NEW BORN CARE AND INFECTIONSPresentation Transcript
Mothers Class New born care and Newborn Infections Vivian C. Barrera Department of Family and Community Medicine Perpetual Succour Hospital
Caring for a newborn is one of the greatest challenges a parent or caregiver faces. A new baby is completely dependent on loved ones to care for him or her
NEWBORN SCREENING RA 9288 orNewborn Screening program of 2004
CONGENITAL ADRENAL HYPERPLASIA excessive or deficient production of sex steroids
GALACTOSEMIA Rare genetic metabolic disorder incidence is about 1 per 60,000 births Without treatment, mortality in infants is about 75%.
PHENYLKETONURIA occurs in 1 in 10,000 to 15,000 newborns. Most cases of PKU are detected shortly after birth by newborn screening treatment is started promptly
G6PD DEFICIENCY Persons with this condition do not display any signs of the disease until their red blood cells are exposed to certain chemicals in food or medicine, or to stress Red cells break down when exposed to certain drugs or stress of infection
Antimalarial drugs Aspirin Nitrofurantoin Nonsteroidal anti-inflammatory drugs (NSAIDs) Quinidine Quinine Sulfa drugs Other chemicals, such as those in mothballs, can also trigger an episode. ) Are African American Are of Middle Eastern decent, particularly Kurdish or Sephardic Jewish Are male Have a family history of the deficiency A form of this disorder is common in whites of Mediterranean descent Dark urine Enlarged spleen Fatigue Pallor Rapid heart rate Shortness of breath Yellow skin color(jaundice
Neonatal Period ( 0 - 1st mos ) Vulnerable time Completing vulnerable changes High morbidity and mortality rates U.S. Deaths in 1sy year of life: 2/3 in neonatal period No longer dependent on maternal circulation
Parental role in Maternal-Infant Attachment Requires dedication because a newborn's needs are urgent, continuous, and often unclear
Mother is freaking out for? Is it something worth freaking out?
Normal Temp: 36.5- 37.5 C RR: 40- 60 cpm HR: 100-180 bpm (70-80 bpm asleep) Menstruation???
The Newborn Average term newborn weighs : 3.4 kg (7½ lb) Boys are slightly heavier than girls are Length : 50 cm (20 in) head circumference : 35 cm (14 in),
Occasional Coughing Sneezing Hiccups Regurgitation The following are considered NORMAL:
I AM GOING HOME WITH MY BABY!
Newborn’s Basic Needs Lots of feeding Lots of sleep clothing Lots of Cleaning Up
FEVER IN NEONATES Fever is a prominent symptom of many different disease processes
Neonates and young infants may manifest fever as the only sign of significant underlying infection. A rectal temperature of 38ºC(100.4ºF) generally is regarded as fever in the neonate 0 to 28 days of age. FEVER IN NEONATES
HYPERTHERMIA IN THE NEWBORN TRANSITORY FEVER OF THE NEWBORN, DEHYDRATION FEVER Temp: 38-39 2nd -3rd day of life Risks factors: Breast fed infant whose intake is low Overdressed Exposure to high temperatures Manifestations Infants may lose weight Diminish urine output Depressed fontanel Infant takes fluid avidly
HYPERTHERMIA IN THE NEWBORN TRANSITORY FEVER OF THE NEWBORN, DEHYDRATION FEVER Should be evaluated for local or systemic infection Treatment“: Addtional nursing formula NOT pure water
Check TEMP Loosen up clothings Cool environment WHAT TO DO? Call a friend
Presence of fever should be evaluated laboratory evaluation CBC, Blood Culture, UA , CSF CXR and Stool Cx Admission Visit an M.D.
General Appearance Myoclonus Is brief, involuntary twitching of a muscle or a group of muscles. It describes a medical sign and, generally, is not a diagnosis of a disease. Brief twitches are perfectly normal us
EDEMA Produce superficial appearcance of good nutrition (+) Pitting Generalized Prematurity Hypoproteinemia Non immune hydrops Congenital nephrosis Hurlers syndrome Unknown cause 1 or more extremities: initial sign of turners syndrome
HYPOCALCEMIA (TETANY) Common complication of VLBW pre term infants Can lead to fracture Major cause : inadequate intake of calcium to meet the requirement for growth Prolonged parenteral nutrition Vit D and calcium mal absorption Intake of unsupplemented human milk Urinary calcium losses from chronic diuretic use.
called a milk spot or an oil seed is a keratin-filled cyst that can appear just under the epidermis or on the roof of the mouth commonly associated with newborn babies found around the nose, eyes, and genitalia In children milia often disappear within 2 to 4 weeks. Milia
Erythema toxicum Common Harmless Rash Appears within 1-2days after birth goes away on its own within a week Not contagious, does not require any medical treatment
tiny bumps that are firm, yellowish or white, and surrounded by a ring of redness.
Sometimes these bumps are filled with a fluid that looks like (but isn't) pus. Sometimes there are no bumps at all — only a splotchy redness
The rash usually appears on the baby's face, chest, arms, and legs It may be concentrated on only one area of the body it may cover much of the child's skin, although it usually does not affect the palms or soles of the feet
TRANSIENT NEONATAL PUSTULAR MELANOSIS BENIGN idiopathic skin condition mainly seen in newborns
has distinctive features characterized by vesicles, superficial pustules, and pigmented macules
present at birth. occur on the chin, neck, forehead, chest, buttocks, back, and, less often, on the palms and soles The vesicles and pustules rupture easily and resolve within 48 hours. The brown macules may persist for several months NO SPECIFIC THERAPY is indicated for transient neonatal pustularmelanosis
Main cause not known But it could be due to the increased sensitivity of the infant's sebaceous glands to maternal hormones during pregnancy Peaks at around 2 months Rarely needs treatment.
NEW BORN INFECTIONS
Signs to Look for Many infections cause similar symptoms. Call your child's doctor or seek emergency medical care if your new baby shows any of these possible signs of infection: poor feeding breathing difficulty listlessness decreased or elevated temperature unusual skin rash or change in skin color persistent crying unusual irritability
Group B Streptococcal Disease A common type of bacterium that can cause a variety of infections in newborns. Some of the most common are sepsis, pneumonia, and meningitis. Babies usually get the bacteria from their mothers during birth — many pregnant women carry these bacteria in the rectum or vagina, where they can easily pass to the newborn if the mother hasn’t been treated with antibiotics.
Group B streptococcal Disease Babies with GBS often show symptoms of infection within the first week of life, although some develop symptoms weeks or months later. Depending on the infection (pneumonia or sepsis, for example), the symptoms might include trouble breathing or feeding, a high temperature, listlessness, or unusual crankiness
Listeriosis Serious infection affecting pregnant women and newborns Can lead to diseases such as pneumonia, sepsis, and meningitis in newborns. Most people encounter the bacteria by eating contaminated food Bacteria are found in soil and water and can end up on fruits and vegetables, as well as in foods that come from animals, such as meat and dairy products .
Listeriosis Food that isn't properly cleaned, pasteurized, or cooked may give someone listeriosis Babies can acquire bacteria from their mothers if the mother contracts listeriosis while pregnant. In severe cases, listeriosis may lead to premature delivery or even stillbirth. Babies born with listeriosis may show signs of infection similar to those of GBS
It is important to follow general sanitary rules and keep a clean food preparation area while cooking to avoid becoming infected with listeriosis.
Do not eat hot dogs or lunch meats unless they are heated until they are STEAMING HOT. Wash all surfaces and hands after handling hot dogs, lunch meats and deli meats. Do not eat refrigerated, smoked seafood. Do not eat refrigerated meat spreads. Canned spreads are generally okay.
SYMPTOMS jaundice, pallor,, breathing problems, rashes, vomiting, or diarrhea. As the disease progresses, babies' fontanels, or soft spots, may begin to bulge.
HOW IS IT DIAGNOSED AND TREATED
SEPSIS Is a serious infection that involves the spread of germs throughout the body's blood and tissues. It can be caused by viruses, fungi, parasites, or bacteria. Some of these infectious agents are acquired during birth, while others are picked up from the environment. As with meningitis, the symptoms of sepsis are not specific and vary from child to child.
How is it diagnosed and treated? To diagnose or rule out sepsis Blood test Examine cerebrospinal fluid and other body fluids to look for bacteria or other pathogens. They typically look for sepsis and meningitis in the same work-up. Once a positive diagnosis is made, the child will receive a course of antibiotics during a stay in the hospital.
CONJUNCTIVITIS(PINK EYE) Some newborns develop an inflammation of the eye's covering membranes appears as redness and swelling in the eye, usually accompanied by a discharge. Both bacterial and viral infections can cause conjunctivitis in newborns.
HOW IS IT DIAGNOSED AND TREATED? The infection can be very contagious, so the doctor may also suggest that other children in the family limit contact with the baby. If a more serious type of conjunctivitis is suspected, hospitalization may be necessary
CANDIASIS An overgrowth of the common yeast candida, found on everyone's body, leads to the fungal infection candidiasis. In newborns, it usually shows up as diaper rash, but babies can also develop oral thrush in the mouth and throat. It causes cracks in the corners of the mouth and white patches on the tongue, palate, lips, and insides of the cheeks. Newborns who get thrush have often picked up the fungus from the mother's vagina during delivery or during breastfeeding.
HOWIS IT DIAGNOSED AND TREATED?
It's more likely that babies will be born with an infection if their mothers become infected for the first time with a particular germ while pregnant. However, transmission to the baby doesn't always occur, so many babies born to mothers with these infections don't have the infection themselves. Other newborns may not initially show signs of disease, but may later exhibit its effects.
Congenital infections include The risk these infections pose to an infant often depends on when the mother is exposed to the germ
Complications Large or small head Small body size Seizures Problems with the eyes Skin rashes Jaundice Enlarged abdominal organs A heart murmur. heart disease brain damage Deafness visual impairment Miscarriage Infection later in the pregnancy may lead to less severe effects on the fetus but can still cause problems with the infant's growth or development
How are they diagnosed and treated?
When Troubled? VISIT NEAREST HEALTH FACILITY
PREVENTION IS BETTER THAN CURE A good prenatal check up = Better baby outcome