Moderator: Hello, everybody, here is the interview between Sohu health, I'm your host plateau, in order to allow more children to healthy growth, Sohu Health and Pediatrics Peking University First Hospital, jointly launched a series of interviews with experts in childhood diseases, today is the series of interviews fifth, how to detect development status of newborns. Our guest today is invited to Peking University First Hospital, Yuzawa in the pediatric director of father and mother asked him to answer all their questions about newborn development. Please Tangzhu Ren and say hello to our friends now.
Yuzawa in: netizens Good afternoon, I was in Peking University Hospital of Pediatrics Yuzawa, today I am fortunate enough to chat with netizens on the neonatal development issues.
much less considered newborn children?
Moderator: Firstly, please Tang Zhuren to us about, what is the newborn, that is the first day of the baby from birth to be considered within a few months after birth, newborns do it?
Yuzawa in: neonatal time frame is very short, the medical provisions of looking after a child is born the moment off until 28 days after birth is around the time, later called the baby the first year, in fact, with the newborn baby is a continuation of the process, All problems have a continuous development.
newborn Development Index which
Moderator: around 28 days or less be regarded as the newborn stage. this stage physical development of children is usually what indicators?
Yuzawa in : general measure of physical development in several ways, such as his weight, and the second is his height, and head circumference, chest and so on physical aspects. a normal full-term infants born in the average weight of about 3 kg, our home in 95 years there have been large sample survey, the average weight of urban children at 3400 grams, born after at least 35 cm in length, full-term newborn head circumference of 34 centimeters, from these can be seen that the nutritional status during pregnancy how to ten months, including the bones also brain development, so as to measure the evaluation of the child's development status.
neonatal neurological and intellectual development and change
Host: New Life In addition to physical development of children than there are neurological and cognitive changes, specifically what?
Yuzawa in: In the past thought that newborns also ate and slept and cried, as if there is no communication with adults, in fact, so many years by the recent observation, there are some very angry neonatal behavior. From the intellectual point of view already has the ability to exchange with the adults, such as our state of the newborn is usually divided into deep sleep, light sleep, state of consciousness, awareness and sub- stability awakening, activity awareness, etc., the last state of the crying. in a quiet state of awakening the child to do this, it was discovered that he has a special act of anger, such as we adopt a child, the parents face to the child, he was talking to you will be staring at you, even when your child to the side of the crooked crooked to the side with you, that visual development is very good, but also to hear parents tell him. If a parent to give him a sound stimulus, he will find the source of the sound the first will be twisted to one side.
If a child crying, we while she took his hands, a hand or two hands, it is not on the belly bulge gently rubbing him, and he can be very fast quiet, he has a communication ability to understand other people's comfort. From the point of view, is not just physical development, as well as neurobehavioral capacity. clinical evaluation tools which also has a newborn neuropsychological rating scale, this quantity form is widely used in clinical, a total of 20 projects, if it is a normal full-term newborns should score 37 points or more, less than 37 points may be prompted to have some problems.
Hospital will make a volume of newborn Table
Moderator: This scale is equal to the time of birth in the hospital to do the measuring?
Yuzawa in: Yes. usually the case, the scale more of our children is a disease mentioned normal children can do the same, the scale promotion in the country about ten years or so.
criterion of normal child development
Moderator: You mentioned that scale, which newborns from landing means by which time we doctors to determine the normal development of the child do now?
Yuzawa in: We usually look at the development of the child look at the situation in general, whether in quantity, length is enough, waist size is appropriate, in addition to those of outside the state will look at different ability to respond to him how, as mentioned earlier, listening, comfort, communication and so on. Some kids despite the development of good physical development of standard requirements, but can see that the child , the normal newborn the next day on the first day about 20 hours sleep, woke up every three to four hours over the need to play with while feeding and then sleep. If the child sleep too long or too short it may have prompted some problems. From these perspectives can be seen a child's developmental problems.
parents how to determine whether the child developed normally
Moderator: General newborns in the hospital stay up to three to five days, after a period of time we Parents brought the baby home to care, this time the parents how to determine whether the child developing normally? are we going to the hospital for checkups on a regular basis like?
Yuzawa in: the state 42 days after birth there is a follow-up, if After the birth of a child have a disease state, from obstetrics to pediatrics, the usually let the children come back week after discharge follow-up, take a look at how to restore disease status, such as children and half weeks is about the development status of normal newborn, evaluation After the judge finished the child is not normal, take a look at the growth rate of weight infants, and so the situation there.
child's development there are several very key things, one month, three months, six months, these months is the development of child development, symbolic phenomenon. according to the full moon to full moon, like children, this is a critical developmental signs. three-month-motor development, the child looked very good lift, motor development proved her children well. to six months, there will be other children in addition to turning a very standard action is to sit up and development of such children should be said that very well. There are also adaptive development, etc., the parents how to get attention?
information is now developed, I said the development of evaluation index, which age what kind of development that occurs, these indicators easy to find online have them. All the children of Beijing have a manual filing of birth, a child development behind the Screen , so that professionals call the Denver Children's screening form, a list of some stage of the child should know what things should be, parents can control to judge. If you think that children can keep up with the basic is normal, if that there are problems, to the hospital to consult.
neonatal prevention of common diseases Moderator: Just now you mentioned that there will be some common neonatal diseases, such as jaundice, conjunctivitis, how to prevent?
Yuzawa in : Neonatal jaundice is very common, especially in recent years the phenomenon of breastfeeding is particularly common in newborn babies jaundice is mainly not the same as their metabolic characteristics, the case of adult disease can be jaundice, newborns have a physiological jaundice. because the newborn the blood are not the same with adults, hemoglobin is relatively high, more red pigment, which is a low stomach environment damaged red blood cell metabolism, jaundice is coming from the damaged red blood cells, together with the liver itself, there Some enzymes, jaundice phenomenon that can not handle.
not especially afraid of physiological jaundice, jaundice is normally lower source of about two or three days there, if premature inappropriate. early appearance of jaundice within 24 hours may not the peak period is about five days to a week. If the time is dissipated under normal circumstances is a term, then two weeks should step down, not the same as premature children may be three to four weeks a month to step down soon close. met the clinical A formula-fed children the laws of almost all the same.
If you are breastfeeding a child may be superimposed on the basis of Health and jaundice breast milk jaundice in the process, fade time delay. breastmilk jaundice may be extended by one month or month and a half, Also see the two months before the clinical remission.
how to determine the child's normal or abnormal jaundice is very important, certainly not too early jaundice. jaundice have a limited degree, in general, which we measured blood levels of cholesterol , term not exceeding 12 milligrams, more than this figure may not.
at home, how do you know how much cholesterol in the blood? which can be judged from the naked eye, if the jaundice go beyond the elbow and knee, usually first appears in the facial , then the trunk, if more than Zhouxi jaundice, then, can that is 15 mg or more. jaundice should be back two weeks to two weeks after the rebate, even if the breast milk jaundice is a disease of the back when the rebate is not on . to a couple of weeks back, but three to four weeks later there, so parents should pay attention to some of jaundice, not at home, should go to the hospital to see.
breast milk for the children will not have significant impact, just a kinds of phenomena, how to distinguish? through some simple ways that they have such a child usually does not affect the feeding, growth and development is very good, the long and gained weight, had normal sleep-wake cycle and so on. If you see such a conditions, then you can stop breastfeeding a few days, usually three days or five days, try to switch to formula. jaundice significantly reduced if the child proved to be breast milk jaundice, breast milk can then eat.
pathological jaundice What is the impact on children
Moderator: pathological jaundice have any effect on the children?
Yuzawa in: There will be affected, especially newborn brain confined, high permeability, usually within a week, blood and brain structure called a peace between the wars, the blood can not be in direct contact with brain tissue, nutrients can go to, toxic substances can not go. cerebellar development of the child is not mature enough, these substances do not pass over. jaundice greatest impact for children the nervous system, generally greater risk of the first three days, over a week later to a smaller risk.
we bilirubin in the blood if the above is probably more than 18 mg of bilirubin encephalopathy, of the consequences after brain injury really occurred if the very serious consequences of bilirubin encephalopathy, early ventilation may cause, if the child will have some consequences Teng survive, this legacy is mental retardation, one with cerebral palsy, and the third one is hearing and vision barriers, as well as dental abnormalities. These four consequences are very terrible, high bilirubin So the children have some disadvantages.
we often encountered in clinical practice, some parents misunderstanding, that what the child but not jaundice, a few days just fine, except that part which corresponds with the biological children of Phase pathological children, doctors need to pay attention to him, this is a way to get through the treatment of jaundice in early down as soon as possible, do not let it go inside the brain. according to current medical standards, especially the domestic level in Beijing is very rare occurrence of bilirubin encephalopathy, because of our attention to it.
neonatal conjunctivitis, pneumonia, what performance? < br> Moderator: In addition to neonatal jaundice, the newborn conjunctivitis, pneumonia, what performance?
Yuzawa in: the performance of neonatal conjunctivitis in the eyes of the main problem is likely to have a discharge, mostly purulent secretions, purulent discharge in accordance with the eyes and said Beijing is called angry, in fact, is the infection is an inflammation of the performance. usually causes the disease caused by a Staphylococcus, usually the surface of parasites in normal skin staphylococci, the second pathogen is Chlamydia, which is relatively common.
Chlamydia can live inside the mother's reproductive tract, vaginal delivery of the child if there is such a possibility. conjunctivitis there is a very heavy, for special the production of child mothers, mothers with high risk of Neisseria gonorrhoeae, the child's conjunctivitis is very important, for such children to take to do bacteriological examination of secretions, so that if the disease should be actively treated. conjunctivitis in general can use eyedrops solve the problem, but the conjunctivitis after a long time, some children will be secondary to dacryocystitis dacryocystitis a lot of trouble, if the inflammation of the lacrimal sac.
that there will be always a child in tears, always in tears of. If found to have conjunctivitis, a relatively long time, not easy to well, there are tears situation, so be sure to go and see the children. Our pediatric ophthalmology hospital, if there is to do something special treatment dacryocystitis.
newborn pneumonia, said it is a big name, speaking topics are more general, there are two broad categories. a large class of infection caused by inflammation, another type of early neonatal birth process due to absorption caused by mother's amniotic fluid, etc. The. inhaled pneumonia, amniotic fluid aspiration pneumonia, the child before birth is no obvious movement, but amniotic fluid throughput, if stimulated under certain circumstances, to let him out, such as the phenomenon of hypoxia occurs, it will stimulate his own Respiratory formed after the formation of spontaneous breathing in amniotic fluid of the lungs, there are many things into it. This is the first one. Second, the process of birth, or the period after the birth of the first step is to get his attention set up breathing, the breathing create a good After the child very well, if the establishment is not good there is some breathing problems. The first step to establish breathing thing which clean up the respiratory tract, the respiratory tract have not had time to clean up if these things should inhaled into the lungs. the mother's amniotic fluid is a child row out meconium, amniotic fluid will be sucked into this more deeply. in the stomach inside the state of hypoxia may have pneumonia, or improper handling of the child born may have pneumonia. infection pneumonia usually has a relationship with my mother, our gut Road is not sterile, there are some probiotics, there are some pathogenic bacteria, these bacteria are not pathogenic for the mother is not obvious clinical manifestations. If these bacteria into the uterine cavity is for the children affected, broken amniotic membranes early burst, so that the bacteria may enter the vagina child's body. there are still some mother of the child with fever, some children demonstrated that some children do not show it. the mother has done that time in the previous vaginal examination revealed some special bacteria and other parasites such as pneumonia after the baby is born susceptible, resistance is generally poor children, premature children are relatively weaker development of the immune system that some of the children, so that external internal together, this part of the kids are prone to pneumonia.
premature and normal newborn children other developmental What are the differences?
Moderator: You mentioned pneumonia in preterm children need attention, then the development of premature and normal newborns of other children What are the differences?
Yuzawa in: so many different , one sentence, the development of premature children are not very different systems mature, the children born before 37 weeks, called premature children, preterm children were subdivided into categories, children born before 37 weeks is generally less than 2,500 grams of weight and even some children less 1500 grams, so that very low birth weight children is called child, and even children born under 1,000 grams. weight the smaller the child the more his problem, the more mature development.
we are most concerned about children brain development, premature children have a few special children's brain disease, one is bleeding inside the brain, premature children to what extent the immature brain? human brain between the two hemispheres of the brain dead some cavity system, the brain The cells are brain dead from the next set of hair out of the house and extend the growth migration, most of the hair growth is very, very fine integration of very, very thin, especially in children born before 34 weeks, these vessels are very rich, even a child is crying or give him some stimulation may cause the blood vessels rupture, causing bleeding in this place easily. to discuss some of the bleeding may not be something big, for fear that is relatively heavy, and even the bleeding inside the brain dead. It is obvious brain problems premature children.
another brain development in preterm children is very rich in some places, the blood vessels in some areas and very weak, where weak blood vessel development more likely to cause ischemia, deep in the brain next to brain death, and if blood pressure Once the low to ischemia, most of the brain where nerve fibers. These places may affect a child's motor development in the future.
lungs and eyes, premature children are also more critical issue is inevitable after the birth of a premature child respiratory problems, need artificial oxygen, and some kids even need the breathing machine. preterm children themselves immature retinal blood vessels, and if to give him a long time to improve a little, resulting in disorganized growth of blood vessels, these vessels also degenerate out chaotic, blood vessels contraction of the worst of the back of the eye after the retina detached from the retina out of the serious consequences of this blindness caused by a child in the future. aware of the problem for us to do newborns is very concerned about the people working these issues, if the child is a newborn early History of oxygen at birth, usually over a period of time for check-ups, because this disease is not such a disease, there is a process of development, different stages of finding it. usually in 37 patients before treatment of the problems identified will be retained by sight, over the 37 possible decreased visual acuity, this is a very important issue.
there is a lung problem, the Ministry of the lung tissue as the normal full-term children we alveolar development of a good organ, the relative immaturity of his side later lung development. response to immature lungs, the child prone to hyaline disease, lack of surfactant, the lungs can be stabilized the lung open, if not the substance, not the lung to breathe air, these problems can prevent or even human to Some surface-active substances, with the scientific development of these problems are not a challenge. The real challenge is on a breathing machine a child susceptible to inflammation, so that the child's lungs are not normal lung, prone to pulmonary fibrosis, lung disease.
there are feeding problems in preterm children, feeding both the digestive system problems, including the entire problem of child growth and development. nutrition can not keep up with the organs long for premature child nutrition is a lot of knowledge, is relatively professional.
Moderator: The development characteristics of premature children, or special needs our attention.
Yuzawa in: usually premature children hospitalized after a doctor said we had ten such children need to pass, after a ten off premature children to go home to mother, possible only after a healthy body.
What causes neonatal vomiting?
users: there is often spits up after birth, neonatal What causes vomiting?
Yuzawa in : neonatal causes vomiting mainly two types one is the functional one is organic, functional neonatal vomiting, such as the first day of the second day, especially after the first day of feeding the child spits up, we always feed him some irritating things in the mother's amniotic fluid inside the blood of the mother swallow intestinal mucus inside, nausea and spit out the gastric mucosa, for such children are usually diluted with some saline or sodium bicarbonate to him after a stomach wash, after washing do not spit. This is the case for episodic vomiting.
addition in some cases the relationship because of their development status, newborn's stomach and relatively shallow, horizontal prone to vomiting, stomach ���� phenomenon. stomach and Comparison between esophageal sphincter relaxation, this situation can easily lead to vomiting. This situation is generally not very serious vomiting, usually after feeding the legs if the child so hard mounted the pedal to overflow from the child's mouth, it is overflow milk, but not really vomiting reflux, which is a pathological state, adults also.
a child old repeated vomiting, can affect nutritional status, the most worrying is that spits out milk and then into the lungs easily inside. in clinical disease, there is a sudden death, if the child spits the phenomenon I suggest that parents do not imprudent. The other is the digestive tract abnormalities, newborn baby with the big spit spit spit not the same as with adults, newborn born just spit development of the gastrointestinal tract may have some abnormalities in the esophagus from the beginning has been to export any part of the anus is possible malformations, deformities a child's vomiting is not normal, even if the spit is a more powerful spray of spit, spit, when accompanied by a belly bulge or not to defecation, the disease may have potential in it, the doctor must specifically look at. just said ���� general problem, parents should pay attention to care, mainly to prevent choking of milk to the child, the child appropriate to lift the upper body a little higher or right lateral feed, side feed, then choking back again to avoid milk.
matter how the child vomit foam
friends: the child was born 24 days, there are foam vomit, how is it?
Yuzawa: If the child had a fever or poor feeding or mental process of cough, difficult breathing children, normal breathing is 30m50 time around newborns, if the child is always breathing in the fifty or sixty times, or around the mouth and nose blue, if there is such a phenomenon combined with Momo spit, see if there is respiratory tract infection. If you find such a situation, advising parents to see, let the doctor listen to, some children need chest X-ray film.
User: Birth 37 days, more and more severe jaundice does not retire, according to hospital doctors want Blu-ray, fearing side effects too, worry about your baby uncomfortable, there is no other way to treat?
Yuzawa in: 37 days of jaundice does not fade is certainly not normal, should the two retire later than four weeks later, no rebate is certainly not normal. For such a child to figure out why, according to Blu-ray is no longer required 37 days, according to Blu-ray is a child within a week, then less than two weeks later the child according to the Blue light, blue light is very effective for early neonatal, late neonatal is not necessarily the preferred approach. the child's growth and development of how, stool color, urine color is not a special exception, some children may need to test liver function, If you clearly understand what the cause, illness treatment. If breastfeeding, stop breastfeeding observation, for a month or two children in addition to breast milk jaundice jaundice may be other reasons, the most common is the liver or biliary reasons, these diseases necessary for treatment. There are some drugs, but these drugs temporary solution, you can eat some Chinese medicine, there are oral drugs or adsorption of bilirubin Smecta, etc., these drugs are treating the symptoms not the root of the problem, and not so immediate. or should go to the hospital to check the cause.
users: 35 days boy, born 6 pounds, the full moon's not a lot of the Inspector General, jaundice does not retreat. and now found to have bronchial inflammation, such children usually should be how to prevention?
Yuzawa in: jaundice that no particular way to prevent, but if it is bronchitis usually is the case of two factors, the child itself, the problem is still resistance to external factors, prevention, then the child inside the month of resistance is indeed power is poor, but the Chinese custom of the full moon after the child has a lot of friends and family see the child, this is a very bad phenomenon. grown on the surface normal, in fact, we will carry with them a certain amount of bacteria, these bacteria In the process of children's exposure to even touch some people feel that their kids amiable hand, touch the child's face, try to avoid this situation. confinement time is usually very strict to close the window, indoor air circulation is not good enough, the air likely to have poor circulation of the breeding of bacteria. I suggest that the ventilation window on a regular basis every day, winter weather is dry to wet. so much of the child has no way to improve the resistance? has not yet.
users: more than three years old boy the right testis in the scrotum, similar to the left scrotal testis can be seen above the groin.
Yuzawa in: testes inside the abdominal cavity with the development of the first transitional gradually into the scrotum, it is likely the child left testis decreased in the transitional process that kind of illness is called Yin testis, toddler down and certainly not if the testicle is not normal, just a few days of the child being born without testicles drop down is normal. overcast testis is best to move the normal operation position of the testes in the groin This place is prone to injury, the local temperature of the groin and scrotum is not the same temperature, the temperature of the scrotum is still relatively low, this child should be reading to children after surgery for surgical hospital.
users: 30 days baby, nose or a little yellow on the spot, his face did not, this is not normal?
Yuzawa in: the little yellow dot on the tip of the nose is not jaundice, medical terminology is called epithelial pearl, not a pathological phenomenon, basically after the birth of all children There is secreted by the subcutaneous fat accumulation in the skin, a phenomenon not control, will naturally fade slowly with less.
friends: I have heard too early to put up to hold the baby will affect the cervical spine, should be a few months after vertically hold?
Yuzawa in: cervical part of the development is the earliest, often large motor development laws from top to bottom, usually about two months a child has begun trying to rise the awareness of the basic two and a half to lift the better, about three months should be said that very well. The so-called very good hand is lifted after the upper body to lift, take the little hands in front of insisted. If a child three months the situation looked very good in this before the need to give him some training, it should be two and a half later you can try to hold on end. but the time not too long, as the months of increases, lengthwise hold appropriate reduction.
friends: three and a half He now holds that every time your head will shake vertically.
Yuzawa in: This is doing exactly the opposite, and it stands to reason that a child holding three and a half should be very stable in the head, if the instability that this legislation lack of training, should be more to do to do such a thing. vertically have a number of methodological issues, the traditional way to get children to hold face to face, so have a problem, the head is hanging in there, as a way to hold for . Baby Face dashed forward, his head leaning against the mother's chest, one hand under the child's buttocks, arm round the child's chest, and will not shake the very powerful head of the child.
Moderator: Other problem is the first year of baby's nutrition, experts can help users to answer under the net. We end this interview today, thanks to Tang Zhuren Sohu Health Interview guest rooms, giving users so many questions answered.
Yuzawa in: Thank you, Moderator, Thank you friends.
how to monitor the situation and development of newborns?
baby is born, the family are very happy, but also very worried that the baby can be perfectly healthy to grow? Dad Dad Moms know how the baby is developing good? Sohu specially invited to the North pediatric health experts, tells you how in life conditions to monitor the development of newborns.
Special Note: If you have any questions later in the log comments made, experts will answer it.
Interview Time: 2008.06.05 15:00-16:00
interview guests:
Yuzawa Pediatrics Peking University First Hospital in the newborn, deputy director of professional Dr
1992 was awarded medical degree, received his medical degree in 1999, received his MD in 2005, the main clinical expertise critical neonatal intensive rescue, such as neonatal and infant respiratory disease and interventional bronchoscopy after inspection treatment, HIE's mild hypothermia, premature children hydrocephalus after intracranial hemorrhage and bleeding in the treatment, and treatment of severe jaundice and exchange transfusion.
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