Reactions that reflect the child's adaptation to birth stress, new living conditions are called borderline (transitional, transient, neonatal physiological) conditions of newborns.
These conditions, in contrast to the anatomical and physiological features of newborns, appear at birth or after birth, and then pass after a certain time.
Transient hyperventilation
Crying after birth is her first breath.
The respiratory rate is 30-60 beats per minute and the respiratory rate is 6-8 ml / kg
In healthy infants, breathing in the form of gasps (breathing is deep and breathing is slightly difficult) is observed for the first 3 hours, which helps to open the lungs and evacuate fetal fluid inside the alveoli.
During the first 2-3 days of the adaptation period, the minute air exchange rate of the lungs is 3 times higher than in older children.
Transient changes in blood circulation
Fetal blood circulation differs from that of newborns by 3 main features:
With the presence of the placental circulation;
With the openness of anatomical shunts (oval hole, bottling network, Aransiev network);
The amount of blood flowing through the lungs is minimal (6-9% of the volume of heart contractions).
Transient polycythemia
In addition, polycythemia (excess red blood cells) is observed in infants. This condition is characterized by an excess of hemoglobin of 180-220 g / l and a hematocrit of 0,55-0,65 and above, the number of erythrocytes is 6-8 × 1012 / l. These transient changes in blood circulation disappear spontaneously and do not require special treatment.
Transient dysbacteriosis
This condition consists of 3 phases.
The aseptic phase - lasts until the mother puts it on the breast
The phase of reproduction of the infection is observed up to 3-5 days of life of the child. Intestinal entry of the above microorganisms.
Transformation phase - observed from the beginning of the last-1 weeks of 2 week. Bifidobacteria multiply and begin to be considered the main intestinal microflora.
Transient failure of heat exchange
Transient hypothermia - during the first 30 minutes after birth, the temperature of the skin and rectum decreases, and an hour later the body temperature stabilizes. If the temperature in the delivery room is 22-23, the baby's temperature may drop to 35,5-35,7 ° C. The temperature is even lower in the arms and legs.
Transient hyperthermia is characterized by high room temperature (3-5 ° C) in the first 38,5-39,5 days of life, excessive wrapping of the child, as well as insufficient breastfeeding, heating an increase in body temperature as a result of metabolic disorders as a result of lying down. If the causes of transient disruption of heat exchange in infants are eliminated, these conditions will pass easily.
Transient changes in renal function
Early neonatal oliguria is observed in the first 3 days of life of all healthy infants, which is due to the lack of fluid in the body and the peculiarities of blood circulation. The amount of urine excreted on the first day is about 0,75 - 1ml / kg per hour, then 2-5 ml / kg per hour. This condition is a compensatory-adaptive reaction of newborns.
Physiological proteinuria (albuminuria) is observed in all infants in the first days of life. This is due to the increased permeability of the balls and tubes.
Urinary acid infarction of the kidneys occurs at the end of the first week of a child's life. In this case, uric acid in the form of crystals accumulates in the cavity of the collecting ducts of the kidneys, resulting in discoloration of the urine, turbidity, and a yellow-brick stain on the diaper that surrounds the child. This condition does not require special treatment, but care should be taken to ensure that the baby is adequately breastfed.
Sexual crises
Sexual crises are observed in 65-70% of infants.
Physiological mastopathy - enlargement of the mammary glands occurs in 3-4 days after birth, reaches its maximum in 7-8 days of life, then gradually decreases and returns to its original state by the end of the neonatal period. In most cases, when such an enlarged gland is pressed, a milky liquid is released.
Metroragy. In 5-7 days of life of girls sometimes (in 5-10% of cases) for 1-2 days there is a rare (0,5-1,0 ml) bleeding from the external genitalia.
The rash (spindle) rises slightly above the skin surface and is located mainly on the nostrils, forehead and chin, and in some cases on the entire body skin
Physiological jaundice in infants
The cause of physiological jaundice in infants is a direct increase in bilirubin in the blood in all infants in the first 2-3 days of life, and in 60-70% of cases it leads to marked jaundice.
Yellowing of the skin and mucous membranes occurs in 2-3 days of life, the amount of unbound (unconjugated) bilirubin is 51-60 μmol / l in premature infants and 85-103 μmol in premature infants. / l increases
The maximum amount of bilirubin in the blood is 130-170 μmol / l.
Transient (transient) decrease in body weight
Transient weight loss occurs in 3-4 days of a child's life, ranging from 8% to 10%. Typically, such weight loss does not exceed 6%. Physiological weight loss in premature infants is 12-14%.
Physiological weight loss is divided into 3 levels:
Grade 1 - less than 6% weight loss does not show signs of dehydration, but it is possible to feel the baby sucking greedily
Grade 2 - with a decrease in body weight by 6-10%. Symptoms: redness of the mucous membranes, impaired recovery of skin folds, the child cries with the same sound, palpitations and shortness of breath
Grade 3 - with a decrease in body weight by more than 10%, with symptoms of thirst: dryness of the skin and mucous membranes, sinking of a large larynx, irritability, severe tachycardia, cold hands and feet.
Transient conditions of the skin
Normal erythema is a reddening of the skin 2 days after birth. This condition usually disappears by the end of the first week of a child's life. Physiological erythema persists for a relatively long time (up to 2-3 weeks) in premature infants and children with maternal diabetes mellitus.
Physiological itching of the skin occurs on days 3-5 of a child's life and is mainly observed in the chest and abdomen. This condition can be more severe if the baby is born prematurely.
Congenital edema is caused by a blockage of blood in a vein in the same place where the baby was born.
Toxic erythema - an allergic reaction that manifests itself as red spots on the skin, sometimes in the center of which may be nodules or blisters. This condition occurs in 20-25% of infants and occurs in 2-5 days of a child's life. These spots are most often located around the joints, in the buttocks, in front of the chest.
