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What does a neonatologist treat? Perinatal pathology of the nervous system. What diagnostic methods does a neonatologist use

The birth of a child is an indescribable happiness for parents, but at the same time, an incredibly difficult natural process for the baby and mother. It was designed by nature, and all mammals are endowed with a similar reproductive system, in which fertilization occurs inside the body of the female. Almost all of them are able to give birth on their own, but if this is the norm for animals and their cubs, then for people this method of birth is fraught with serious consequences, both for the mother and for the newborn.

Fortunately, our life and health are in good hands, because modern medicine is very developed, and some danger and risks are minimized, although they can never be ruled out. All prudent pregnant girls are registered in a timely manner, unconditionally follow the recommendations of their gynecologist, and starting from the second half of the term, they are slowly looking for the very obstetrician whom they would like to see at childbirth. This doctor is definitely important, as is his entire team. But there is one more doctor in it, whose competence should be as high as possible, and whose reputation should be brilliant. A specialist is called a neonatologist, and who is a neonatologist and what he treats, we will understand further.

Who is a neonatologist?

Childbirth is the most important and completely new stage for two people: mother and child. A newborn comes into this world, into a new environment for himself. A small organism receives stress, therefore its initial state and further behavior should be assessed by a specialist, who is just a neonatologist.

The science of neonatology arose not so long ago. In the world they learned about it in the 19th century, but in Russia it could only begin to take root by the 20th century. In Latin, the word "newborn" is translated as "neonatos", so the name of the direction is quite logical. The specialization "pediatrician-neonatologist" in domestic medicine was registered by the end of the eighties. Today it is very much in demand and valuable. All the best maternity hospitals, perinatal centers and other medical facilities are trying to attract the most highly qualified professionals from this industry.

Neonatology has made particularly important advances in relation to premature babies. A neonatologist plays an incredibly important role in the life and care of such babies.

Every premature baby should be under the supervision of doctors until his body grows and gets stronger, as it should happen inside the mother.

As for children born at term, in the first minutes after their birth, the neonatologist:

  • Performs a full examination, takes measurements, if necessary, helps the baby to take its first breath, or conducts resuscitation.
  • Then it is he who puts the baby to the mother's breast so that contact occurs between them, and the newborn takes over her microflora. This necessary action is the prevention of infectious diseases, since the child's body is completely sterile, but he already needs to start his immunity and develop protective mechanisms.
  • During the time that the mother and child will be in the maternity hospital, the doctor must come to the ward daily and examine the latter.
  • It is to him that parents are supposed to contact in the first month of a baby's life if he has symptoms of an umbilical hernia or bleeding from the navel, jaundice, thrush, diarrhea, constipation, vomiting, diaper rash, etc.

The first 4 weeks after the birth of a child, everything in his body is rebuilt. And depending on how this will happen, we can assume what to expect in the future.

We have given a detailed answer to who a neonatologist is and what he treats, so now let's take a closer look at what else he can do.

Danger for a newborn appears from the first seconds of his life. Up to this time, his lungs were filled with liquid, but now he needs to learn how to breathe oxygen. Therefore, the first thing a neonatologist checks is the frequency of breathing and heartbeat. If there was no first breath, then he wipes the small body and taps his feet. If procedures are ineffective, an oxygen mask may be required. When breathing appears and normalizes, they proceed to measurements of the circumference of the head and chest, as well as height and body weight.

  • Child's pose. The norm is considered to be bent and pressed to the body limbs, closed fingers on the hands, pressed head to the chest;
  • His expression. With a frightened or painful facial expression and absent emotions, one can assume some problems;
  • Skin condition and tone. In healthy babies, the skin is pinkish and velvety. Nails are dense, ear cartilages are elastic;
  • The shape of the head and the opening of the fontanelles;
  • Assessment of the genitals, anus, oral cavity;
  • The mobility and breeding of the limbs are checked, the collarbones are examined - in order to exclude birth injuries (dislocations, fractures, etc.).

An equally informative source of information is the cry of the child, his activity and general behavior.

At the end, the doctor listens to the rhythm of the heart and breathing, probes the tummy, checks muscle tone and reflex reactions, and then makes a conclusion about the health and condition of the newborn.

What symptoms require neonatologist's help?

With the birth of a child, parents have a huge responsibility, because in addition to basic duties, such as feeding, bathing and walking, they need to carefully monitor the well-being of their child, and if there is any suspicion, immediately involve a specialist. We are talking about the first 28 days, when it is not at all clear to young parents how it should be and how not, what is the norm and what is the deviation.

If, after the initial examination, the neonatologist reveals some kind of congenital disease or other pathological condition, he will immediately notify the family about this and prescribe the appropriate treatment. In some cases, surgery is even required, but all conclusions are made exclusively by this specialist. But even in completely healthy babies, something may appear in the first month of life, and most often it is:

  • Bleeding from the navel - they say that the umbilical cord was loosely bandaged;
  • Wild meat - when a dried skin came off from the navel, under which there are bleeding tissues;
  • Umbilical hernia - occur due to weak discharge of flatus, continuous crying of the child, or again, due to a poorly bandaged navel;
  • Diaper rash on the body - specific redness, usually observed in the area of ​​\u200b\u200bfolds and genitals;
  • A rash on the skin - may be a manifestation of an allergic reaction, or a sign of a dermatological disease.

is a doctor who deals with newborns. His specialization includes examination, diagnosis of diseases and their treatment in children of the first four weeks of life.

Skills and Skills of a Pediatric Neonatologist

A pediatric neonatologist usually works in a maternity hospital. His competence includes monitoring the condition of newborn children, identifying pathologies and treating them (unless, of course, the disease is one of his specialties).

What diseases can a pediatric neonatologist treat?

As noted above, the neonatologist deals only with newborn children. They, as well as adults, can suffer from a variety of diseases, among which there are those that are difficult to treat.

Consider only those of them that are treated by a pediatric neonatologist:

  • Albuminuria. It is a disease that leads to disruption of the kidneys. In this regard, many newborns in the kidneys have an increased protein content. The problem arises as a result of the fact that in the first days of life in most newborns, the permeability of the kidney cells that produce urine is increased. Although not always a positive reaction to protein in the urine can signal the presence of a disease. Indeed, in some cases, it may appear for other reasons: for example, due to the presence of impurities of salts or mucus in the urine;
  • . This disease is quite common and occurs in almost 2/3 of newborns in the world. It appears due to the fact that the enzyme systems of the liver are still underdeveloped, which is why it produces too much bilirubin. The disease can manifest itself immediately after birth or after a few days of life. Usually on the 2nd or 3rd day the skin turns yellow. By the way, this coloring can also appear on the mucous membranes of the eyes. Urine and stools are of normal color and texture for newborns.

As a rule, after about 10 days the disease completely disappears. In some cases, the disease is normal, the child feels well, so treatment is not required. However, it is not recommended to leave the maternity ward until the symptoms of the disease have completely disappeared.

If the disease appeared after discharge, then it is better to contact a pediatrician who will reveal its extent. If the child is thin, lethargic and passive, then treatment may be needed, since these symptoms are not signs of physiological jaundice;

  • manifested by the accumulation of fluid between its shells. It can last up to one month, and then disappear on its own;
  • In the first two days after childbirth may appear inflammation of the vaginal mucosa. From here, a white-gray discharge may flow, which should disappear on its own by the third day. In this case, it is advisable to rinse the girls with a solution of potassium permanganate, but this should be done as carefully as possible. After all, if there are undissolved crystals in the solution, they can lead to severe burns on the delicate skin of the child. In addition, decoctions of chamomile, St. John's wort or string will have a beneficial effect on the baby's skin. These herbs are famous for their disinfecting properties, so they will not affect the child from the negative side;
  • Sexual crises. It occurs due to changes in hormonal balance. The chest of boys and girls increases slightly, the skin on it coarsens. Its maximum increase is observed on the 7-8th day. As a rule, the disease persists for one month, and then passes. A liquid (secret) appears in the roughened mammary glands, which in no case should be squeezed out, as this can cause infection, and subsequently mastitis. It is much better to apply a sterile napkin moistened with camphor oil to the coarsened areas;
  • Uric acid infarction of the kidneys. This is the most common pathology that occurs in almost all newborns. It occurs due to the fact that metabolism is disturbed in the kidneys due to the deposition of a huge amount of crystals of uric acid salts in it. You can understand the presence of the disease without examination: the child's urine will be cloudy, brick-yellow. Usually this phenomenon ends by the end of the first week. But if it persists longer, then this is already a pathology, so you should seek help from specialists;
  • If the signs of jaundice made themselves felt not 2-3 days after birth, but in the first hours, then in this case we can talk about hemolytic disease;
  • Labored breathing. The first breath taken by a newborn is not able to fully expand the lungs. This will happen a little later, during a special type of breathing that newborns usually use. The child takes a deep breath, but at the same time his exhalation is slightly restrained. Actually, it is thanks to this that the lungs expand when the newborn pushes the air out with little difficulty. But premature or weak babies are usually less developed, so for them this process takes more time. However, if the child is completely healthy, then his lung tissue should straighten out in about 5 days;
  • Change in the skin;
  • As a rule, all children are born with "red" skin. The fact is that reddening of the skin is a kind of reaction of the newborn's body to the removal of the original lubricant that enveloped the child inside the mother's belly. As a rule, this redness becomes most pronounced on the 3rd day, but by the end of the first week it almost completely disappears. And this phenomenon is called physiological erythema;
  • Immediately after erythema, another problem appears - physiological peeling. It is usually most pronounced on the chest and abdomen. But if the child's skin began to peel off, then the erythema completely disappeared. If the peeling is too noticeable, then the child's skin can be lubricated with a hypoallergenic baby cream;
  • birth tumor. The part of the baby's body that was closest to the uterus before birth is slightly swollen. The swelling usually persists for 1-2 days. In some cases, point hemorrhages occur at the site of the birth tumor, which will soon disappear without doctor's intervention;
  • Toxic erythema, which differs from the physiological only in the form of leakage. It is the formation of red dense spots on the child's body (sometimes in the center they can be filled with liquid). It occurs in a quarter of newborns. Most often appears on the legs, arms and chest. Very rarely - on the face and abdomen. Usually this disease does not require special treatment. But if a lot of spots appear on the body, and the child is naughty at the same time, then you should definitely consult a doctor who will prescribe treatment;
  • Decreased body temperature, fever. The occurrence of such a disease is not uncommon. It is due to the fact that the thermoregulation of newborns is far from perfect, so it cannot keep the baby's body temperature constant. Because of this, the baby's body temperature changes when external conditions change;

The skin of a newborn has a special structure. It is rich in capillaries and blood vessels, but poor in sweat glands, which causes rapid overheating and hypothermia of the child. If more fluid is excreted in the urine and feces of the child than he received during feeding, then this can cause him anxiety, fever, etc. In this case, the child should be undressed, rubbed with alcohol, and given boiled water to drink. If after this the temperature does not subside, then an enema with analgin may be needed. Its implementation consists of two stages: a regular enema, after which the medicine will be better absorbed, and then an enema with analgin.

To do this, you must do the following: crush one tablet of analgin to make a powder. Mix a tenth of it with water, the size of a small children's rubber spray, which is sold in a pharmacy.

Relief should come within 30 minutes. But if the temperature of the baby, on the contrary, is lowered, then in this case one should act differently. The baby should be wrapped in sterile diapers, and then placed under the lamp. By the middle of the first day, a constant body temperature of the child should already be established.

  • Dysbacteriosis. Even a child placed in a completely sterile room is not protected from bacteria. In the first hours of life, the baby does not yet encounter them, but after 10-20 hours, his skin, intestines, and mucous membranes are populated with bacteria. Some of them are essential for digestion. You can determine how it flows by looking at the child's stool;
  • stool disorder(physiological dispersion) occurs in absolutely every newborn;
  • First three days dark green meconium. A little later, particles of yellow and white colors appear in it. The consistency becomes more liquid. As a rule, dispersion lasts a short time. After 2-4 days, the child's feces will become mushy, the stool will be permanent. All this will indicate that a sufficient number of bacteria necessary for favorable digestion has appeared in the baby's intestines;
  • . Usually this condition appears in children 3-5 days of life. Weight loss is observed due to the evaporation of fluid from the body through the respiratory tract and skin, since not enough of it enters. Almost all newborns regain their weight by the end of the first week. But if the mother begins to feed the baby immediately after birth (within 2 hours), then weight loss may be less. It is also worth paying attention to the fact that the child needs not only milk, but also water, since the body of a newborn needs fluid. And if the energy of the baby is not used for its intended purpose, then this can lead to a thermal imbalance, resulting in overheating or hypothermia.

A decrease in the weight of the child can also be caused by a lack of milk in the mother. If such a problem exists, then the pediatrician should suggest the optimal infant formula for the child. He will also determine what dose should be given to the baby when feeding. You should not choose baby food yourself without consulting a specialist in advance, as this can cause a variety of problems.

What organs does a pediatric neonatologist treat?

He deals with the treatment of any pathologies that have appeared in the newborn.

In what cases should you seek help from a specialist?

With any deviations in the newborn, you should visit a neonatologist. Every parent should be aware of the following:

  • Violation of muscle tone. This means that the child is lethargic, hard to bend and unbend the arms, poorly responsive to external stimuli. But the child of the first month of life should have a good tone. That is, his half-bent arms and legs should easily unbend (the mother does not need to make any effort). Immediately after they are released, they quickly return to their original position;
  • If children's limb activity is not the same. It is important that the arms and legs move with symmetrical dynamism;
  • The child should not often spit up, choke on milk;
  • If the child only turns his head to one side, often shudders during sleep, after which he wakes up.

Each child of the first month of life is necessarily examined by a neurologist, who determines whether everything is in order with him. However, parents should also be aware of all these symptoms in order to notice the presence of a particular pathology in time.

What tests can be prescribed for newborns?

Each child of the first month of life needs to do the following tests:

  • eosinophilic cationic protein;
  • bilirubin total;
  • bilirubin direct;
  • blood type and Rh factor;
  • general blood analysis;
  • immunoglobulin E;
  • allergy panel Ig G;
  • streptococcus A;
  • streptococcus B;
  • general urine analysis;
  • coprogram;
  • feces for intestinal dysbacteriosis and some others.

In any case, the referral for tests is given by the doctor, so this list can be slightly changed.

Diagnosis by a neonatologist

The neonatologist performs the following types of diagnostics:

  • Ultrasound of the thyroid gland;
  • Ultrasound of the abdominal and retroperitoneal space;
  • ultrasound of the scrotum;
  • Ultrasound of the head and neck;
  • pelvic ultrasound;
  • Neurosonography in children;
  • Echocardiography.

VIDEO

Everyone is looking forward to the moment when this miracle from the tummy will lie next to you. But when this time comes, the newly-made parents for some reason have a panic associated with the fear of harming the baby.

In order for the first days of the baby’s existence to be safe for him, you need to pay attention to the following nuances:

  • There are babies who sleep all the time after giving birth. This is normal, as they thus rest from the stress they endured earlier. They should not be interfered with, but offering a breast at this time is very important, since a certain feeding regimen must be observed from the first hours of a child's life. Already 2-3 days after birth, the child begins to actively suck on his mother's breast. Other children have a more pronounced appetite. They are ready to eat constantly, but the mother must understand that it is necessary to take breaks between feeding at least 2 hours so that the child does not overeat;
  • If doctors allow the child to be nearby, then it should be gently unfolded and applied to the chest. Sometimes, due to the stress received during childbirth, the baby refuses to take the breast into his mouth or sucks it for a short time. But if the mother is allowed to feed the baby right in the delivery room, then the newborn from the very first moments of life will be able to cuddle up to the mother and enjoy the warmth of her gentle hands. It is very important that the mother shows the baby that she loves him: you can smile at him or say a gentle word (the child will feel that the mother's voice is caring and gentle). If this is the first birth and there is no experience of interacting with small children, you can ask the nurse to help with this. It is important that the child learns to take into his mouth not only the nipple, but also near the nipple area;
  • Some physiological features of children can scare mothers. In the first days of life, the baby's skin is red, which is associated with dilated blood vessels. And many mothers confuse this phenomenon with pathologies. On day 3, the skin of babies usually acquires a yellowish tint. But this, too, should not be afraid: this phenomenon is called physiological jaundice, and it is completely safe for the health of the baby. As a rule, it occurs as a result of the fact that the embryonic hemoglobin in the blood of a child is replaced by a human one. This problem will pass in a few days. Parents should water the child as often as possible and bathe to speed up the recovery process;
  • The baby begins to breathe immediately after birth. Therefore, he should be placed in a well-ventilated room, and nothing should interfere with his breathing. Pillows, blankets should not be placed near the face, which may interfere with the flow of fresh air;
  • Thermoregulation in babies is still poorly developed. Therefore, the child may not feel cold for a long time, although at this time he may be cool. At this point, he begins to behave capriciously, attracting the attention of his mother. He should be dressed warmly so that he does not catch a cold. Excessive clothing will also not lead to anything good. He still does not know how to sweat, so his body will quickly overheat. The mother is obliged to ensure that the baby is dressed in accordance with the temperature of the room;
  • The digestive system of the crumbs is also still poorly developed. She needs time to adapt to new conditions. In the mother's abdomen, the baby's intestines were completely sterile, and after birth, it begins to be populated by microflora. The first stool is called meconium. The child is cleansed of everything that was accumulated during his stay in his mother's tummy. As a rule, this phenomenon lasts only about three days, after which the stool returns to normal. The mother is obliged to provide organized meals for the baby. The most suitable is mother's milk. Breastfeeding should be as long as possible;
  • In the first days of life, little water enters the child's body, so the baby urinates very rarely and in small portions. In some children, orange crystals may appear in the urine. They appear due to the fact that the mother in the last days before the birth was fond of protein foods. They are not dangerous. The mother must pay attention to her diet. It is desirable that her diet should contain as little protein as possible, but she should drink much more often;
  • By the end of the first week, the baby may have symptoms of a sexual crisis. It can manifest itself in different ways: swelling of the nipples, discharge from the vagina. As a rule, the problem does not last more than two weeks and is solved by itself. Of course, the mother can contribute to the rehabilitation of the baby, but in no case should warm compresses be placed on the child's chest;
  • Already 4-5 days after the birth of the baby, if the mother and child are completely healthy, they are discharged home. Before you go home, it is advisable to ask the nurse to show you how to properly handle the baby's umbilical cord;
  • It is advisable to spend the first day at home without visitors, in complete peace, so that the baby can better adapt to new conditions.

You are unlikely to meet him in the staff list of the district clinic. This doctor works only in the maternity hospital where the newborns are or in the children's hospital. Neonatologist - who is this? A doctor responsible for ensuring that the smallest and most fragile patients get a chance for a full life, and strong and healthy babies are vaccinated against dangerous diseases in time.

What does neonatology study?

Neonatology (Latin for “new birth”) is the science of nursing premature, underweight babies. She studies diseases and pathological conditions of newborns. As a separate branch of medicine, it was formed only in the 20th century. The term "Neonatology" was proposed by Alexander Shaffer in 1960, and since 1987 neonatologists have appeared in Russia. Prior to this, only pediatricians dealt with all diseases of children.

The medicine of the Russian Federation is developing rapidly and confidently, and the association of neonatologists of Russia is becoming more popular among pediatricians every day. This public organization, established in 2013, promotes the development of neonatology as a branch of medical science, unites neonatologists to improve their skills and exchange experience, to improve the quality of neonatological care. Regional branches of the organization are already represented in 35 regions of Russia, with more than 1 thousand members.

What does a neonatologist do?

Young mothers will tell about what heals, because a neonatologist is the one who first meets children in this world, after an obstetrician-gynecologist, the chief pediatrician of a maternity hospital. The most frequent patient of such a doctor is a premature baby weighing less than one kilogram. In such children, the main problems are the difficulty of independent breathing, violation of thermoregulation.

Who is a neonatologist? In difficult cases, doctors of the perinatal center are forced to deal with congenital malformations and intrauterine infections in children. To do this, it is necessary to take tests, give injections, and a neonatologist is the one who knows how to properly take blood from a man the size of a palm, how to put him on a drip and calculate the dose of medicine.

What does a neonatologist do when he takes birth that has begun long before the due date? First of all, as soon as the child is born, he carries out resuscitation. These can be measures for artificial ventilation of the lungs, blood transfusion, even the "start" of the heartbeat. To do this, all neonatologists must have the specialization "anaesthesiologist-resuscitator".

Each maternity hospital and hospital department should have such a specialist. At the same time, in remote villages, remote settlements, where women give birth extremely rarely, it is unprofitable for either the hospital or the doctor to keep a separate neonatologist. Then, for each individual birth, a freelance doctor is invited from the nearest more or less large maternity hospital, where he works constantly.

neonatal period

While the child is in the mother's tummy, the obstetrician-gynecologist takes care of the two of them. This period is called prenatal or intrauterine. After the birth of the baby, the neonatal period begins, which lasts four weeks. Any treatment of children at this time is carried out with the participation of a neonatologist. In some regions of the Russian Federation there are even district neonatologists. They monitor the health of children until they reach the age of one month, and only then transfer them to pediatricians.

Video: neonatologist's work

In the video below - a story about one of the best representatives of this small but important profession, about the well-deserved savior of little people. Natalya Makarova, a neonatologist from the Trans-Baikal Perinatal Center, is the leader of the All-Russian competition "Children's Doctor 2014". More than 10 years of experience, high qualifications, the ability to empathize - these are the main components of success.

A neonatologist is a pediatrician who works in departments for premature and newborn babies in medical hospitals and maternity hospitals.

The work of a neonatologist is very delicate and responsible, as he deals with the smallest children - from birth to the 28th day of life. During this period, it is necessary to identify those diseases that can later turn into chronic forms and even make a person disabled. Therefore, neonatologists try to carefully examine babies.

Despite the fact that a neonatologist deals only with infants, he is a generalist doctor, since by the nature of his activity he encounters a wide variety of diseases of systems and organs. In addition, a neonatologist is also a diagnostician and an obstetrician.

What diseases are within the competence of a neonatologist?

  • diaper rash;
  • Vomit;
  • Umbilical hernia, wild meat, bleeding from the navel;
  • jaundice in newborns;
  • Childhood cholera;
  • Diarrhea;
  • Bronchitis;
  • Short frenulum of the tongue;
  • Constipation;
  • Blennorrhea in newborns (purulent inflammation of the eyes);
  • Thrush;
  • Rash in babies;
  • Hypothyroidism (decreased thyroid function);
  • Phenylketonuria (congenital metabolic disorder).

What organs does a neonatologist check?

  • Lungs and heart. With the help of a phonendoscope, the neonatologist listens to the child's lungs and determines the frequency of his breathing, rhythm and heart sounds;
  • Head. At the consultation, the neonatologist determines the size of the fontanel of a small patient, probes (palpates) the bones of the skull and determines whether edema (birth tumor) is present;
  • Neck. The neonatologist probes the clavicles, as it is necessary to make sure that they were not damaged during childbirth. The doctor also palpates the sternocleidomastoid muscles, since with muscular torticollis the muscle can be shortened;
  • Sex organs. In boys, a neonatologist will feel the testicles and see if they have descended into the scrotum. In girls, the doctor examines the large labia, which should cover the small ones;
  • Tummy. The neonatologist without fail probes the newborn's tummy and checks the size of the spleen and liver. At the consultation, the neonatologist asks the mother if the child had a stool. On the first day, the child passes meconium (original feces), viscous and thick, olive or dark green in color.

In addition, the neonatologist checks the baby's muscle tone. As a rule, infants have physiological muscle hypertonicity, which causes the baby’s posture: the arms are bent and pressed to the sides, the head is tilted to the chest, the hands are clenched into fists, the legs are bent at the hip joints and knees. The doctor determines muscle tone by bending and unbending the arms and legs of the child.

The legs in the hip joints should be easily bred, and the folds on the legs should be symmetrical. If the legs are difficult to separate, the neonatologist may suspect joint dysplasia.

The neonatologist also evaluates the main reflexes during the examination.

When should a mother consult a neonatologist?

  • When a newborn has bleeding from the navel, umbilical hernia, wild meat. If blood from the umbilical cord appears in the first hours after childbirth, this indicates a poorly bandaged umbilical cord. Usually, such bleeding is not long-term. It happens that blood appears 3-5 days after birth, during the fall of the umbilical segment. Sometimes, after the umbilical cut has fallen off, in the navel you can see a piece of red meat sitting on a thin leg. This phenomenon is called wild meat. In such cases, you should contact a neonatologist.
  • If a newborn has a hernia, which often occurs as a result of a poorly bandaged umbilical cord or from a strong cry of a child and gaziki.
  • If the child has diaper rash. Its most frequent localization is in the buttocks, genitals, lower abdomen, behind the ears, in the axillary and inguinal areas, skin folds. There are three degrees of diaper rash: a mild degree, when there is a moderate reddening of the skin without breaking the integrity, an average degree, when there is a bright redness with visible erosions, and a severe degree, when weeping redness of the skin is noticeable with the formation of ulcers. Diaper rash is easily infected, so you should not delay it, but you should seek the advice of a neonatologist.

What tests will the neonatologist ask for?

  • Rh factor analysis;
  • Blood type analysis;
  • neonatal screening.

In the maternity hospital, a neonatologist must take a blood sample from newborns, which he applies to a special test strip. Test strips are examined in the laboratory for VG and PKU. If there is a suspicion of any disease, parents receive an urgent notice with a request to contact the endocrinological dispensary (EC) or medical genetic consultation (PKU) for re-examination. With the final confirmation of the diagnosis, appropriate treatment should be prescribed immediately.

If the baby does not have any pathologies, parents, as a rule, are not notified.

From birth, the baby should have the following reflexes:

  • Grasping - if you put a finger in the baby's palm, he will squeeze it tightly. Sometimes even he can grasp the finger so strongly that the child can be slightly lifted;
  • Search - if you start stroking the child in the area of ​​\u200b\u200bthe corner of the mouth, then he will turn his head towards the stimulus;
  • Automatic gait reflex - if the baby is taken under the armpits and placed on a flat surface, then he will raise his leg, as if he is about to take a step;
  • Proboscis - if you touch the baby's lips with your finger, he will pull them out with a tube;
  • Crawling reflex - if the child is placed on his tummy and put his hands on his feet, he will start to push off and try to crawl;
  • Babinsky reflex - if you lightly tickle the heel of the child, he will begin to unbend and spread his toes.

After a consultation with a neonatologist, the pediatric nurse will tell the young mother how to care for the umbilical cord and skin, how to wash and wash the baby, how to properly dress and apply it to the breast.

A neonatologist is a pediatrician who monitors a child from the moment of birth until the 28th day of his life. A neonatologist deals with both premature babies and children in a hospital and maternity hospital. Considering that this specialist monitors the health of the smallest children, one can understand how responsible and delicate his work is. It is at this age that diseases can be detected in children, which in the future can lead to complications and disability. The task of a neonatologist is to prevent these processes, diagnose the disease and prescribe the necessary treatment. As a rule, neonatologists are generalists. They have to deal with a variety of childhood pathologies and take an active part in the recovery of young patients.

Online Appointment to Neonatologist

Who is a neonatologist?

A neonatologist is a doctor who creates conditions for the baby to adapt to the world. In the maternity hospital, the neonatologist shows the mother for the first time how to feed the baby, how to swaddle. Some maternity hospitals specialize in the pathology of childbirth, there are several neonatologists in such maternity hospitals, they are able to provide resuscitation care to the newborn, if necessary.

After birth, all the organs and systems of your baby are rebuilt. He experienced great stress when he was born! In the first week, it is decided whether the child will live. It is up to 7 days that spontaneous death of newborns most often occurs.

Responsibilities of a neonatologist and main functions

Going to give birth, a woman is interested in finding good doctors (gynecologist, obstetrician), she also studies the features of maternity hospitals. Of course, this is right, because the professionalism and qualifications of such doctors, as well as the equipment of the maternity hospital, are often the determining factors in the outcome of childbirth. Meanwhile, a good neonatologist is an equally important condition in terms of the consideration of childbirth and all aspects associated with them. After all, it is he who plays an extremely important role in the life of the baby.

If we consider the activities of a neonatologist in certain areas, then, for example, the Apgar scale, in comparison with the doctor's data on the child's condition, is the basis for further determining the medical care needed by the child. Moreover, in some cases, women in labor do not even fully realize that this doctor practically “pulls out” the baby from the other world (of course, in this case it all depends on the specific pathology that is relevant to him).

There are maternity hospitals designed for healthy mothers and their babies born on time. In addition, there are separate maternity hospitals that are focused on difficult births, premature births, premature babies, etc. In the conditions of such maternity hospitals, resuscitation and survival of babies are the main tasks, and it is with them that a neonatologist is called upon to cope. In addition, it is important to note that even if we are talking about conventional childbirth, there is no guarantee that the child, for example, will not develop asphyxia or other unforeseen situations will arise in which urgent help from a neonatologist will be needed.

A neonatologist is the specialist that you cannot do without if a baby is born weighing within 1 kg, moreover, the WHO (World Health Organization) has a recommendation for nursing children whose weight is from 500 grams, as well as with a weight somewhat higher than this figure, which, again, determines the need for this specialist. Of course, an important point is the availability of appropriate equipment in a particular maternity hospital, but the equipment and data obtained with its help, as you know, are not always an indisputable guide to action or, conversely, to inaction. For this reason, it is so important to include such a specialist as a qualified neonatologist in the list of specialists in preparation for childbirth. He advises the mother on the proper bathing and feeding of the child, the choice of milk formula, the mode of walking and sleeping. A pediatric neonatologist draws up a vaccination schedule.

What does a neonatologist treat?

The first month of a child is considered by many to be crucial. There is a restructuring in all organs and systems of the baby. The blood circulation changes, the lungs begin to breathe, the child gets acquainted with the new conditions of survival for him, and this process does not always go smoothly and without problems. Immediately after birth, the development of diseases that the neonatologist directly deals with is possible. Let's highlight the main ones:

  • Albuminuria is a characteristic physiological disturbance in the functioning of the kidneys.
  • Thrush.
  • Constipation (diarrhea).
  • Children's cholera.
  • Diaper rash.
  • Rashes of various nature.
  • Blennorrhea of ​​newborns (a disease in which the eyes of a child become inflamed).
  • Phenylketonuria (metabolic disorder of an innate nature).
  • Hypothyroidism (a condition of reduced thyroid function).
  • Umbilical hernia, "wild meat", bleeding, etc.
  • Difficulty breathing. A newborn often takes a breath, but it is difficult for him to exhale. This can last up to 7 days, in premature babies longer.
  • Toxic erythema is an allergic rash in newborns. Most often it goes away without treatment.
  • A decrease in temperature or fever in newborns is a violation of the thermal balance due to imperfect thermoregulation of the baby. At a low temperature, it must be wrapped up; at an elevated temperature, an enema is recommended for newborns with analgin.
  • Stool disorder - immediately after birth, the stool is thick and green. Within 10 days, it returns to normal, becomes mushy, yellowish due to the normalization of the activity of beneficial intestinal bacteria.

Also, after birth, there is a physiological drop in the body weight of the child by an average of 5%.

What does a neonatologist monitor?

Neonatologists monitor the health of the baby and are responsible for its safety. They know everything about deviations in development, pathologies of newborns and are ready to provide assistance at any time. Its effectiveness depends on many factors, the main task of the doctor is to obtain the most complete information about the identified violation. Diagnosis is based on the study of the state of the following organs of the newborn:

  • Stomach. It is mandatory to feel the tummy by a neonatologist, this measure allows you to determine the state of the baby's spleen and his liver (including this allows you to determine the size of these organs). On examination, the doctor determines whether the child had bowel movements (stool), whether there were any features in them. It should be noted that during the first day of life, the original feces in the newborn (meconium) are discharged, and if there are any problems with this (more precisely, if this discharge does not occur), an additional examination may be required. This may be due to the presence of grounds for the relevance of any congenital pathologies (meconium ileus, cystic fibrosis, etc.). Note that meconium has a thick and viscous consistency, resembles resin (olive or dark green), odorless, sticky.
  • Neck. The clavicles are palpated, which allows you to make sure that there are no injuries in them that could have formed during labor, the area of ​​\u200b\u200bthe sternocleidomastoid muscles is also probed (if the pathology of muscular torticollis is relevant, then shortening of the muscle may be noted).
  • Head. A neonatologist performs a visual examination of the baby's head, in particular, they probe the bones of the skull, determine the size of the fontanelles, and also examine the head area for the presence of a birth tumor (edema). Lungs, heart. Using a phonendoscope, the neonatologist listens to the lungs and heart sounds, examines the baby's breathing rate.
  • Sex organs. When examining boys, a neonatologist probes the area of ​​the testicles, thereby determining whether their proper descent to the scrotum has occurred. As for the study of girls, here an examination of the labia majora is carried out, and in particular, whether they cover the small lips.
  • Muscles. In particular, an important role in the general diagnosis in this area is muscle tone, which is considered as a fairly important characteristic of the general condition of the infant. As a rule, physiological hypertonicity (that is, increased tone), noted in part of the flexor muscles, is relevant. This feature is a factor that determines the posture of the baby, in which his head is somewhat brought to the chest, the arms are in a state bent at the elbow joints, pressed to the sides. The child's hands are in a state compressed into fists. The legs are bent at the knees, and, accordingly, bent at the hip joints. The neonatologist, performing flexion and extension of the child's limbs (arms and legs), on the basis of their current state, determines the state of the child's muscle tone.
  • Hip joints. And this area, of course, the neonatologist also does not exclude from the sphere of his own attention. The legs should be adequately bred in the normal state of the hip joints, but if the breeding of the legs is difficult, then there is a possibility of dysplasia. There should also be symmetry in the location of the skin folds on the legs.
  • Reflexes. In newborns, there are quite a lot of them, while the assessment carried out by the neonatologist takes into account their main options.

When should you consult a neonatologist?

In a number of conditions, such as "wild meat", an umbilical hernia, or bleeding from the navel, it is required to see this doctor. If blood appears from the umbilical cord during the first hours after childbirth, it can be argued that it was not bandaged well enough. As a rule, such bleeding stops quickly enough. However, the picture looks somewhat worse when blood appears in the period of 3-5 days from the moment of birth of the child when the umbilical cut falls off. After the umbilical cut disappears, in some cases a piece of meat remains in the navel, resembling a berry on a thin stalk, it is this formation that is called wild meat in the navel.

As for such a pathology as an umbilical hernia in children, the cause of its occurrence is either, again, a poorly bandaged umbilical cord, or the baby's constant cry, or strong gases.

In addition to the listed conditions, they also turn to a neonatologist if the child has diaper rash. Most often, it focuses on the buttocks, genitals and lower abdomen of the child, somewhat less often - in the area of ​​​​the inguinal, axillary, femoral and axillary folds, behind the ears. Intertrigo can manifest itself in accordance with three degrees that determine its condition. So, I degree is characterized as mild, its features are the moderation of redness of the skin, no visible violation of the integrity of the skin is detected. II degree is characterized as a degree of moderate severity, in which the redness is already bright, and erosive formations appear on the skin. And, finally, III degree, which is characterized as severe. Here the skin is red, weeping, sores can form. Among other things, diaper rash is also susceptible to infection within this degree.

Tests that a neonatologist can prescribe

  • Bilirubin total.
  • Bilirubin direct.
  • Blood type and Rh factor.
  • General blood analysis.
  • Immunoglobulin E.
  • Allergological panel Ig G.
  • Streptococcus a.
  • Streptococcus B.
  • General urine analysis.
  • Coprogram.
  • Feces for intestinal dysbacteriosis.
  • Sowing a smear from the pharynx for staphylococcus aureus.
  • Allergological panel Ig E.
  • Sowing a smear from the nose for microflora.

Other tests may be ordered as indicated.

In any, even the most severe cases, when congenital malformations and intrauterine infections are found in an infant, examination and research are entrusted exclusively to neonatologists. They know how to draw blood from a newborn, calculate the dose of medicines or put a dropper.

The need for tests immediately after the birth of a child is dictated by an increase in the number of serious hereditary diseases. To detect and prevent them, the doctor prescribes three main tests, the purpose of which is to determine the blood type, Rh factor and the presence of serious genetic diseases (neonatal screening). The blood is taken from the baby in the maternity hospital. The resulting sample is applied to the test strip and sent to the laboratory. If a genetic disease is suspected, notification of the child's parents is considered mandatory. This is done for the subsequent appeal to the endocrinological dispensary or medical genetic consultation, and the development of an effective treatment program for the child. In cases where the diagnosis is not confirmed, there is no special notification for the parents of the child.

What diagnostic methods does a neonatologist use?

Ultrasound of the hip joints in children, neurosonography in children, echocardiography, visual examination, palpation, thermometry, laboratory tests and other diagnostic methods according to indications.

The baby may refuse to take the breast immediately. Ask the nurse to help you. For 2-3 days he will eat himself.

The skin in the first days of a child's life is red, dry and wrinkled. Don't be scared! And often offer the baby breast and water, but make sure that there is no overfeeding.

Ventilate the room where the child is located more often. It's good for his lungs.

If you are breastfeeding, review your diet for excess animal protein. With them, the kidneys of the child can not yet cope very well. Drink tea, freshly squeezed juices, compotes.

Do not invite guests to the house immediately, postpone the celebration of such an important event for a week ahead. Strangers can scare the baby.

A neonatologist is the first doctor in your child's life. Its development depends on how you follow the recommendations given by the neonatologist in the maternity hospital.