How does it weighs? How tall is he? You’ve probably heard these questions a hundred times since his birth! But wait, what are the average values of weight, size … newborns?

At birth, the babies look alike? Nothing is less true! Each baby has its differences …

1. The measurements of the newborn

The newborn was born at term between 38 and 42 weeks of amenorrhea (cessation of menstruation counted from the first day of last menstrual period).

His birth weight (PN) is between 2600 g and 4000 g with an average of 3500 g. It loses about 10% of his birthweight during the first 3 or 4 days (or 350 g for a 3.5 kg baby) and this should not worry. He must get his birth weight before the 15th day of life. His P.N. double and triple to 6 months to 1 year.

size (TN) ranges from 46-54 cm with an average of 50 cm. It will take 25 cm the first year. Headband or head circumference (PC) is between 32 and 36 cm. It will increase by 12 cm a year.

2. The appearance of the baby at birth

The temperature of your baby is higher than yours. She immediately drops the temperature and adjusts the delivery room to go around 37 ° C within 8 hours. The feet and hands, however, remain colder than the rest of the body. This thermal regulation, immature, requires a surplus of external heat. However, it should not cover too many children because external heat too high is bad.

The pulse is rapid (120-150 beats / min) and regular.

The respiratory rate varies from 35-50 breaths per minute. During the first weeks, the baby breathes only through his nose: he can not breathe through the mouth. This is why it is very vulnerable to nasal obstruction.

By placing premature infants in an environment as close as possible to the uterine environment and boosting their reflexes, doctors in Glasgow hoping to promote their motor development and cerebral.

A premature birth often leaves traces in the psychological, intellectual and motor of a child between one third and half of preterm infants after only 25 weeks of gestation and handicaps keep more or less important, such as disorders language, visual impairment, gait disturbances … These effects depend on the degree of prematurity, but also the quality of care to the newborn. Now, if much progress has been made in this field, their results were above all to live babies born more prematurely, to the detriment of their future development. However, some teams try to create favorable conditions to compensate for the brevity of his stay in the uterus.This is where the Queen Mother’s Hospital in Glasgow, where a particular approach is implemented, with apparently positive results.

1. Recreating the conditions of life of the uterus

The method of the Glasgow team has two objectives: to recreate as much as possible the conditions in the womb, by limiting the external stresses, and try to implement real education measures to avoid deficits are installed.

To achieve the first objective, the neonatal intensive care unit is bathed in darkness and silence unusual in most other hospital services. Many children are buried in a cushion supposed to replace the flexible hose and mild uterine cocoon.

2. Strengthening the role of psychologists

To prevent small deficits evolve towards disabilities, the service uses a variety of specialists, including psychologists, physiotherapists and speech therapists. Thus, some premature babies are not they the sucking reflex which normally take place later in the development of speech.Some therapists seek to develop this reflex using pacifiers. It is the same for the reflex usually present at birth and who may lack in preterm whose brain has not had time to mature. The aim is to stimulate early brain activity and straining the muscles so that the child is more likely to catch up.

Psychologists are finally here to support parents and teach them to communicate with this baby so fragile and distant in his incubator.

According to the team, the first results are quite encouraging: the very preterm leave the hospital sooner and seem to have a more favorable development. But this will take several years to truly judge the merits of this approach.

He was born about 55,000 children prematurely each year in the hexagon Prematurity and reached more than 6% of births in France.

A premature baby is a child born before the 37th week after the first day of last menstrual period (eight months or 259 days). The extreme prematurity (less than 33 weeks) for 9000 children in France.

A newborn whose size and weight are too low relative to gestational age, presents a “delay of intrauterine growth” or IUGR It is still called “hypotrophic.Premature babies may also be hypotrophic.

1. Multiple causes

The causes of prematurity are often multiple and intertwined. There are obstetrical factors (multiple gestation, placenta previa, placental abruption, growth retardation intrauterine etc.), maternal (B streptococcal infections, listeriosis, diabetes, toxemia, etc..), Fetal (chromosomal abnormalities or not, etc..) and socio-economic (multiparity, mothers aged under 18 or over 35 years, etc..). Since 1985, the number of multiple pregnancies has increased significantly due to the rise of assisted reproductive techniques. In addition, the percentage of pregnancies among women over age 35 increased from 6-14%. Finally, premature or medically induced granted (maternal illness, progressive hypotrophy) represents at least 30% of admissions for neonatal prematurity.

2. Features premature

The premature baby is a newborn with all major functions are immature.

• The respiratory system is immature: breathing in premature infants is irregular and broken by “breaks” requiring intensive monitoring.
  Lung immaturity is reflected in the absence of a substance required in the lung surfactant. The instillation of artificial surfactant has revolutionized the treatment of hyaline membrane disease as is the risk of delivery before 33 weeks, injection of corticosteroids to the mother, and his transfer to a facility with maternity and neonatal resuscitation .

• The liver is immature explaining the high incidence of jaundice.

• The digestive system is immature: the premature infant must be force-fed by gastric tube or duodenum, because he lacks the strength to nurse, nor has the habit of sucking or swallowing reflex.

• The immune system is immature, which explains the frequency and severity of infections in premature babies. The latter must be isolated and handled with great care aseptic

• Temperature control is immature: the premature baby is very sensitive to cold and heat. It must therefore be placed at birth in an incubator (incubator) at a temperature of around 34 ° to 35 ° C. is adjusted several times a day. The atmosphere of the incubator should be moist with a relative humidity of 80%. Children are removed from incubator to 2 kg. The early returns to his parents’ home to 2300 g if its feeding behavior permits.

3. Disease of prematurity

During the first days of life: three major hazards threatening prematurity: respiratory distress (hyaline membrane disease), intracranial hemorrhage and infection.

After the first week of life is the period of “breeding” is going smoothly in general. The early remains a victim of choice for infection that doctors try to prevent by aseptic precautions draconian: isolation of premature boxes, wearing mask and cap, using a special gown to each boxing , frequent washing of hands before and after handling each infant, aseptic care, sampling and force-feeding …

4. What future?

Through better monitoring of pregnancy and modern techniques, mortality has declined dramatically, but remains a function of birth weight:

The growth in height and weight of prematurity following manner different from that of the child born at term. It is even more rapid during the first year that birth weight was low. Head circumference reflects brain growth and should be monitored carefully.

When comparing the acquisition of a psychomotor those of a premature infant born at term, the pediatrician takes account of “corrected age” and not the actual age. When a premature baby is born after seven months of pregnancy, we can say he has two months in advance. When it is 10 months old with civility, it will really only eight months corrected age. We must therefore compare the performance of an infant born at 8 months term and not those of an infant of 10 months.

The relationship between parents, caregivers and children are arranged in specialized, so that parents can enter the unit and be kept informed of developments. Parents are invited (but not obliged, of course) to return the units to participate in the care of the baby, talking to him, to caress, etc.. Breastfeeding is encouraged. The hospital stay is as brief as possible. The role of hospital staff is to demystify and explain to parents the role of tools and tricks will astound you.

Neonatal infections are routinely sought in the newborn. They can be transmitted during pregnancy or childbirth. Update on the symptoms and treatments.

Neonatal infection is one of the main obsessions of the pediatrician who works in maternity. It can be maternal infections during pregnancy (toxoplasmosis, rubella, cytomegalic inclusion, herpes, hepatitis B, AIDS, etc.) that affect the fetus or infections occurring in late pregnancy or during the childbirth (listeriosis, group B streptococci, E. coli, etc..).

1. Several warning signs …

Wanted infection in the newborn in a variety of cases: urinary tract infection, vaginal or respiratory mother, fever late in pregnancy, rupture of the amniotic sac more than 12 hours before the expulsion, stained amniotic fluid, etc. . The child’s condition may be normal or already worrying complexion gray pallor, jaundice early or prolonged edema, hypothermia or fever, enlarged liver and spleen, rash, difficulty breathing, refusal to drink, vomiting, weight loss, grunting, neurological …

2. Additional tests

In practice, every child that goes wrong is suspected of infection until proven otherwise. The child must be transferred to a neonatal department in which various tests will be performed: blood tests with NFS (Formula blood count), CRP (C Reactive Protein), chest x-ray, bacteriological, etc.. The treatment is based primarily on intravenous antibiotics and nursing care.

A little too big, too small, slightly more awake … Sometimes baby is a little different, without one really knows why. Yet, nothing too alarming … Everything falls generally in the order in a few weeks.

At birth, your baby is not quite like the others. Too big, too small … the stock of these small cases.

1. The post-mature

These are children born after more than 42 weeks gestation.

They look and behave closer to those of an infant 2 to 3 weeks: Eyes are wide open, giving the baby a face very awake. There is an absence of vernix and lanugo, the length of nails, abundant hair, desquamation important. The subcutaneous blubber is thin.

These children are fragile, vulnerable to incidents. The cause of post-maturity is unknown.

2. The hypotrophic or dysmature (stunted intrauterine)

Newborns hypotrophic are children whose measurements are below those for the term, a term popular according to various criteria: LMP, ultrasound, neurological examination and morphological hypotrophic … The children are fragile.

The causes of low birth weight are highly variable: it is usually the result of a malfunction of the placenta (due to toxemia, high blood pressure, infections, smoking), or of pregnancy in a primipara elderly, etc.. Often, however, no specific cause is found.

3. Large babies

They are those who weigh more than 4 kg at term. Among the causes, the focus is maternal diabetes (non-or poorly treated), multiparity and the large size of the parents. Childbirth is often difficult and traumatic. The main risk is hypoglycemia, which is detected by doing dextrostix (test strips on which a drop of blood is filed) and treated with an additional intake of sugar.

The neurological examination to test the reflexes and tone baby. Automatic operation, “grasping”. movements are all that the doctor will look for and cause. Focus on these simple exercises instructive.

Neurological examination allows one hand to assess the maturation of the child and the other to detect possible anomalies. The tests must be performed in a child awake. While crying or if he sleeps, the results of tests have any value.

1. Automatic operation

After finding liability of the members of tone, the pediatrician do a few exercises to the baby. He is standing on a hard surface and observe the robust recovery of the lower limbs and the trunk and neck. The baby sits up and takes a few seconds vertical. Frequently, he sketches some: it is the reflex of automatic operation. It can even climb over an obstacle.

2. Kissing: An early reflex

If the pediatrician took the baby with both hands, lifting it slightly from the level of the bed and then let go suddenly, it triggers a movement of the arm in extension (abduction) cut their hands, cry and gesture of embrace by closing arms.  This is the Moro reflex, which also be caused by pulling sharply on foot or by causing a sudden noise.

3. When baby grabs!

Many other reflexes are sought. For example, grasping or grasping reflex is obtained by placing his fingers into the palm of the child. The baby’s hands closed over the fingers of the examiner and the tonic reflex, distributed to all flexors of the arm and shoulder, can lift the level of the bed.The portion of the arm is another reflex fun to see the new baby is placed face down, face resting on the table and the upper elongated along the trunk. The infant directs his head sideways to clear his nose and take a better inspiration. In a second step, bends his arm slowly towards the side of the face and puts his hand over his mouth. If it prevents rotation of the head, the reaction is blocked.

The tone and reflexes are judged on the term newborn. By carefully examining the newborn that the pediatrician is able to set a specific neurological age.

The Guthrie test is the famous test that requires a blood sample at the heel of the baby at birth. It can detect certain rare diseases. How is this review necessary?

Your child is born is seems perfectly healthy. To be sure, he will pass the test of Guthrie. On the 4th day of life, a few drops of blood (9 exactly) will be collected by heel prick on the baby (or sometimes by venous sampling).

1. Guthrie Test and Research of Rare Diseases

The drops of blood are sent to the laboratory analysis to detect several diseases:

• Phenylketonuria: is one of metabolic diseases most frequent and most serious: a birth in 15,000. The disease is linked to the absence of an enzyme that does not convert phenylalanine, a component contained in certain foods. If it is not supported, the risk is mental retardation in a few months.Once detected, treatment consists of a diet low in phenylalanine as soon as possible.

• Congenital hypothyroidism: This endocrine disease for a birth in 4000. There is a lack of thyroid hormone production can cause mental retardation. The assumption is based on replacement therapy to compensate for the lack of hormones.

• Congenital adrenal hyperplasia (the Guthrie test since 1996): This disease provides a 12,000 births and results in a problem of synthesis of the hormone cortisol. Treatment with corticosteroids is the development of the child.

• Sickle cell disease: This time of targeted screening, because the disease mostly affects people from African, Caribbean, Guyana and Reunion. This problem with hemoglobin, which can cause serious complications. In the population at risk, it relates to a birth in 4000. The diagnosis allows appropriate treatment to just avoid serious complications.

• Cystic fibrosis (in the Guthrie test since 2002): This disease affects one in 4000. Its symptoms include pulmonary insufficiency. There is no treatment, but its detection allows early treatment and appropriate that improves the quality and expectancy of life. Note: in case of positive blood test must be confirmed by genetic testing, which requires parental consent.

The results of the Guthrie test

The Guthrie test results are quite rapid: less than 15 days. If they are negative, you will not be new. By cons, if a problem is detected, your doctor will tell you, and further tests will be conducted to confirm the diagnosis.

When your baby seems, it requires immediate attention. Cut the cord, cleaning eyes, Apgar test. The first attention of the midwife are paramount. Doctissimo an update on the actions that will accommodate your child.

The delivery suite or birth is the domain of the obstetrician and midwife. The pediatrician is of course its place, but only intervenes when there are at-risk birth, that is to say if significant prematurity, malformation diagnosed by ultrasound or fetal distress detected during delivery by slowing heart sounds with continuous recording of fetal heart rate.

1. First things

You have just given birth. The midwife showed you your baby wrapped in a sheet, the time for the midwife cut the cord, then left a few steps from there to put it on a heating table.

The first actions of the midwife, the obstetrician or pediatrician will be to ensure that the heart and lungs working properly. In case of anomaly, all maneuvers will be performed. The estimation of the severity and monitoring of the child are greatly facilitated by determining the coefficient of Apgar score at one, five and ten minutes of life.

2. Apgar test

Dr. Virginia Apgar developed its score in 1953 in the U.S. The test involves the study of heart rate and respiration, the estimated responsiveness, tone and color of the skin. Each of these elements is rated 0-2. The absence of heartbeat is rated 0, while the tachycardia than normal 100/mn is rated 2. The normal score is 10. The higher the score, the lower the status of the newborn is bad.

3. Gestures routine

Gestures routine and comprehensive review is conducted after the test Apgar.  Among the first acts, the aspiration of mucus sometimes impresses fathers who attend the operation. We introduce a small probe into the mouth and nostrils of the baby to suck the mucus that clogs airways. The descent to a small probe into the stomach to verify the absence of malformation of the esophagus. One then verifies that the anus is well established and permeable.

4. Specific care

• Eyes
  Antibiotic eye drops are instilled in both eyes as a routine to avoid the occurrence of an eye infection.

• The umbilical
  Tying the cord is to clamp Barr plastic, sterile, ready and disposable. The cord is then cut. The navel is then disinfected with chlorhexidine and the gauze was put in place by adhesive maintained nonirritating or net Surgifix. Some pediatricians suggest the cord to the air.

• Vitamin
  Two to five drops of vitamin K1 are placed directly into the baby’s mouth to prevent hemorrhagic disease of

the newborn.

You’re the proud mother of a child and you want or expect another baby … But despite the happiness of a new pregnancy, many fears haunt you … The emotion will she go to? Will you have enough love for two children? Will you have enough time?

Very often the mothers, when they want to have a second child, through a period of questioning at the time of the decision or during pregnancy. They wonder what they will experience during this pregnancy, how to love the new baby as much as the first, how do we share this love between children, will they love them so much? All these questions are also upset in their heads and fill with apprehension and uncertainty …

1. Less emotions and feelings?

Madam, you simply can not imagine a different relationship than you have with your first child: he has already taken such a place in your heart and in your life that you want to know what will happen with the second. The first pregnancy was so rich in emotions and discoveries, it will inevitably be different. You are afraid not to feel such strong feelings: this pregnancy will she too nice?

Your first pregnancy will always keep in your memory the original place, one where you first experienced the changes in your body and feel your baby moving inside you. Everything was new, it was magical. The second pregnancy will inevitably be more serene experience removes the anxiety of the unknown. Bodily sensations and emotions that had invaded you will nevertheless always present.

The relationship whatsoever is between the father, the first child and you in anticipation of the birth of little brother or sister will be a new experience. It will cause further disruptions in your emotional life. The magic is always there but speak differently.

2. Not enough love?

Love is extensible! You’ll love all your children, but not in the same way. It is legitimate to love their children differently, they do not have the same character and your more or less strong affinity with them follows. It may well happen that we feel very close to a child at certain times and less in others, or that another character is closest to your own sensibility. There’s nothing to feel guilty, one important thing: none of your children should feel privileged or preferred over another.

From that love follows a daily experience that will be different with each of your children. Your choice of business with one or the other or both will be decided according to your tastes and interests.

3. Not enough time?

The love of a mother can not multiply, but his time and his availability for the child. This is also the anxiety that can hide behind some fears. Mothers who wonder, often confused, and without the knowledge, love and presence, they have spent and still spend so much time they first wonder if there will be much or somewhat for the second.

Certainly, the arrival of another child again causes changes in the organization of family life.Initially, the mother, who must deal with more of the second child, is worried about the reaction of the first and wondered how long it will devote. But the occupation change with age and daily organized quickly.

At two or three years, the senior can participate in daily life and care of the baby. The mother, with her two children, will organize its activities according to age faster than she thought, her love and her time will share naturally.

Do not forget Dad! It may, too, care for the elder or toddler. Remember that you are not alone. In any case, remember to spend time with each. This will minimize the problems of jealousy and your children know they are unique to you.

Impotence diagnosis code as follows:

1. Married man without penis can not erect or Bo Jian, making it impossible to line intercourse, this be the main clinical manifestations of disease.

2. Impotence has two primary and secondary, but also organic and functional distinction. Primary impotence showed the penis into the vagina from the failure to engage in sexual intercourse, secondary impotence have had sexual intercourse, but occurs after obstacle. The performance of organic impotence at any time for the penis not move on, when neither erection during sexual arousal (such as sleep and when the bladder filling), no spontaneous erections; functional impotence have spontaneous erections, but clinical Housing erectile flop.

3. Most of the disease caused by the psychological factors. Therefore, the patients are under stress to varying degrees, fear, depression, anxiety and distress and other mental state.

4. Patients with this disease, some by the lack of a normal dry knowledge, it is necessary to ask patients about their sexual activity and other issues, in order to clarify the.

5. Exclude functional impotence, should be combined with other signs, tracking the primary disease. As a result of diabetes secondary to who should do blood and urine test checks.