Fitness and healthy lifestyle 

Newborn. Physiological catarrh of the skin of newborns

A newborn is a child from the moment of birth to 3-4 weeks of life.

The body length of a healthy full-term baby at birth is on average 48-52 cm (from 45 to 56 cm). Its body weight is on average 3200-3300 g (from 2500 to 6000 g). The length of the body is a more constant value and rather reflects the degree of development of the newborn.

Morphological and functional signs of a full-term newborn: a loud cry, pink skin color, satisfactory muscles, active movements, a well-defined sucking reflex, regular breathing, loud, rhythmic, head circumference is 1-2 cm larger than the circumference of the chest, bones are dense, large and open in some small fontanelles, on the head 2-3 cm long, protrude beyond the edges of the fingers, in boys the testicles are lowered into the scrotum, in girls the small labia are covered with large ones. To determine the full-term newborn, it is necessary to take into account the duration of pregnancy.

From the moment of birth (the neonatal period), the formation of the functions of all organs and systems occurs, the adaptation of the newborn to an independent extrauterine life. During this period, regular breathing appears, blood circulation is restructured, the umbilical wound heals, a gradual increase in activity and consumption of breast milk, adaptation of the skin to the external environment, formation, etc.

The newborn has so-called special conditions. These include a birth tumor, physiological catarrh of the skin, physiological jaundice, physiological weight loss, hormonal sexual crisis, transient fever.

birth tumor occurs on the presenting part during childbirth as a result of serous impregnation of soft tissues due to stagnation of lymph and blood with the formation of small hemorrhages. More often, the birth tumor is located in the region of the crown and occiput (see Kefalhematoma); it can be on the face, buttocks, limbs and genitals. Usually, in the next 2-3 days, the birth tumor disappears and does not require special therapeutic measures. With a large birth tumor, cold is indicated (an ice pack at a distance of 20 cm from the child's head) in the first 2 hours and antihemorrhagic treatment: inside 5% chloride solution, 5 ml 4 times a day, 0.02 g and vikasol 0.002 g 2 times per day for three days.

Physiological catarrh of the skin characterized by redness of the skin (erythema) as a result of the transition of the fetus to a dry air environment.

hormonal sex crisis observed in newborns due to the transition of estrogen hormones from the mother to the fetus through and with milk. It occurs in 0.7% of cases and is expressed in girls by swelling of the mammary glands in combination with swelling of the labia majora and sometimes bloody-mucous discharge from the genital slit, in boys - swelling of the scrotum. It appears on the 2-5th day of life, the maximum increase in the mammary glands occurs on the 8-10th day and disappears on the 2-3rd week of life. Breast enlargement does not require treatment. However, if the child is worried, the skin over the gland can be smeared with 2% iodine tincture or camphor oil and a light cotton bandage can be applied to reduce friction with clothing. During this period, when infected, its inflammation (mastitis) can develop, often with subsequent suppuration. Clinical manifestations of mastitis: hyperemia of the skin of the mammary gland, an increase in the size of the gland, an increase in body temperature, soreness and swelling of the axillary lymph nodes and the gland itself. Initially, treatment can be conservative: ointment bandages, dry heat, antibiotics. In cases where a softening area appears, a radial 1-1.5 cm long is produced above the softening area. The wound heals on the 7-8th day.

transient fever occurs in 0.5-17% of cases and is manifested by a sudden increase in body temperature to 38-40 °, not associated with overheating or illness of the newborn. It is observed on the 3-4th day of life and lasts more often for several hours. Usually, an increase in temperature coincides with the moment of the greatest physiological weight loss of the newborn. With proper feeding and sufficient fluid intake, fever is rarely observed.

Transient fever can sometimes be difficult to distinguish from fever associated with any disease if it lasts more than 1-2 days or occurs repeatedly. Transient fever does not noticeably affect the general condition of the newborn and does not require medical treatment. It is necessary to give them more to drink - boiled water, 5% glucose solution, isotonic sodium chloride solution at the rate of 80-100 ml per 1 kg of body weight per day, ensure proper care, eliminate the possibility of overheating, provide the child with the necessary amount of breast milk.


Rice. 1 and 2. Scheme of circulatory changes occurring at birth.
Rice. 1. Diagram of the fetal circulation.
Rice. 2. Scheme of blood circulation of a newborn. 1 - aa. carotides communes; 2-vv. jugulares int.; 3-v. brachiocephalica sin.; 4 - arcus aortae; 5 - ductus arteriosus; 5 "- lig. arteriosum; 6 - truncus pulinonalis; 7 - atrium sin.; 8 - arteries and veins of the upper limb; 9 - ventriculus sin.; 10 - pulmo sin.; 11 - aorta abdominalis; 12 - lien; 13 - ren sin.; 14 - v. cava inf.; 15 - r. iliaca communis sin.; 16 - v. iliaca communis sin.; 17 - a. iliaca int.; 18 - arteries and veins of the lower limb; 19 - placenta; 20 - vessels of the umbilical cord; 21 - aa. umbilicales; 21 "- liggurabilicalia lat.; 22-anulus umbilicalis; 23 - gastrointestinal tract and its vessels; 24-v. portae; 25 - hepar; 26-v. umbilicalis; 26-lig. teres hepatis; 27 - ductus venosus; 27 "- lig. venosum; 28 - v. hepatica; 29 - ventriculus dext.; 30 - atrium dext.; 31 - foramen ovale; 31" - fossa ovalis (septum interatriale); 32-v. cava sup.; 33-v. brachiocephalica dext.


During the neonatal period, which lasts 28 days, there is a significant restructuring in the body of the child. Some organs and systems were already functioning in utero. The heart, endocrine glands, kidneys, and even the digestive system (as early as the 14th week, the fetus begins to swallow amniotic fluid, digest them, which then turns them into the original feces - meconium). Others, like the lungs, which begin to work only after birth, and the cardiovascular system dramatically changes its work due to the inclusion of the pulmonary circulation. The child from the endogenous method of nutrition, obtaining oxygen and liberation from metabolic products, passes to an autonomous endogenous method of nutrition, respiration and excretion. Therefore, during the neonatal period, some physiological features are noted.

From the fact that the load on the kidneys increases sharply, since the newborn must independently excrete waste products - the mother will no longer help him here, the newborn may experience urinary crisis. This is the physiological state of the newborn, and is characterized by a high specific gravity of urine (urine is very concentrated), so that even sandy crystals can precipitate. This usually occurs on the 2-5th day from birth and is associated with a large release of uric acid salts, which stain the sediment in the urine in a reddish color.

In addition to a urinary crisis, lack of fluid can also cause transient fever. It is characterized by an increase in temperature, sometimes up to 40 ° C, anxiety of the child and even convulsions. The child just needs to be soldered.

One of the physiological states of the neonatal period is physiological weight loss. Normally, it should not exceed 5-7% of the newborn's body weight, and if the weight of a full-term baby is normally 3000-3200, then in the first 3 days the baby loses 200-250 g of weight. This is due to the fact that the first 3 days of life, the intestines of a newborn are freed from meconium - the original feces (meconium is a dark brown, odorless, viscous mass formed from the secretions of the digestive tract, epithelium and amniotic fluid during five months of intrauterine development) . And since the first food of a newborn - colostrum - is very concentrated and in very small quantities (from a few drops to five milliliters), it basically replenishes energy costs. And only with the advent of transitional milk, the newborn restores its original weight, subject to the presence of physiological maturity. And this usually happens by the 5-7th day from birth.

The next feature of the neonatal period is physiological jaundice, it occurs in 40-45% of physiologically mature newborns (in premature babies, jaundice is mandatory, and it lasts up to 3-4 weeks). This is due to the fact that in the liver there is an intensive restructuring of fetal (fetal) hemoglobin, which was necessary for the fetus for oxygen exchange through the placenta, to mature hemoglobin, which is used for gas exchange in the lungs. Jaundice, as a rule, is not very pronounced - it is a slight icteric staining of the skin, mucous membranes, and sclera of the eyes. It appears on the 2-3rd day of life and usually lasts 7-10 days. She does not require any treatment. Give more water to the child, if the weather is sunny, keep the child in the sun for five to seven minutes. Ultraviolet helps remove bilirubin, which turns the skin yellow (sunlight is effective, it passes through clean glass, although 60% of ultraviolet is retained by glass). But if the baby seems too yellow to you in good light. If the palms and soles of the child's feet are yellow, the child is lethargic and does not eat well, or the temperature has risen, you should consult a doctor.

Need to know about sexual crises. In recent years, they have been found in almost all newborns, and this is due to a gross interference in the hormonal background of the woman in labor. Maternal hormones enter the blood of the baby during childbirth and later with mother's milk, causing intense breast engorgement in both boys and girls, sometimes with milk-like drops from the nipples. In addition, girls may experience bloody discharge from the genital slit, and boys may experience swelling of the scrotum. This usually occurs in the first days of life and ends by the 8-10th day. You can not press on the mammary glands, massage them, and even more so try to express drops of liquid from the nipples. Any manipulations with the mammary glands in infants are dangerous because they can lead to the development of mastitis in newborns, and this is a very serious disease and can only be treated surgically. To make you calm, just make a pad of cotton and gauze and put it on the mammary glands under the baby's vest. With vaginal discharge, the girl should be washed with a light pink, cool solution of potassium permanganate from front to back.

A newborn baby's skin is coated with a lubricant at birth, which helps it pass through the birth canal more easily and protects it from bacteria. Gradually, the lubricant is washed off, and you can see in the newborn physiological catarrh of the skin. This is redness of the skin with a slight bluish tinge. It occurs due to a significant expansion of the skin capillaries, more often on the feet and hands, and lasts from several hours to 3-4 days, followed by peeling. In the old days they said: "The baby is blooming."

Often in newborns there is blockage of sebaceous and sweat glands in the form of white seals the size of millet - on the nose, on the forehead and, less often, on the cheeks. They rise slightly above the level of the skin, without causing any discomfort to the baby. In children with ancestors of the Mongoloid race, more often in the region of the sacrum there is a gray-cyanotic spot that does not protrude above the surface of the skin, a spot of "Mongoloidness", which disappears with age. Telangiectasias are somewhat less common - expansion of skin capillaries, remnants of embryonic vessels. Usually they have the appearance of red or slightly bluish spots of irregular shape and size with a clear border from the surrounding normal skin. When pressed, they turn pale, but then the color is restored. More often they are located on the upper eyelids, on the back of the head, on the forehead, on the border of the scalp. By the year, these spots turn pale, by 3-5 years they disappear, more often without medical intervention. People call them "birth marks".

Often in the first days of newborns, whitish nodules appear all over the body in the thickness of the skin, surrounded by a red rim. This toxic erythema, it resembles traces of nettle burns. After two days, he disappears without a trace. The skin of the child takes a great part not only in thermoregulation, but also in gas exchange. Up to 70% of metabolic products are excreted through the skin, and therefore it is so important that it be clean and healthy. Considering that the subcutaneous fat in infants has a special structure - there are few connective tissue partitions in it, and it has a very good blood supply, in connection with this, any inflammatory process of the skin very quickly passes to the underlying tissues, and this requires especially careful care of the skin of the newborn . The child must be washed, bathed, swim with him - every day. Make sure that diaper rash does not occur - they are an indicator that the child is overheating, or may be the first symptom of exudative-catarrhal diathesis. In this case, the mother needs to keep a food diary in order to identify the foods that cause diaper rash, and treat the places of diaper rash (usually the neck folds, armpits, inguinal folds) with either olive oil or potato starch. But in no case do not combine one with the other, and most importantly - do not overheat the child.

Transient intestinal catarrh(physiological dyspepsia of the newborn, transitional catarrh of the intestine) is a peculiar stool disorder observed in all newborns in the middle of the first week of life. During the first or second (less often up to the third) day, meconium leaves the intestines of the child - the so-called. original cal. Meconium is a viscous, thick, dark green, almost black mass. Later, the stool becomes more frequent, inhomogeneous both in consistency (lumps, mucus, liquid part can be seen) and in color (areas of dark green color alternate with greenish, yellow and even whitish). Often the stool becomes more watery, resulting in a water spot around the feces on the diaper. Such a chair is called transitional, and the condition associated with its appearance, as you may have guessed, is a transitional intestinal catarrh. After 2-4 days, the stool becomes physiological - homogeneous in texture and color. Simply put, it acquires a mushy, yellow appearance with a sour-milk smell. It reduces the number of leukocytes, fatty acids, mucin (mucus) and tissue protein. The severity of transient catarrh varies from child to child. In some, the frequency of bowel movements reaches six or more times a day, the stool is very watery, in other babies the frequency is up to three times and the consistency is not much different from the usual.

Be that as it may, the transitional catarrh of the intestine is a physiological phenomenon and can only frighten the newly minted mothers and fathers, but not harm the child. Trying to influence the transitional catarrh of the intestine is an unjustified undertaking. You just need to wait a bit - when the baby more or less "learns" to use his digestive system, the stool will return to normal.

Transient dysbacteriosis- a transitional state that naturally develops in all newborns. The normal course of pregnancy allows the fetus to develop in sterile conditions. The birth of a child willy-nilly marks his transition to the world of microorganisms. It seems possible to fight back pathogenic, “foreign” microbes only thanks to the existence of the so-called autoflora - bacteria that naturally inhabit the human body in a physiological way.

From the moment a child is born, his skin and mucous membranes are inhabited by the flora of the mother's birth canal. Involuntary sources of additional introduction of microorganisms can be air, hands of medical staff, care items, mother's milk. At the same time, the primary bacterial flora of the intestines and skin, mucous membranes is represented not only by bifidobacteria, lactostreptococci and epidermal staphylococcus aureus, but also by opportunistic microbes: Escherichia coli with altered properties, Proteus, fungi, which in small quantities can also be natural companions of an adult.

Therefore, it is no secret that from the end of the first and the entire second week of life, pathogenic staphylococci can be isolated from the skin, nasal mucosa, pharynx, and feces in most absolutely healthy newborns, in half - enterobacteria with reduced enzymatic properties, Candida yeast-like fungi, and in every tenth child to detect Proteus and hemolytic enterobacteria. In the nasopharynx of newborns, Staphylococcus aureus, Escherichia, Klebsiella also often settle down. Transient dysbacteriosis is also facilitated by the fact that the barrier function of the skin and mucous membranes at the time of birth is less perfect in a number of indicators than in children of the second week of life. Only by the third week of the newborn in the intestines do bifidobacteria win their proper place.

In accordance with this, the so-called. phases of the primary bacterial colonization of the intestines of newborns. The first phase, which takes twenty hours from the moment of birth, is called aseptic, that is, sterile. The second phase, the growing infection, can last up to three to five days. At this time, colonization of the intestine by bifidobacteria, Escherichia coli, strepto- and staphylococci, fungi occurs. By the second week, the displacement of all other microorganisms by bifidoflora (transformation stage) should begin. From this moment on, various E. coli, sarcins and staphylococci, whether they like it or not, are obliged to understand - bifidobacteria becomes the queen of the microbial landscape.

It is well known that mother's milk is an important supplier of bifidoflora and inevitably leads to the displacement of pathogenic microorganisms or to a sharp decrease in their number.

They help to overcome transient dysbacteriosis and reaching 5.0 (or even 3.0!) Skin pH by the sixth day, and increasing acidity of gastric juice. Non-specific and specific factors of immune protection are actively synthesized, including local ones - on the skin, mucous membranes and in the intestinal wall.

Transient dysbacteriosis is a physiological phenomenon, but if hygienic care standards are not observed, artificial feeding, dysbacteriosis is delayed and can cause a child’s illness as a result of a layering of a secondary infection or activation of endogenous pathogenic flora.


Based on materials by I. Lazareva

Borderline (transient) conditions of newborns are symptoms caused by the adaptation of the body of the newborn and do not require special treatment. They pass by themselves by the end of the neonatal period (it lasts 28 days).

Transient hypothermia (decrease in body temperature). It occurs in the first 30 minutes after birth (by 0.3 ° C in 1 minute), and by 5-6 hours of life, the body temperature rises and a constant temperature is established. Late recovery of the body temperature lowered after birth indicates insufficient activity of the child's compensatory-adaptive reactions. In order to prevent hypothermia, the baby is immediately wrapped in a sterile heated diaper immediately after birth, gently blotted with it to prevent heat loss when amniotic fluid evaporates from the skin, placed on a heated table under a radiant heat source, and the air temperature in the delivery room is maintained at least 24 ° C .

Physiological weight loss. Occurs as a result of starvation (lack of milk and water) in the first days of life. The umbilical cord also dries up, the original feces (meconium) are released, as a result, body weight decreases. The maximum loss of initial body weight (MUMT) is usually observed on the 3rd-4th day. Under optimal conditions of feeding and nursing in healthy full-term newborns, MUMT does not exceed 6-10% (on average, babies lose no more than 300 g). Then a healthy child begins to gain weight from 10 to 50 g daily.

Transient features of kidney function. Early neonatal oliguria- urine output less than 15 ml/kg per day. This condition is observed in all healthy newborns in the first 3 days of life and is considered as a very important compensatory-adaptive reaction (in the first days of life, a child experiences a deficit in fluid intake due to unsteady nutrition, suffers large losses of fluid with breathing). At the same time, the number of urination does not change - it is about 20 times a day during the 1st month of life, however, in the first 3 days, the amount of urine during each urination is much less than in the following days. Despite this, when using disposable diapers, it is recommended to change them every 2-3 hours from the first hours of a child's life.

Proteinuria (presence of protein in the urine) occurs in all newborns of the first days of life. Due to proteinuria, urine may become somewhat cloudy, which is a consequence of increased permeability of the epithelium of the renal glomeruli and tubules.

Uric acid heart attack- deposition of uric acid in the form of crystals in the lumen of the collecting ducts of the kidneys. On the diapers, you can notice a brick-yellowish coloration, which is just a manifestation of a uric acid infarction. In newborns, there is an increased decay of some cells, especially blood cells (leukocytes), the decay products turn into uric acid crystals, which are deposited in the lumen of the collecting ducts of the kidneys and damage the wall - epithelium, hyaline and granular cylinders, leukocytes and itself appear in the urine. uric acid. All of them disappear by the 7-10th day of life without treatment.

Transient dysbacteriosis. This is a transitional state that develops in all newborns and is characterized by a violation of the composition of the microflora. With an uncomplicated course of pregnancy, the fetus is sterile, while extrauterine life takes place in the world of microorganisms, where the natural human flora is of great physiological importance. Already at the time of birth, the skin and mucous membranes of the child are inhabited by the flora of the mother's birth canal. Sources of infection can also be the hands of medical staff, air, care items, mother's milk. At the same time, the primary bacterial flora of the intestines and skin, mucous membranes is represented not only by such normal inhabitants as bifidobacteria, lactic streptococci, saprophytic staphylococcus, but also by conditionally pathogenic staphylococci, intestinal coli, proteus and pathogenic fungi. Transient dysbacteriosis is also facilitated by the fact that the barrier function of the skin and mucous membranes at the time of birth is less perfect in a number of indicators than in children at the end of the 1st week of life. That is why the newborn needs especially careful care; in addition, if possible, it is necessary to give preference to the joint stay of mother and baby in the maternity hospital, which contributes to the colonization of the skin and gastrointestinal tract of the newborn by mother's microorganisms.

Transient catarrh of the intestine (physiological dyspepsia of the newborn). This is a stool disorder that occurs in all newborns in the middle of the 1st week of life. Primordial feces (meconium) - a thick, viscous mass of dark green (olive) color, which is released, as a rule, only within 1-2, less often - 3 days. This is, in fact, what your baby swallowed while still in the stomach. Further, the stool becomes more frequent, inhomogeneous both in consistency (lumps, mucus, liquid part), and in color (areas of dark green color alternate with greenish, yellow and even whitish), more watery (water spot on the diaper around the stool) . Such a chair is called transitional, and the condition is called transitional catarrh of the intestine. Then the stool normalizes and when breastfeeding it will be yellow, with a sour smell. It may also contain a small amount of mucus and whitish lumps. With artificial feeding, the stool is more dense, with a pungent odor.

Toxic erythema of the newborn. This is a spotted pink rash with grayish-yellow seals in the center, which is most often located on the extensor surfaces of the limbs around the joints (on the elbows, knees, on small joints), on the chest. Appears on the 3-5th day after birth. Often it coincides with the moment of maximum weight loss. The well-being of the babies is not disturbed, the body temperature is normal. The reason is the entry into the blood of endotoxins of microorganisms, including opportunistic pathogens, which colonize the intestines of a newborn in the first days. These microorganisms secrete toxins that are absorbed from the intestines into the blood. After a few days, the normal flora itself displaces these microorganisms. More often, toxic erythema occurs in children with a hereditary predisposition to allergic skin lesions. Within 1-3 days, new rashes may appear, after 2-3 days the rash disappears. Treatment is usually not required, but with abundant toxic erythema, additional drinking is recommended, sometimes the doctor prescribes antihistamine (anti-allergic) drugs.

Peeling of the skin. Occurs on the 3-5th day of life, more often on the stomach, chest. Especially abundant peeling is observed in post-term children. This condition does not require treatment, however, it is better to lubricate the peeling areas after bathing with a moisturizing baby cream or cosmetic milk.

Physiological jaundice. In utero, the erythrocytes (red blood cells) of a child contain the so-called fetal (fetal) hemoglobin, which differs in its structure from the hemoglobin of an adult. After birth, an active process of breakdown of erythrocytes with fetal hemoglobin and synthesis of erythrocytes with adult hemoglobin begins. The liver must utilize (bind) the excess bilirubin, a breakdown product of hemoglobin, but the immature liver enzymes of the newborn cannot cope with its large amount, bilirubin enters the bloodstream and gives a yellow color to the skin. Transient jaundice of the skin appears on the 2-3rd day of the child's life, reaches a maximum on the 4-6th day, disappears by the 7-10th day. The well-being of the baby does not suffer. The minimum level of bilirubin in the blood is 26-34 µmol/l, and the maximum is 130-170 µmol/l.

However, jaundice may not be physiological. For example, in case of a conflict between the blood of the mother and the baby (the mother has a Rh-negative group, the child has a Rh-positive group, or the mother has a 1 (0) group, and the baby has any other). Therefore, if you see an increase in yellowness of the skin in a baby, you must immediately tell the doctor about it.

Hormonal (sexual) crisis. The causes of the hormonal crisis are the increased production of estrogens (female sex hormones) in the fetus, which stimulates the growth and development of the mammary glands (both in boys and girls), the structural sections of the uterus.

In premature babies, a sexual crisis is less common and its severity is small, since they themselves have not yet matured and are not capable of increased synthesis of hormones.

The manifestations of a hormonal crisis can be milia, vulvovaginitis, metrorrhagia, breast engorgement and increased skin pigmentation.

Milia. They arise due to blockage of the sebaceous glands and appear as small white dots (like “millet grains”) on the face and nose. Normally, the ducts of the sebaceous glands open on the 2-3rd week after birth, and the milia gradually disappear.

Desquamative vulvovaginitis (from "desquamation"- desquamation, in this case - desquamation of the scales of the vaginal epithelium). Manifested by abundant mucous secretions of a grayish-whitish color from the genital slit in 60-70% of girls in the first three days of life. After about 2-3 days, they gradually disappear.

Metrorrhagia. Vaginal bleeding occurs on the 5-8th day of life in 5-10% of girls, although occult blood in the vaginal mucus can be found in all girls with desquamative vulvovaginitis. The duration of vaginal bleeding is 1-3 days, the volume is 0.5-1 ml - this is a brownish spotting discharge on the diaper. Such "bleeding" is absolutely not dangerous, but they require hygiene rules - wash your baby more often and change diapers.

Breast engorgement (physiological mastopathy). It starts on the 3-4th day of life and reaches a maximum by the 7-8th day of life. Then gradually the degree of engorgement decreases. Enlargement of the mammary glands is usually symmetrical, the skin over them is not changed, sometimes slightly reddened. The degree of enlargement of the gland in diameter is 1.5-2 cm. On its own or during palpation of the gland, discharge sometimes appears, initially grayish, and then whitish-milky in color, in composition approaching the mother's colostrum. Enlargement of the mammary glands is observed in almost all girls and half of the boys.

Skin hyperpigmentation. The skin around the nipples and scrotum in boys becomes darker. Disappears without any treatment at the 2nd week of a newborn's life.

Tepeangiectasia. These are raspberry-colored spider veins, sometimes they are called "stork's mark". They are dilated capillaries and are located, as a rule, in the occipital fossa, on the forehead and in the region of the nose. Teleaniectasias should disappear by 6 months.

Transient hyperthermia (increased body temperature). It occurs on the 3rd-5th day of life, the temperature can rise to 38.5-39.5°C and above. The child is restless, sucks greedily, he has signs of dehydration (dry skin, retraction of the fontanel). Contributes to the development of transient hyperthermia overheating (when the air temperature in the ward for healthy full-term newborns is above 24 ° C, the location of the baby's bed next to the radiator or in direct sunlight, etc.), as well as dehydration. It can be caused by the fact that the child is used to being in the water, but gets into the air, where it is dry and the temperature is unstable. In addition, in the early days, the mother may have little milk. The loss of even 50-100 g of water for a newborn is significant.

Transient immunodeficiency. Stress and altered hormonal levels during childbirth, a massive antigenic attack (colonization by microorganisms) immediately after birth, natural starvation for children in the first days of life, the end of the intake of biologically active substances contained in the mother's blood through the placenta are the causes of transient immunodeficiency - one of the borderline conditions in all newborns. It is most pronounced in the first three days, which determines the particular danger of infection at this particular time. Therefore, in maternity hospitals, “maximum sterility” is observed when handling babies at this time: diapers and clothes are carefully processed.

In conclusion, we emphasize once again that all the conditions described above are physiological, that is, normal, and do not require any treatment.


In addition to the general indicators of the physiological and nervous development of the child, there are special conditions of the child during the neonatal period, which the relatives of the baby need to know.

Immediately after the birth of a child, he has special reactions that reflect the process of adaptation to new living conditions. These reactions are called the transitional state of the newborn.

Among the special, borderline with the norm conditions of the child of the newborn period are the following:

Ancestral catharsis;

Physiological peeling of the skin;

Toxic erythema;

Physiological weight loss;

Sexual crisis;

Physiological jaundice;

transient fever;

Physiological dyspepsia;

birth tumor;

Simple erythema (physiological catarrh);

Expansion of sweat glands and some others. The occurrence of all these conditions is directly related to the natural change in environmental conditions that occur immediately after the birth of a child.

Generic catharsis (purification) is a protective reaction of a newborn to a birth act, which is manifested by a weakening of the reaction to pain, light, sound and other stimuli with a sharp decrease in muscle tone. It is believed that this condition of the newborn is associated with a sharp increase in the blood level of specific compounds that act on sensitive receptors, inhibiting and blocking their work, and is considered as one of the protective reactions against birth stress.

Physiological catarrh of the skin (simple erythema) is a reddening of the skin that develops as a result of a sharp transition of the body from the conditions of being in a humid environment (in amniotic fluid) to being in a dry environment (air). It intensifies after removal

Original lubrication, the first bath. The phenomena of physiological catarrh of the skin gradually decrease by the 3-4th day of the child's life and completely disappear by the end of the week.

Toxic erythema occurs in almost half of newborns. It is more common in breast-fed children than in formula-fed children. Erythema usually appears on the 2-4th day of life. Against the background of general reddening of the skin (physiological catarrh of the skin), more intense red spots of various sizes and irregular shapes and small thickenings of light yellow color, dense to the touch, around them there is a halo of hyperemia (redness) can be determined. Spots and thickenings can be all over the body, but the skin of the face to the scalp is more often affected. The stool may become more frequent, but the general condition does not suffer. The described rashes last up to 3 days, after which they disappear without leaving a trace. You should know that elements of toxic erythema never occur on the feet, palms and mucous membranes. There is no need to treat toxic erythema, it goes away on its own.

Physiological weight loss is a decrease in the weight of a newborn on the 3rd day after birth within 8% of the original weight. This phenomenon is observed in almost all newborns. Physiological weight loss is a process of adaptation to a new life that requires additional energy and fluids. For The formation of this energy breaks down some nutrients that are in the body of a newborn in the form of a reserve.

Physiological weight loss may be somewhat less or somewhat more depending on a number of reasons (food volume, additional fluid intake, ambient temperature, humidity). In addition, factors such as intrauterine development conditions, the presence or absence of complications during childbirth, care for the newborn, etc. are taken into account. By about the 6-7th day of life, the child's initial weight should be restored.

Physiological jaundice. Most often, manifestations of physiological jaundice are determined on the 2-4th day of a child's life, less often - a little later. Jaundice lasts for several days and by the 7th-12th day passes without a trace. Manifestations of physiological jaundice are a slight icteric staining of the skin, visible mucous membranes and whites of the eyes. Physiological jaundice does not affect the general condition and well-being of the child.

Signs of a sexual crisis are a slight swelling of the mammary glands, swelling of the genital organs, mucous, bloody or mixed discharge from the genital slit in girls. All these phenomena develop as a result of the effect on the fetus of the mother's hormones that penetrate the placenta with blood before childbirth, and exposure to them during the birth act.

Swelling of the mammary glands is the most common manifestation of a sexual crisis, it occurs in almost all children (in girls and boys). Swelling is usually noted by the 3-5th day of a newborn's life and manifests itself as much as possible by about the 8-10th day. At this time, even with slight pressure on the mammary gland, a milky liquid is released from it, similar in chemical composition to colostrum. After the specified period, the swelling of the mammary glands gradually disappears. Treatment is not required, but it is necessary to keep the breasts and genitals clean to avoid infection.

In girls, during a cataract crisis, whitish discharge, less often bloody, is noted from the genital organs. Under the influence of maternal hormones,

Loosening and redness of the mucous membrane of the vagina and uterus come out, through the altered mucosa there is an intensive penetration of part of the blood cells, which cause the appearance of secretions. They appear by the 5-7th day of life and last for 3-5 days, then gradually disappear.

Transient fever is a sudden increase in body temperature of a newborn around the 3-5th day of life. Transient fever is not associated with any disease and is not a consequence of overheating. Usually its appearance coincides with the peak of the greatest physiological weight loss. Transient fever does not occur in all children, but only in 1/6 of the total number of newborns. The duration of transient fever ranges from several hours to 2-3 days. Short-term transient fever does not affect the general condition of the baby in any way and does not require any special treatment, it is only recommended to give the child a little more water than normal.

The development of physiological dyspepsia, often accompanied by vomiting, is associated with the intensive colonization of the intestines of the newborn by individual microorganisms.

Physiological vomiting occurs in many newborns during the first day of life. When vomiting, the so-called birth fluid, mucus and blood, which the child swallowed during the birth act, are removed from the stomach of the newborn. Physiological vomiting subsides after emptying the stomach and no longer resumes. It does not adversely affect the general condition of the newborn. , The birth tumor appears due to strong compression during childbirth of the tissues of the presenting part of the fetus. Swelling of this part of the head is due to venous and lymphatic stagnation, punctate hemorrhages. Since in most cases a child is born head first and the presenting part is the parietal region and the back of the head, then in the region of the parietal and occipital tubercles, a birth tumor most often appears. It does not last long, the puffiness subsides by the end of 2 days, and the traces of hemorrhage resolve by the 5-6th day of the child's life. The birth tumor does not affect the general condition of the baby, it disappears on its own.

Even with very good baby skin care, almost every mother is bound to face problems. There are many of them, and they are quite diverse.

Today I will consider conditions when skin changes are due to the age characteristics of the newborn and do not require treatment.

The skin of newborns differs from the normal skin of a child in temporary changes that are physiological (normal) and do not require treatment:

— germinal down (lanugo);

— physiological peeling;

— physiological catarrh, or simple erythema;

— physiological jaundice;

— Milia;

— Telangiectasia
Now I will talk about each state in more detail.

Lanugo or primary hair- fluff that covers the skin of a newborn on the back, torso, limbs and sometimes on the face. By about a month, the hairs fall out.

Physiological catarrh of the skin (erythema simplex)

Physiological catarrh of the skin, or simple erythema- a condition associated with the adaptation of the skin of a newborn to extrauterine life. It is a reddening of the skin due to the expansion of skin capillaries due to exposure to a lower ambient temperature (20-25 instead of 37 ° C) on the body. Occurs after cleansing the skin of the original lubrication a few hours after birth or after the first bath. Usually, erythema lasts 1-2 days, and almost completely disappears by the end of the first week of life.

Physiological peeling

Physiological peeling usually manifests itself on the second or fifth day of life in the form of lamellar peeling. It is especially abundant in post-term children. This condition does not require treatment and goes away on its own.

Toxic erythema

Toxic erythema usually occurs on the second or fifth day of life in the form of reddish dense spots, papules, vesicles, which are usually located on the limbs, chest and abdomen, buttocks, less often on the face and limbs. Toxic erythema never happens on the palms, feet, mucous membranes. One to three days after the onset, the rash disappears without a trace. At the same time, the child feels well, body temperature is within the age norm.
Often in children after birth, yellow-pink dots about 1 * 1 mm in size may appear on the tip and wings of the nose, as well as adjacent parts of the cheeks, resembling simply (English millet). These are clogged excretory ducts of the sebaceous glands - milia. They occur in about 50% of all newborns. They disappear gradually after two or three months. They do not require specific treatment, but if hygiene rules are violated, they can become inflamed and then they need to be treated with a 1% alcohol solution of chlorophyllipt.
The sweat glands in newborns are underdeveloped. Sometimes on the skin of a child are found miliaria- clogged excretory ducts of sweat glands, similar to drops of water. They are found in the neck crease, on the scalp, less often on the shoulders, chest. These elements are easily removed with a cotton swab moistened with alcohol or 1% alcohol solution of chlorphyllipt, while the skin remains intact. There are no recurrences.
jaundice skin or physiological jaundice of newborns often observed in perfectly healthy children on the second or third day of life due to an increase in the level of bilirubin due to physiological hemolysis (destruction) of red blood cells. At the same time, the physiological immaturity of enzymatic systems, in particular liver enzymes, plays an important role. Physiological jaundice observed in approximately 2/3 of children and disappears on the 7-10th day of life. No specific treatment is required. It is necessary to give the child more water to accelerate the removal of bilirubin from the body.

Telangiectasia

Telangiectasia- local expansion of subcutaneous capillaries, often called "spider veins". They can be located on the back of the head, forehead, bridge of the nose. Telangiectasia does not require treatment and, as a rule, resolves on its own by one and a half years.

In today's note, I described the conditions that are normal in newborns and do not require additional action, but they are the ones that most often raise questions among young parents.

This concludes a series of articles on the features of the skin of newborns and transient conditions. I plan to tell you about skin diseases that are most common in the neonatal period and their prevention.

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