The first 28 days of life are called the newborn (neonatal) period. Most babies stay well, but a few conditions are common in this time, and many are easy to treat when caught early.
Danger signs: see a doctor at once
Take the baby to a hospital immediately if you notice any of these:
Not feeding well, or stopped feeding
Fits (convulsions)
Fast breathing (60 or more breaths a minute) or chest drawing in with each breath
Fever (37.5°C or above) or feeling cold to touch (below 35.5°C)
Moves only when touched, or does not move at all
Yellow palms and soles, or yellow skin in the first 24 hours
Bluish lips or tongue
Redness, pus or a bad smell around the umbilical cord
Jaundice and infections
Neonatal jaundice
Yellowing of the skin and eyes caused by bilirubin, a yellow pigment from the normal breakdown of red blood cells. A newborn's liver is still immature, so mild jaundice is common in the first week.
Signs: Yellow face and eyes, spreading to the chest and legs. Dark urine or pale stools need urgent attention.
Causes: Usually normal (physiological) jaundice. Less often, blood group mismatch with the mother, infection, prematurity or liver problems.
Treatment: Frequent breastfeeding. Phototherapy (blue light) if levels are high; rarely, exchange blood transfusion.
See a doctor if: Jaundice appears in the first 24 hours, reaches the palms and soles, or lasts beyond two weeks (three weeks in preterm babies). Very high bilirubin can damage the brain.
Neonatal sepsis
A serious blood infection in the first month of life and a leading cause of newborn deaths in India.
Signs: Poor feeding, lethargy, fever or low temperature, fast breathing, vomiting, a swollen belly, fits.
Causes: Bacteria passed on during birth or picked up afterwards from unclean hands, instruments or surroundings. Higher risk in preterm and low-birth-weight babies.
Treatment: Hospital admission and injectable antibiotics, usually for 7 to 14 days.
Prevention: Clean delivery, handwashing before touching the baby, early and exclusive breastfeeding.
Umbilical cord infection (omphalitis)
Infection of the stump of the umbilical cord.
Signs: Redness and swelling around the navel, pus, a foul smell.
Treatment: Antibiotics. Spreading redness needs hospital care, as the infection can enter the blood.
Prevention: Keep the cord clean and dry. Do not apply oil, ash, turmeric, cow dung or any other substance to it.
Eye infection (neonatal conjunctivitis)
Infection or irritation of the eyes, usually in the first two weeks.
Signs: Red, swollen eyelids; sticky or pus-filled discharge.
Causes: Bacteria from the birth canal, or a blocked tear duct.
Treatment: Antibiotic eye drops or ointment, sometimes oral or injectable antibiotics. Pus from the eyes in the first days of life needs urgent care, as some infections can damage vision.
Oral thrush
A mild fungal (Candida) infection of the mouth.
Signs: White patches on the tongue, gums and cheeks that do not wipe off like milk; fussiness while feeding.
Treatment: Antifungal drops or gel prescribed by a doctor. Breastfeeding mothers may also need treatment for the nipples.
Prevention: Clean and sterilise any feeding bottles, spoons and pacifiers.
