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About newborn screening

Newborn screening is carried out in the first few days of your baby’s birth. Typically, it will be done before you leave the hospital for home with your little one. The purpose of newborn screening is to check the baby for any medical conditions or disorders that require attention. As with any other illness, early detection followed by the appropriate treatment is the key to prevent further damage.

What does newborn screening involve?

Shortly after birth, i.e. within 24-48 hours, a blood sample is taken from your baby. While it does involve some pain, rest assured that the discomfort will be minimal for your newborn. Additionally, newborn screening also includes a test to evaluate the baby for hearing loss and the pulse oximetry test to check for congenital heart disease. The timing on these tests is crucial because certain medical conditions may go undetected after 24 hours of birth.

Why is newborn screening recommended?

Most new-borns look healthy and are born healthy. However, some can be born with serious medical conditions that cannot be detected by merely looking at them; this is what makes screening one of the best starts you can offer your baby at birth itself. This pre-emptive testing makes sure that any conditions are caught immediately before the baby can actually get sick because of them.

What are the tests offered under newborn screening?

Globally, a range of tests are offered, and the parents may elect to opt for some more as well, under medical advice. Below is an indicative list of some of these tests:

• Phenylketonuria (PKU)
• Cystic fibrosis
• Sickle cell disease
• Critical congenital heart disease

All these tests can be carried out using the same sample of your baby’s blood.

Awaiting new-bornscreening test results

If your baby’s test results come back negative, it means that all his parameters are in the normal range and do not require further investigation. However, should the reports come in as positive, they should definitely be discussed with your doctor. Often, the concerns can be addressed right from then itself, for instance by incorporating a special diet and follow-up testing. What you need to keep in mind is, do not let this be a stressful or trying time for you as a parent.

Your next steps

Once the reports are in, your doctor will discuss them at length with you if there is anything that requires attention. But do keep in mind that a screening test is not diagnostic in nature and needs to be followed up with further testing that is specific to the indicative condition. Hence, while as a new parent you would naturally be anxious, do not panic and evaluate all available options calmly with your doctor.

Benefits of breast milk

It is a wonderful gift — it contains the exact amount of nutrients he needs, like water, proteins, sugars, and fat. It also contains antibodies to build up his immune system, and growth factors and hormones to ensure growth at a healthy pace.

Due to this, around 425 – 700 calories get secreted through your breast milk on a daily basis. It isrecommended to increase your daily calorie intake by around 500 calories every day. Ensure that the extra calories are from healthy sources, and not empty calories in the form of junk food or sweets.

With breast milk being affected by what you consume, it is imperative to ensure the nutrition you’re passing on is as healthiest as possible.

Diversity in diet

Eating healthy benefits both you and him. But having a more well-rounded diet will help in different ways. It isn’t only about the diverse nutrients your baby will get! No, there’s also another surprising benefit. If he’s exposed to a varied diet via breast milk,he’ll be more likely to have a broader palate when you start weaning him. Now you know what you have to do to get him to eat vegetables!

Important foods

It is always a good idea to eat an ample amount of fruits and vegetables, whatever you fancy. Theypossess a host of nutrients and go a long way in maintaining a healthy diet. Also include carbs — bread, rice, pasta,and potatoes. All these foods, along with pulses, will provide much-needed fiber, too. Proteins are important with fish, poultry, eggs,and lean meats as your best bet. And of course, consume lots of dairyto get lots of calcium. Milk, butter, cheese, cream, yogurt, anything!

Instead of sugar?

Sugary treats like muffins, cookies, and chocolate sound wonderful for your cravings, but may not be the best idea. Instead, replace with healthy alternatives that provide you much-needed energy like sunflower seeds, berries or raisins. If you want something sweet, you can opt for some fruit with yogurt. They also have the benefit of releasing sugar into your bloodstream at a lower rate as compared to processed foods.

Keep hydrated

It is recommended to drink at least 2 litres of water a day, as water is an important component of breast milk. You can also drink milk, juices or smoothies. Stay away from coffee though, it’s a diuretic and will make you lose water rapidly.

The NICU – Where Supportive Care starts

The Neonatal Intensive Care Unit is the first place where supportive care for your pre-term baby starts. This room is fully equipped with alarms, tracking systems, monitors, and other sophisticated paediatric equipments that help observe and keep a check on your baby and his vital organs, breathing rate,and other essentials.

This NICU is managed by a dedicated team of experienced doctors and nurses who take care of the feeding schedules, checking of fluid levels, blood pressure, body temperature, and other vital parameters of the baby. Gone are the days when women felt scared when they delivered a pre-term baby. Today, thanks to the advanced medical technologies, your pre-term baby recovers quite quickly and you can take him back home sooner than you ever imagined.

Respiratory Assistance

Providing your baby with a seamless way to breathe is the most important part of supportive care. Depending on the age and condition of the baby, he can be introduced to any one of the following forms of respiratory assistance:

• Endotracheal Tube – warm air is passed through a tube inserted in the baby’s windpipe
• Ventilator – baby breathes with the help of a machine and it is connected to the endotracheal tube
• Continuous Positive Airway Pressure – helps naturally-breathing babies to get air more freely
• Oxygen hood – oxygen is pumped into the baby’s body with the help of an external box

Feeding Assistance

Different kinds of feeding assistance are provided by experienced medical experts, depending on the age and condition of the baby. Some of them are:

• Intravenous Lines – used for babies who cannot suck or swallow by themselves due to immature digestive system. These lines are used so that nutrition can reach the blood stream directly.
• Umbilical catheter – used in rare cases; a machine is surgically inserted in the umbilical cord of the baby
• Oral and nasal feeding- given to babies who can digest breast milk, but cannot suck or swallow on their own
• Central Line – babies are fed through intravenous lines inserted into their veins

Other important points of supportive care for pre-term babies

• They may get treated for jaundice under bright lights, also called bilirubin lights
• The assistant at the NICU trains you on kangaroo care, a trick that you must master, as it deals with the correct position of holding your baby
• Pre-term babies benefit a lot when you hold them properly. Excellent skin-to-skin contact can help them recover quickly as it helps them regulate their body temperature. When you hold your baby properly, you can breastfeed him well, thereby helping him to get enough nutrients for his steady growth.

At birth

At the outset, you should keep in mind that no two babies are the same. While one may weigh in slightly more on the scales than another, another baby who weighs less is also likely to be as healthy. On an average, a newborn weighs about 5 to 8 pounds. In certain cases the baby may be born large or small.

Large Babies:

If the mother or both parents are overweight, the infant may be born large. While large babies may be prone to issues like low blood sugar, calcium, and other problems, staying in touch with your pediatrician can help you maintain your baby’s health.

Small Babies:

A baby may be born small due to various reasons like being born early, malnutrition, or genetic reasons. A small baby may have to have their temperature, glucose, haemoglobin levels monitored, to ensure healthy development.

Influencing factors at Birth

Remember, as,witha lot of aspects concerning babies, weight too is determined by multiple factors. These include:

• Mother’s health during pregnancy: If you have been healthy throughout your pregnancy, chances are that your baby has an average or more birth weight. However, any health issues you may have had may influence your baby’s birth weight.
• Baby’s health: Medical complications during pregnancy can influence the baby’s weight. For instance, pre-term birth or complications in pregnancy may impact your baby’s birth weight.
• Nutrition during pregnancy: What you eat when you are pregnant is important for the baby. A poor diet, for example, can affect your baby’s birth weight. Hence is advisable to include a variety of nutrients to ensure a healthy pregnancy and birth.

What more should you know?

As a new mother, it’s often difficult to gauge whether your little one is gaining weight or not. A newborn will lose weight in the first few days, around 5-7 days, of his life, but will steadily gain his birth weight over the next few weeks. Keep these things in mind when it comes to weight gain:

• How often your baby is fed is important. A 5% weight loss is normal for a formula fed babies, while 7-10% is normal for breastfed babies for the first few days.
• Babies will have gained much more weight by about 3-4 months. At 4 months weight gain will look different for breastfed and formula fed babies. The best judge is your pediatrician. Consult them to ensure your baby has a healthy weight.
• Keep track of wet diapers. An average baby will have 5-7 wet diapersand 3-4 dirty diapers a day.Now, this may change with time. Plus, formula fed babies may have fewer bowel movements.

Here’s some more information

Remember that at the end of the day, genetics and environment have a large role to play in your baby’s weight gain and growth. Even if your baby has started off being smaller, there is nothing to say that he won’t gain weight as he grows. Keep monitoring your baby to ensure that he is healthy and active, and let weight be a guide and not the only factor by which to judge your baby’s health.

Symptoms of milk allergy

The symptoms of milk allergy can be divided into two types – immediate and delayed. Even if don’t notice any allergic reaction in your baby after feeding him cow’s milk, we recommend you to wait for 2 hours to about 2 days to see if he is showing any signs of discomfort. Some of the symptoms that you can watch out for are:

• Vomiting and diarrhoea (sometimes, your baby can experience a delayed onset of diarrhoea 2 days after drinking cow’s milk)
• Skin problems (itches, rashes, redness, hives, and eczema)
• Respiratory problems such as wheezing and noisy breathing
• Stomach pain
• Swelling in the body or any body part (a rare symptom that need immediate medical help)

To confirm if your baby is allergic to cow’s milk, you could note down these symptoms, whenever they occur and have a detailed discussion with your paediatrician about the same. They would then conduct certain tests such as blood tests and skin prick tests to confirm the allergy.

Managing your child’s milk allergy

If you are breastfeeding

• If you consume cow’s milk, it could pass on to your baby while you are nursing him. Therefore, it is important that you eliminate cow milk-related products from your diet right away to see if there is a positive change in your baby’s allergic reaction.

If your baby is formula fed.

• The doctor may suggest a specialised formula milk, in which the protein is broken down into tiny pieces so it isn’t recognised by your baby’s immune system.

If you suspect your baby is suffering from cow’s milk allergy, it is best to consult your paediatrician and follow their advice on the same.