Recently, because of the fire of “Chang’an Twelve Hours”, all kinds of talents have made every effort to move closer to the hot spot, all kinds of twelve hours came into being, what food twelve hours, what health twelve hours, even a fellow senior of Sister Sa has launched “Twelve Hours of Normal Birth” and “Twelve Hours of Cesarean Section”, watching Sister Sa is really itching in her heart!

Since the twelve o’clock of cesarean section and vaginal delivery have let you finish writing, we are not far behind, you write mother, let’s write the baby, today Sister Sa will bring you is:

Twelve hours for newborns!

Sister Sa once saw such a question:

Why was the baby taken away by the midwife when it was born?

What happened during all this time?

Rest assured, it is definitely not a change of children.

This newborn came to the first hour in the world, there are many things to do:

Recording

After the birth of the newborn, the midwife reports the time (hours, minutes, seconds) and sex of the newborn, which are recorded by the person concerned.

Wipe dry

Newborns are often accompanied by blood, fetal fat and even feces, at this time it is necessary to use a soft towel to start to dry the newborn thoroughly within 5 s, and within 20~30 s, complete the drying action for the eyes, face, head, torso, limbs and back in order.

attract

If there is meconium contamination within 1 minute after birth, and the newborn is not viable, endotracheal intubation is performed to absorb meconium and clear the respiratory tract.

assess

During the drying process, the newborn’s breathing status is quickly assessed.

After thorough drying and stimulation, if the newborn is breathing or crying, and the score is satisfactory and no special treatment is required, then the baby can be placed in a prone position (abdomen down, head to one side) and skin contact can begin on the mother’s chest.

At this time, the newborn has not yet put on clothes, you can use a cleaning towel or a small bag to cover the newborn’s body, or you can put a small hat on the newborn.

After thorough drying and stimulation, if the newborn develops wheezing or inability to breathe, immediate assistance should be sought to treat the umbilical cord as soon as possible, and quickly move to the warmed resuscitation area to begin resuscitation.

Effective ventilation must be established within 1 minute

At this time, time is life is definitely not a false statement.

These operations, in fact, are carried out very quickly, basically completed in the first minute of the baby’s arrival in this world, and there is another link that must be carried out, that is

Cord clamping

。

When the umbilical cord pulsation of the newborn ceases (about 1~3 min after birth), the delivery staff will use two sterile hemostatic forceps to clamp the umbilical cord at 2 cm and 5 cm from the umbilical cord root, and use sterile scissors to break the umbilical cord once at 2 cm from the umbilical cord root.

If the baby is well, after treatment, or at the same time as the umbilical cord is handled, the baby will have the first intimate skin-to-skin contact on the mother’s chest.

This is the baby from the mother’s belly, really “migrate” into the mother’s arms, once in the womb may have listened to the heartbeat countless times, again in the baby’s ear remember,

This is the most precious warm beginning of life.

During the close contact between the baby and the mother, there are still medical staff and family members around to take care of them.

In this process, it is still necessary to closely observe the neonate’s vital signs and signs of breast foraging when they appear

When drooling, opening your mouth wide, licking your tongue/lips, looking for/crawling, biting your fingers,

Mothers can begin to be instructed to breastfeed, promoting early sucking and early initiation.

Breastfeeding should not be rushed, although babies are born with foraging functions, but breastfeeding is still a new skill that needs to be learned for both mother and newborn, and most newborns will go through multiple attempts to breastfeed successfully.

Under normal circumstances, signs of milk foraging will appear after 20 minutes of birth in newborns, and a small number of newborns need longer, if the baby does not show milk foraging temporarily, there is no need to be too nervous, do not rush to force.

The respiratory and body temperature of the neonates are monitored once every 15 minutes.

If the newborn presents with symptoms, the newborn should be examined and managed promptly.

After doing this, basically the first hour the baby came to the world, it has almost passed, so what is left in this part of the “twelve hours”?

measurement

The midwife will tell you that it is a () baby, and after confirming the sex, they will start taking a series of measurements on the baby.

For example, length and weight, and then tell mom and family about the results measured.

Regular checks

Check to see if the newborn is in good health or if there are any problems. Examples include breathing (including moaning, sunken chest, shortness of breath such as shortness or slowness), activity and muscle tone, skin color, umbilical cord appearance, birth trauma, and deformities.

Collect newborn footprints and give them wristbands with identification on their wrists or ankles.

Take your temperature

In general, the newborn is taken every 6 hours. Using a mercury thermometer, clamp the tip of the thermometer under the newborn’s armpit, hold the newborn’s upper arm to clamp for 5 minutes, and check the results.

The normal axillary body temperature of newborns is 36.5~37.5 °C. If the baby is hypothermic, which can lead to death, it is more common in premature and low birth weight infants.

The body temperature is lower than normal at 35.5~36.4 °C, and warmth needs to be improved (such as kangaroo care).

A temperature below 35.5 °C is a danger sign (hypothermia).

A temperature above 37.5°C is also a danger sign, unless due to excessive warmth (e.g., exposure to direct light).

Care for the umbilical cord

If your baby’s broken cord shows no signs of infection, there is no need to apply any medicine, whether it is Chinese medicine or other disinfectants, to the broken end of the umbilical cord. There is no need to wrap a bandage, cover a diaper, or wrap something else on the broken end of the umbilical cord.

The severed end after cord clamping should be exposed to air and kept clean and dry to promote the removal of the umbilical cord stump.

If the broken end of the umbilical cord is contaminated with feces or urine when your baby urinates, wash it with clean water and wipe it dry to keep it dry. If the broken end of the cord bleeds, ask your doctor to re-ligate the cord.

If redness or pus is found at the severed end of the umbilical cord, then considering the possible infection, the infected area can be treated with 75% alcohol 3 times a day and dried with a clean cotton swab. If there is no improvement in pus discharge and redness within 2 days, referral should be made.

Injection of vitamin K1

Clinical guidelines recommend routine administration of vitamin K1 to prophylactic bleeding in newborns at a dose of 1 mg (0.5 mg for preterm infants < 1 500 g).

This is given intramuscularly, with the neonatal mid-thigh front and lateral to the lateral side. Newborns with birth trauma, premature birth, maternal interference with vitamin K treatment in utero, and surgical procedures are at risk of bleeding and must be given intramuscularly vitamin K1.

Mothers should not be upset because they think their baby is fine, but they want to give us injections, which is actually preventing bleeding in their babies.

Vaccinations

Usually, vaccinations are started after your baby is born.

Routine vaccinations include hepatitis B vaccine and the first dose of BCG to bring better immunity to the baby, and if it is a baby with special circumstances, such as low-weight premature infants, the first dose of the vaccine can be postponed as appropriate.

Eye care

Mothers sometimes have birth canal infections that affect their baby’s eyes. For example, women infected with gonorrhea need to use the newborn after birth

0.5% erythromycin eye ointment

to prevent neonatal gonococcal ophthalmia.

In fact, we now recommend routine neonatal eye care, which can prevent serious eye infections.

This is especially true in areas with a high incidence of genital tract infections.

The guidelines recommend the use of drugs to prevent eye infections, and erythromycin eye ointment is recommended, as well as drugs approved and recommended by local health care institutions.

When applying erythromycin eye ointment to your baby, you can squeeze out about 0.5 cm long and apply it from one end of the nose of the lower eyelid and extend to the other end of the eyelid. The other eye is also medicated. Eye care for ordinary newborns requires only 1 dose.

If your baby’s eyelids are found to be red, swollen or discharged excessively, further specialist care is needed.

In these 12 hours, the baby’s schedule can be said to be very tight, after a series of examinations, measurements and some routine preventive treatment and vaccination, for the baby, this can be said to come

The most precious experience in the world

After these 12 hours, if everything is normal, the little person can start eating, sleeping, and sleeping, and then wait with his mother and leave the hospital and return home~

References:

Perinatal Medicine Branch of Chinese Medical Association, Obstetrics and Gynecology Professional Committee of Chinese Nursing Association, Maternal and Child Health Center of Chinese Center for Disease Control and Prevention. Clinical implementation recommendations of basic neonatal health care technology (Beijing, 2017) [J]. Chinese Journal of Perinatal Medicine,2017,20( 9 ): 625-629.

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