After birth, the hormonal background of the fetus changes dramatically. This causes the development of a sexual crisis, the manifestations of which include the following conditions.
Breast engorgement. The mammary glands in newborns begin to enlarge at 3-4 days. They are dense, painful, sometimes slightly reddish. The gland may secrete colostrum in appearance. Usually, by the end of the newborn period, the baby's glands return to normal.
Vaginal discharge. Mucous copious discharge from the vagina in newborn girls can be noticed almost immediately after birth. After 2-3 days their number decreases significantly, and by the end of the first week of life they completely stop. In some girls, mucous discharge is replaced by bloody discharge. Bleeding continues for 1-2 days.
The blood loss is insignificant, usually no more than 1-2 milliliters, and does not affect the girl’s health in any way.
Severe sexual crisis- one of the indicators of a child’s good adaptation to extrauterine life. In children who have undergone a sexual crisis, the newborn period usually goes very smoothly, they are calm, sleep well, eat and gain weight.
Genital organs in boys: normal and pathological.
In newborn boys, the scrotum is often swollen and enlarged. The swelling goes away in 1-2 weeks. A small accumulation of fluid in the scrotum (hydrocele) is also not a pathology. The liquid resolves within a month.
When examining a boy's genitals, it is necessary to make sure that the testicles have descended into the scrotum (in the fetus they are located in the abdominal cavity). In full-term boys, the testicles can be felt in the scrotum in the form of dense round formations with a diameter of about a centimeter. If the testicles cannot be felt during the first examination, the procedure should be repeated the first time the newborn is bathed (the testicles in little boys are very mobile and can be hidden in abdominal cavity in response to mechanical or cold stimulation). If during the first week you still cannot find the testicles, contact a pediatric urologist.
The length of the penis in newborn boys is 2-3 cm. If the length of the penis is less than 1 cm or more than 5-6 cm, the boy needs to consult an endocrinologist. The head of the penis is covered foreskin, you cannot forcefully open the head, this often leads to infection.
Sample answer to ticket No. 20
Task 2.
Newborn baby 2 days old. From a repeated normal pregnancy, a second term birth, with a weight of 3400 g, length 51 cm, Apgar score of 8/9 points.
Objectively: By the end of the first day, bright hyperemia of the skin appeared. On the second day, the erythema became brighter, and then its intensity gradually decreased and completely disappeared by the end of the first week of life. After the disappearance of the erythema, small pityriasis-like and large-plate peeling of the skin appeared, especially on the abdomen and back.
General state the child is not impaired. The temperature is normal. Sucks actively. Physiological functions are normal.
Tasks:
1. Identify the newborn's problems.
2. Determine and justify the physiological state of the newborn.
3. Create a nursing intervention plan.
Professional task
Identify the newborn's problems.
Real (real) problems of a newborn:
Bright hyperemia of the skin;
Small pityriasis-like and large-plate peeling of the skin;
Lack of maternal knowledge about child care;
A newborn cannot perform personal hygiene independently for 2 days.
Potential problems:
High risk of infection skin;
Violation of the integrity of the skin.
2. Determine and justify the physiological state of the newborn
Simple erythema is a reactive hyperemia of the skin that occurs after removal of the original lubricant. The redness in the first hours has a slightly cyanotic tint, on the 2nd day it becomes brightest, then its intensity gradually decreases and disappears by the end of the 1st week of life; in premature infants, erythema is more pronounced and lasts longer - up to 2-3 weeks;
-Physiological peeling of the skin– large-plate peeling of the skin occurs on days 3-5 of life in children with bright simple erythema as it fades; Excessive peeling is observed in post-term infants.
Rationale: based on objective examination data.
3. Create a nursing intervention plan.
- To fill the mother's lack of knowledge about the causes, features of the course of simple erythema, as a transitional state of the newborn.
- Obtain informed consent for procedures.
- Ensure comfortable conditions in the newborn's room.
- Carry out regular cleaning, ventilation and quartzing of the newborn ward.
- Maintain optimal temperature regime in the ward.
- Provide feeding for the newborn breast milk on demand".
- Observe asepsis and antisepsis during care (prevention of nosocomial infection).
- Monitor the child’s condition, record breathing patterns, respiratory rate, heart rate, blood pressure, changes in skin color and integrity, and note the nature of the temperature curve.
- Follow the neonatologist's instructions.
Sample answer to ticket No. 21
Task 3.
Practical manipulation
Demonstrate the manipulation on a phantom: “Technique for morning toileting of a newborn”
Practical manipulation
Usually, to relieve irritation and alleviate such symptoms, doctors recommend applying warm compresses to the nipple area. camphor oil or warm dry dressings. And in order not to provoke skin irritation in the child, the baby’s mammary glands area should be treated with the utmost care.
In most cases, by the end of the first month of life, physiological mastopathy in infants goes away. If it is observed for two to three months or even more, it is most likely that the newborn has developed mastitis. With this problem you should definitely consult a doctor.
Changes in the genitals
Approximately on the third to sixth day after birth, girls may begin to have vaginal discharge that looks like grayish-white or bloody mucus (micromenstruation). This phenomenon It is quite widespread - it can be observed in every tenth girl. In addition, the baby’s labia may become enlarged.
After two or three days, the symptoms described above usually disappear. However, before everything returns to normal, the girl needs to be provided with proper intimate hygiene. It is necessary to wash the baby under running water in the direction from the vagina to the anus. At the same time, when washing, you only need to remove the mucus that has come out - you cannot clean the entire genital slit, as you can easily damage the mucous membrane.
As for boys, changes in their genital organs occur in almost the same period of time as in girls. As a rule, slight swelling is observed on the genitals of babies, in some cases accompanied by dropsy (due to the accumulation of fluid, the testicles become slightly enlarged). After three weeks, these symptoms disappear.
If, after the expiration of the time allotted for what is happening in children's body changes, in girls the vaginal discharge does not stop, and in boys the dropsy does not go away, in order to avoid serious violations internal organs you should contact your pediatrician.
"Acne" of newborns
During a hormonal crisis, you can also see “acne” on the faces of some children. Microscopic yellow dots form on their forehead, as well as on their cheeks. Towards the end of the second week of the baby’s life, these points usually go away - they have nothing in common with ordinary juvenile acne. As for caring for a child’s face during this period, there are no special events when such “acne” appears, it is not required - ordinary hygiene procedures.
Links
- Problems of newborns and ways to solve them
- Physiological characteristics of a newborn, social network for parents Stranamam.ru
- The baby's first month is special. , social network for parents Stranamam.ru
It is so established by Mother Nature that children among us, representatives of the human race, are born of different sexes. In this regard, most new mothers and fathers often worry about how different is caring for a newborn girl from how to care for a boy? As for feeding, daily routine or, for example, morning toilet, there are no fundamental differences in the algorithm of actions and the means used. But if we talk about intimate hygiene, then yes, already in the maternity hospital and in the first days after discharge, parents understand that behind their little princess or behind the newly born tomboy, in connection with characteristic features structure of the genital organs, you will need to take care of it in a special way. Are you expecting to have a daughter? Then it’s time to learn about the intricacies of hygiene procedures for little representatives of the fairer sex.
In the first days
Like most systems in a newborn's body, it reproductive system at the time of birth, it is still immature and is in the process of development and formation.
In a girl, this is externally expressed in the fact that the mucous membrane of her genital organs is very thin and delicate, and therefore is it vulnerable to all kinds of damage? which can cause the baby to get into the body harmful microorganisms and pathogenic bacteria.
For this reason, caring for a newborn girl must be carried out not only carefully and regularly, but also in compliance with certain rules.
Let's start from the very first day after birth. If you notice a creamy or light gray coating on your recently born daughter’s labia, don’t worry. This - smegma – original lubricant, or rather its remnants.
Previously, vernix was washed off immediately after the birth of the child. Today it is believed that if it is absorbed into the skin, it will only benefit the newborn
Usually the secretion is absorbed into the skin for some time after childbirth. But if there is a lot of lubricant, it must be removed to avoid oxidation of the fats contained in it. They can cause reproduction pathogenic flora and, as a result, inflammation of the mucous membrane.
Your actions: remove smegma with cotton pads or swabs soaked in warm water boiled water. The plaque can be very dense and washed off in pellets. In this case, do not rush and clean it in two or three steps. In a couple of days the secret will completely disappear.
But these are not all the features related to gender that can alarm and discourage you in the first days and during the first month after the birth of your baby.
Hormonal crisis
Hormonal crisis in newborns - this is a transitional state, when the baby’s body has not yet established the production of its own hormones, and after birth it no longer receives maternal hormones through the umbilical cord
During pregnancy, the child, while in the mother's womb, through the umbilical cord, receives from the mother's body all the substances necessary for its growth and development. Including hormones. After separation from the mother, the baby must become completely autonomous, that is, learn to independently produce everything that is needed for the full functioning of his body.
Until this happens, immediately after birth and some time later, the level of hormones in the newborn’s blood rapidly drops. And their lowest content is observed at the end of the first week from the moment the baby is born, which is natural and inevitable, and which may manifest itself in some nonspecific reactions.
In girls, these reactions are often much more pronounced than in boys. They got one common name – hormonal (or sexual) crisis. Although these are several local phenomena, each of which deserves separate consideration.
Vulvovaginitis
Use cotton pads for any hygiene procedures, incl. and for removing mucus during vulvovaginitis in newborn girls
The end of the first week after the birth of a girl for her parents may be marked by the discovery of mucous membranes or even bloody discharge from the vagina.
And again, do not rush to swallow validol and call the emergency room. This is precisely one of the manifestations of a hormonal crisis in newborns. Within 10–14 days, when the baby’s hormonal levels return to normal, the discharge will stop.
Your actions: If you find it, carefully remove mucus from your daughter’s labia with cotton pads moistened with boiled water, and carefully monitor compliance with all hygiene rules.
Physiological mastopathy
Choose your baby's wardrobe very carefully. There's no place in it synthetic fabrics and materials made from artificial fibers
Evidence of the presence of maternal estrogen in the baby’s body is the redness and swelling of her mammary glands on days 4–7 after birth. For some it is weakly expressed, for others it is stronger. Colostrum may also be released from the breasts. These phenomena are considered normal. In most cases, no intervention is required and everything goes away by the end of the first month of life.
Your actions:
- Make sure that the baby's nipples come into contact with clothing as little as possible, which should definitely be made of natural fibers. There should be no seams, fasteners, or embroideries in the chest area.
- Do not rub the girl’s breasts or squeeze colostrum out of them under any circumstances.
- If your breasts become very swollen or red, consult your doctor immediately. To relieve the symptoms of physiological mastopathy, he may prescribe treatment of the nipples with a weak solution of furatsilin and compresses with camphor oil.
This is what a hormonal rash or bloom looks like
A reddish rash, sometimes with white dots, on the facial skin of a newborn girl is popularly called blooming, but doctors attribute its appearance to hormonal imbalances in the body.
Your actions: This is not an allergy, not an infection or a cold, as some may think, and these pimples do not require treatment. Let mom not torment herself with a diet, don’t swallow antihistamine tablets and does not give syrups of the same content to the baby. IN in this case the best doctor is time. 1-2 months later there will be no trace left of the flowering on the little face of your beloved daughter.
Intimate hygiene
Air baths have a beneficial effect on baby's skin
Rule one. And this is not even a rule, but a commandment that every mother of every newborn girl must fulfill. Change diapers frequently and wash your daughter under running water after each change.
Important!
- Wet sanitary napkins should only be used in extreme cases. They cannot be an alternative to washing.
- For hygiene of a girl’s genitals, only running water is suitable. Washing in a container with water is unacceptable for females, even newborns.
Rule two. An adult must wash their hands thoroughly with soap before washing the baby.
Rule three. When washing, use soap 1-2 times a day, not more often, otherwise you risk drying out delicate skin labia of a newborn girl or disrupt the microflora of the mucous membrane.
The little princess should be washed in the direction from the pubis to the anus, and in no case vice versa
- It is very important to wash your little princess correctly. This means that first, from the bottom up towards the tailbone, the perineal area around is soaped and rinsed anus(this way you will avoid infection in the vagina).
- And only then the outer labia are soaped from the pubis to the vagina and also rinsed with running water.
- You wipe your daughter’s genitals like this: with a soft, ironed towel, first blot the genital area, then the outer labia. There is no need to wipe the internal genital organs to avoid damaging the microflora.
- After washing, lubricate the delicate skin of the baby’s outer labia and perineum with baby oil (sterile sunflower, olive) or baby moisturizer.
And one more important point. Several times a day, during diaper changes or before bathing, leave your daughter without clothes for a while. Let her skin, as they say, breathe. Air baths – best prevention any skin problems in newborns.
Bathing
Up to a year old, you need to bathe your baby in the bathtub, and when she gets older, you can do so in the shower.
An infant girl needs to be bathed every day in the bathroom, and it will be enough to use baby soap or foam only 1-2 times a week. On other days, you can add decoctions to the bath medicinal herbs– strings, calendula, chamomile, which have a beneficial effect on overall well-being, tonic and disinfectant.
Visit to the gynecologist
All newborn girls undergo a routine preventive examination by a gynecologist when they are 1 month old. But in some cases, it is not worth waiting for the appointed time, but you need to consult a doctor immediately.
Remember, a disease diagnosed in time is easier to treat. Therefore, if you notice any health problems in your daughter, consult a doctor without delay.
Symptoms for which consultation with a gynecologist is necessary:
- appearance purulent discharge from the vagina;
- severe swelling in the area of the mammary glands;
- noticeable restlessness of the baby during each urination.
These manifestations may be accompanied by an increase in the girl’s body temperature, lethargy, and disturbances in appetite and sleep. And they are a reason not to delay visiting the appropriate specialist.
Video “Girl Hygiene” Komarovsky
Swelling mammary glands in infants - this is a typical case, which, in most situations, does not threaten anything. This is the normal development of the mammary glands, associated with hormonal changes in the body. Let's figure out whether you should worry, how to recognize the pathology and not miss the disease.
Breast engorgement in newborns can be very frightening for parents. It would seem that the mammary glands are not even fully formed yet - why should they swell? This looks especially strange if the boy’s nipples are swollen. Along with breast changes, other symptoms may also occur - small pimples on the face, changes in skin color.
This is all a normal process. The newborn develops the correct hormone ratio for its gender. If the baby was not diagnosed with any pathologies in the maternity hospital, then there is no need to worry ahead of time.
Hormonal crisis in newborns
Hormonal crisis in newborns is the medical name for a phenomenon associated with hormonal changes in the first days of life. The baby adapts to the world around him, adjusts his body to interact with environment . Why is this necessary? The point is that during intrauterine development
, the child receives hormones from the mother. They are needed to maintain pregnancy and to protect against early birth. At the moment of birth, the child stops receiving maternal hormones, their concentration drops sharply, and the body begins to produce its own. Severe swelling occurs mainly in girls. Some parents believe that it is the breasts growing, but in fact the breasts only grow temporarily. This phenomenon is called age-related mastopathy and also occurs in boys. It's true for boys hormonal changes
goes differently, so the breasts return to normal faster.
- Age-related mastopathy in newborns is manifested by the following symptoms:
- Around the beginning of the second week of life, the skin around the nipples turns red.
- The mammary glands enlarge and can reach a diameter of 5 cm. This largely depends on the weight of the newborn and gender.
Interestingly, severe age-related mastopathy is observed only in three quarters of newborns. In 25% of children, symptoms are so mild that they may not be noticed. Mastopathy may be mild in children born with underweight. All doctors agree that breast engorgement in newborns in the first weeks of life is physiological norm. You need to be wary only if you experience any atypical symptoms other than those described above.
The following symptoms are also normal:
- Discharge from the genitals may be mixed with blood. This is normal, since the genitals are open to the external environment, they produce their own mucous membrane and get rid of excess cells.
- Swelling in the genital area. A hormonal rash on the face is called milia. It looks like a scattering of small light pimples with white dots in the center.
It is important to practice good hygiene to help your child’s body adapt to the world around it.
How to behave as parents
You need to carefully monitor the signs of a hormonal crisis. If atypical symptoms appear, you should not put off going to the pediatrician. Pimples should not be squeezed; they will go away on their own. The task of parents is to prevent infection. In the first days of life, the body is especially vulnerable to viruses and bacteria.
Treatment Adherents folk ways They often say that you need to apply various compresses and use anti-inflammatory ointments. In fact, this is strictly prohibited. Neonatal mastopathy is a physiological, natural condition. There is no need to interfere with the body’s formation of hormonal levels.
Pediatricians also advise refraining from tightly swaddling the baby in the chest area. It is important to avoid any injury. Otherwise, microcracks will appear on the chest, through which it is easy to get infected.
On average, the crisis passes in 3 weeks. All this time, natural symptoms can be observed. You need to worry if, a month after birth, the signs of mastopathy do not become less noticeable.
Interesting fact: age-related mastopathy also occurs in adolescents, regardless of gender. Breasts increase in both young men and girls. Of course, girls' breasts are more enlarged and they begin to actively grow. And in boys, signs of puberty mastopathy usually disappear by the end of puberty. If the mammary glands remain enlarged, this is a reason to suspect gynecomastia.
How to determine the disease
Mastopathy can be not only physiological, but also pathological. How to determine the disease? The disease occurs due to the penetration of infection into microcracks in the chest. A newborn’s body does not yet know how to fight bacteria and viruses, so any infection is extremely dangerous.
If infection occurs against the background of age-related mastopathy, then purulent mastitis. Inflammations occur, enlarging the already swollen mammary glands, and the temperature rises. Since the child is not able to overcome the infection, a mandatory consultation with a doctor and taking all prescribed medications is required.
Symptoms of mastitis:
- Develops only on one breast.
- A lump appears in the mammary gland and it becomes harder.
- It hurts when touched.
- Literally every hour the swelling and inflammation increase.
- Increased body temperature, convulsions and vomiting may occur.
- The skin on the affected breast is red and hot.
- The child refuses to eat and sleeps poorly.
- Purulent discharge appears from the nipples.
If you have the symptoms described above, you should consult a doctor immediately. On early stages mastitis is treated with medications. If the disease is advanced, surgery may be required.
Treatment
Treatment tactics are chosen based on many factors: the health of the child, the severity of symptoms, the presence or absence of underweight. If only inflammation is observed, and purulent foci have not yet appeared, then antibacterial drugs, physiotherapeutic procedures and semi-alcohol compresses. Treatment of newborns is carried out in a hospital setting.
If mastitis progresses to purulent form, then surgery will be required. The incision is made under general anesthesia, pus is removed through the incision, then drainage is installed to further clean the wound. After the operation, a course of antibiotic therapy will be required.
If you do not call a doctor for a while, phlegmon can form - these are purulent-inflammatory foci that are located under the skin, at the level of fatty tissue. Through these foci, the infection can enter the bloodstream and sepsis will develop. In the first weeks of life, a child's health is very fragile.
For girls, mastitis is even more dangerous - surgery, purulent foci can damage the milk ducts, which will not make it possible to breastfeed in the future. In addition, any trauma to the mammary glands increases the risk of developing mastopathy at a young age and breast cancer in adulthood.
Prevention
The best prevention is responsible care for a newborn baby. The most important thing is to follow the simplest rules of hygiene and not to self-medicate.
Important rules:
- Wash your hands before touching your child.
- Bath your baby daily.
- Change diapers and nappies in a timely manner and wash with water.
- Avoid contact of the newborn with people suffering from infectious diseases.
And if parents notice any problems in the child’s body, then they need to answer the following questions:
- Is only one breast swollen?
- Is there fever, lethargy, inflammation?
- Is this condition similar to the symptoms of mastitis?
If yes, then the help of a doctor is required. If the answers are negative, then most likely the child has age-related mastopathy.
Hormonal crisis of newborns(syn. genital or sexual crisis, synkainogenesis, “minor puberty”) is one of the typical transitional (so-called transient) states of a child accompanying its adaptation to life outside the uterus. The main reason for the manifestation of symptoms of “small puberty” is sharp drop the level of female sex hormones in the baby’s body, which begins almost immediately after birth and rapidly progresses during the first week of life. The level of estrogen in the blood of a newborn during this period decreases tens and even hundreds of times, which causes a change in the background secretion of other hormones and a response from the most various organs and systems of the child.
The most common manifestation of a hormonal crisis is physiological mastopathy, occurring in the vast majority of newborn girls and about half of boys. Physiological mastopathy is expressed in engorgement of the mammary glands - an increase in the size of the latter usually begins on the 3-4th day of life, reaches a maximum after a week, after which it gradually regresses, disappearing on average by the end of the first month. The engorgement is always bilateral, occasionally accompanied by slight redness of the skin around the glands. Sometimes, to the great concern of mothers and fathers, mastopathy in a baby is accompanied by light whitish discharge from the nipples (since the Middle Ages, this discharge has been associated with the eerie folklore definition of “witch’s milk”).
In my own way chemical composition the secretion of the mammary glands of newborns is indeed somewhat reminiscent of a woman’s (and by no means a witch’s :)) colostrum and is quite physiological symptom sexual crisis. Mastopathy does not require therapeutic measures- only with very significant enlargement of the mammary glands is it recommended to use slightly warmed cloth bandages (to prevent mechanical irritation from the vest) and warm compresses.
Quite often, the baby’s skin reacts to changes in hormonal levels - so-called milliae may appear on the child’s face(comedones, or newborn acne). Nothing to do with appearance Millias do not have “acne” during puberty - the comedones of newborns are tiny in size (1-2 mm) and yellowish-white in color. These miniature formations are overflowing with secretions. sebaceous glands skin and most often disappear spontaneously within 10-14 days without any treatment. To prevent the development of inflammation in the area where comedones are located, it is quite enough to regularly cleanse the baby’s skin adequately.
Another cutaneous manifestation hormonal crisis - increased brownish pigmentation in the area around the nipple(and in boys - the scrotal area). Of course, such hyperpigmentation of the skin does not require treatment at all and does not cause concern for parents - unlike swelling of the external genitalia and transient hydrocele of the testicles (hydrocele), which are also typical symptoms of sexual crisis in newborns. However, in fact, such concern is premature - you should wait 2-3 weeks and it is quite possible that swelling and hydrocele will disappear on their own (i.e., without any medical intervention).
Inexperienced parents are even more frightened by reactions from the genitals of newborn girls. Approximately every 10-20th of them have metrorrhagia (bleeding from the vagina) at the end of the first or beginning of the second week of life. However, bleeding is perhaps too strong a word: the amount of blood released normally almost never exceeds 2 ml, while the “micromenstruation” itself lasts only a day or two and does not require treatment. Much more often than metrorrhagia in newborn girls, desquamative vulvovaginitis occurs - hormone-dependent changes in the vaginal mucosa, manifested by grayish-whitish mucous discharge from the genital slit. This vulvovaginitis also goes away completely on its own within a few days.
Despite the fact that sometimes manifestations "minor puberty" may look quite “turbulent”, they are not considered a pathology - on the contrary, somewhat simplifying, we can say that a sexual crisis indicates a relatively successful course of the intrauterine period in general and the satisfactory functioning of the mother’s placenta in particular. It has been noted that synkainogenesis mainly occurs in large children who adapt well to extrauterine life and is very rare in babies with intrauterine growth retardation or those born prematurely.
