurisy. The outcome is not always favorable.

Septic pneumonia is most often caused by staphylococcal infection. There may be primary staphylococcal pneumonia resulting in sepsis and secondary - as a complication of sepsis.

Symptoms Septic pneumonia is the most severe form of pneumonia in newborns, sometimes has a fulminant course with a fatal outcome. The history may indicate foci of staphylococcal infection (pyoderma, maternal mastitis, etc.). The onset is violent, toxicosis is pronounced. Destructive changes in the lungs are characteristic: bullous emphysema with small and large cavities and abscesses of various locations, sometimes with a breakthrough into the pleura and the development of pyopneumothorax and empyema.

Intrauterine pneumonia develops in the fetus as a result of maternal illness during pregnancy or aspiration of infected amniotic fluid during childbirth.

Symptoms The general condition of the child from the first hours of life is very serious: shortness of breath, cyanosis, attacks of asphyxia, elevated temperature, hard breathing, dry and moist wheezing can be heard in the lungs.

Atelectatic pneumonia often develops in premature and weakened newborns, since they easily develop multiple atelectasis with disruption of normal lung ventilation and subsequent congestion.

Symptoms of the disease are not always clearly defined. Moderate shortness of breath, deterioration of general condition, increased cyanosis are observed, and attacks of asphyxia are possible. Over the lungs, there is a dullness of percussion sound according to the location of atelectasis. Moist rales can only be heard at the depth of inspiration when the child cries. The course of the disease is sluggish, long-term, with periodic exacerbations.

Treatment of pneumonia in newborns. Natural feeding, careful care (raised head end of the bed, frequent change of position of the child by turning him from one side to the other, on his back), ensuring a constant flow of fresh air and supply of humidified oxygen - preferably in an oxygen tent in doses; correction of acidosis. Antibiotics: penicillin (40,000-50,000 units/kg body weight per day, in severe cases - 150,000-200,000 units/kg body weight per day intramuscularly), semisynthetic penicillin preparations, erythromycin (0.04-0. 05 g/kg body weight per day), ceporin, gentamicin and other broad-spectrum antibiotics. The duration of continuous treatment with antibiotics is 10-15 days; combinations of antibiotics are advisable in accordance with the existing scheme of rational combinations of antibiotics according to A. M. Marshak. If treatment is ineffective, then after 4-6 days you can change antibiotics or give other combinations of drugs.

For prolonged, especially staphylococcal pneumonia, stimulating therapy is indicated: antistaphylococcal gamma globulin 1.5-3 ml IM every 2-3 days, for a course of 3-5 injections; transfusion of antistaphylococcal plasma, direct blood transfusion at the rate of 5-10 ml/kg body weight several times every 3-4 days. For toxicosis - drink 5% glucose solution and intravenous infusion of 10-20% glucose solution at 15-20 ml/kg body weight daily, isotonic sodium chloride solution. Sometimes, in severe cases, a short course of prednisolone is prescribed at the rate of 1 -

2 mg/kg body weight per day for 7-8 days (the maximum dose is given for 3-4 days, followed by a decrease until complete withdrawal). From the very beginning of the disease, cordiamin 0.2 ml 3-4 times a day under the skin or sulfocamphocaine 0.1 ml 10% solution intramuscularly 2-4 times a day is prescribed, depending on the severity of the condition.

NAVEL, DISEASES. Normally, the umbilical cord remains mummified and falls off on the 5-7th day, the umbilical wound heals on the 10-14th day. When infected, these processes are delayed, and gangrene of the umbilical cord, a weeping navel, fungus, and omphalitis may develop. In addition, congenital changes can be observed - umbilical fistula and hernia of the umbilical cord.

Gangrene of the umbilical cord. The umbilical cord remains green-brown in color, an unpleasant odor appears, and the general condition is disturbed. The process can spread and cause peritonitis.

Treatment. Begin immediate treatment with broad-spectrum antibiotics and systematic toileting of the umbilical cord; surgically necrotic areas are removed.

Weeping navel. The umbilical wound heals slowly, there is serous or serous purulent discharge.

Treatment. Careful systematic treatment of the umbilical wound with hydrogen peroxide and cauterization with a 5% solution of silver nitrate. You should refrain from hygienic baths; Skin treatment is carried out in sections.

Fungus. When the umbilical wound does not heal for a long time, excessive development of granulation tissue is observed, which protrudes from the wound like a cone.

Treatment. Thorough treatment of the umbilical wound and cauterization of granulations with a 5% solution of silver nitrate.

Omphalitis- purulent inflammation of the umbilical wound, skin and subcutaneous tissue around the navel. At the same time, the child is restless, does not gain weight, regurgitates, and his temperature rises. Purulent contents are separated from the umbilical wound, the skin around is swollen and red. Culture for flora and diphtheria bacillus is required.

Treatment. Rinsing the umbilical wound with a 3% solution of hydrogen peroxide, followed by treatment with a 5% alcohol solution of silver nitrate. Subsequently, bandages with furatsilin or hypertonic sodium chloride solution. At severe course broad-spectrum antibiotics and stimulating therapy—gamma globulin, vitamin therapy—are prescribed.

Umbilical fistula- congenital disease; is formed when there is partial or complete obstruction of the vitelline or urinary duct. From the umbilical wound, respectively, constantly secrete or feces, or urine. The umbilical wound does not heal. The probe can be easily inserted into the existing hole.

Treatment. For complete non-union, treatment is only surgical; for partial, careful care and treatment of the umbilical wound. If the fistula does not close on its own within 3-5 months, surgical intervention is indicated.

Umbilical cord hernia. If the hernial sac is small, only the omentum comes out in the navel area, but it can be easily reduced. Treatment is carried out conservatively, special dressings are applied, usually with an adhesive plaster. It is necessary to eliminate flatulence. In severe cases, not only the omentum, but also the intestines, liver, and spleen fall into the large hernial sac. The size of the hernia can sometimes reach the size of the child's head. In these cases, urgent surgical intervention is indicated.

Diseases of the umbilical vessels - periarteritis of the umbilical artery and phlebitis of the umbilical vein - develop when antiseptic rules are violated during the treatment of the umbilical cord remnant and replacement blood transfusions.

Symptoms The general condition of the child is disturbed, the temperature rises. Inflammatory phenomena in the navel area may be absent, but upon palpation of the abdominal wall, compacted vessels in the form of cords are determined at a distance of 1.5-2 cm from the navel. When pressing from top to bottom or bottom to top, a drop of pus may be released from a non-healing umbilical wound. Vascular inflammation can occur latently and be complicated by phlegmon, peritonitis, diffuse hepatitis with liver abscess, and sepsis.

Treatment. Breastfeeding, broad-spectrum antibiotics, gamma globulin. Locally - bandages with hypertonic sodium chloride solution.

SEPSIS is a disease to which newborns are especially susceptible. The causative agent can be a wide variety of microorganisms and their combinations. Recently, staphylococcus has been isolated especially often. Infection is possible in utero, during childbirth, and more often extrauterine. The source of infection is the sick mother; personnel caring for the child may be a carrier of the infection; Contaminated care items, as well as the child’s food and inhaled air, are important. Entry gates of infection can be the skin, mucous membranes, gastrointestinal tract and respiratory tract; The most common portal of infection is the navel. Sepsis does not have a specific incubation period; with intrauterine infection, it can begin in the 1st week of life, in other cases - in the 2nd and even 3rd week. According to the course, there are two main forms of the disease - septicemia and septicopyemia.

Common initial manifestations of sepsis are deterioration in health, sluggish sucking, regurgitation, vomiting, cessation of weight gain or slight decrease in body weight. May be high fever, low-grade fever and even normal temperature. Skin with a grayish tint.

Septicemia is more often observed in premature and weakened children, and is more violent and malignant. Often begins acutely with severe intoxication, disturbances of water-mineral metabolism, with the development of dyspeptic symptoms, jaundice, hemorrhagic syndrome, quick loss masses. Tachycardia, muffled heart sounds, and toxic breathing are observed. Sometimes symptoms of damage to the nervous system (anxiety, confusion, convulsions) prevail. Enlarged liver, spleen, anemia, leukocytosis, neutrophilia, and increased ESR are noted. Leukocytes, red blood cells, and casts may be found in the urine.

Septicopyemia, i.e. sepsis with metastases, secondary purulent foci, is more benign, more often observed in full-term children, with better reactivity of the body. It begins with the appearance of pustules on the skin, sometimes abscesses and boils develop. There may be purulent foci in the pleura, pericardium, in the lungs, as well as purulent otitis media, meningitis, etc. With umbilical sepsis, in cases where the entrance gate of infection was the navel, in addition to general phenomena, omphalitis, periarteritis of the umbilical artery and phlebitis of the umbilical vein can be observed.

Treatment. Careful care, breastfeeding. Immediate prescription of broad-spectrum antibiotics, penicillin is used in a daily dose of up to 200,000 units/kg body weight. It is advisable to administer antibiotics at the site of the lesion (intrapleurally, into the abscess cavity, etc.). In severe cases, a combination of antibiotics with sulfonamide drugs is indicated at the rate of 0.2 g/kg body weight per day. Stimulating therapy is carried out - direct blood transfusion, administration of plasma (up to 10 ml/kg of body weight every 3-4 days) and targeted gamma globulin (1.5-3 ml every other day, 3-5 times in total). Corticosteroids are prescribed in a short course only in acute period sepsis with severe general toxic effects (1 mg/kg body weight per day). Vitamins, enzymes, and local treatment of septic lesions (medication, surgery, physiotherapy) are recommended. The prognosis is favorable with timely and active treatment.

SCLERODEMA - swelling of the skin in newborns; occurs more often in premature infants. The reason is unknown.

Symptoms The skin is pale, cold, dense. With a limited process (usually on the hips), the general condition does not suffer. In common forms, the condition is serious.

Treatment. Careful care, constant warming of the body (heating pads, warm baths), massage. In severe cases, prednisolone (1 mg/kg body weight per day for 5-7 days).

SCLEREMA—diffuse swelling of the skin and subcutaneous tissue, develops mainly in premature, weakened, malnourished children. The reason is not clear.

Symptoms Swelling most often begins in the legs, then successively spreads to the torso and upper extremities. The fabrics are very dense, when pressed on them there are no marks left. Limb movements become limited. The child's general condition is serious.

Treatment is the same as for sclerodema. It is advisable to prescribe cordiamine and caffeine. The outcome is usually favorable.

BIRTH TRAUMA, INTRACRANIAL. The condition is characterized by dysfunction of the central nervous system and regulation of the activities of other organs and systems. Birth trauma may be caused by various diseases mothers during pregnancy, especially toxicosis of the second half, cardiovascular diseases, various deviations during childbirth: pathological birth, intrauterine infection.

Symptoms During childbirth - asphyxia, disturbance of rhythm and frequency of breathing, cyanosis, in the lungs - atelectasis. Violation cardiovascular activity(muffled heart sounds, bradycardia, arrhythmia, decreased blood pressure); decreased muscle tone, reflexes, possible convulsive syndrome, quiet monotonous scream; violation of thermoregulation (may be hyperthermia and hypothermia), pained facial expression.

Treatment is the same as for intracranial hemorrhage.