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NEONATOLOGY

ABOUT NEONATOLOGY

Paras Bliss has well developed centers that are focused on neonatal care. Each delivery is supported by the Department of neonatology – which comprises of a well experienced team of neonatologists, intensive care specialists and anesthetists to take care of your new born – bundle of joy. The experts are also well trained and equipped to handle any complications such as – pre term delivery, infections, breathing difficulties, to list a few. All units of Paras Bliss adhere to the international standards of developmental supportive care – a specialized medical approach to handle the sick and fragile newborns.

At Paras Bliss, the state of the art level III Neonatal – ICU is equipped with the  latest technology – Multi functional Monitors, Conventional Ventilators, Non invasive Positive Pressure Ventilation (NIPPV), Dedicated Nasal CPAP devices, Blood Gas Analyzer, Incubator Care, Servo Controlled Digital Open Care Warmers; Double Surface Photo Therapy; Digital Syringe & Infusion Pumps.

Every NICU at Paras Bliss has been designed keeping in mind the requirements of the neonates. The supporting staff and nurses are all trained to handle the fragile bundles of joy with care and compassion in compliance to the international standards of developmental supportive care, laying stress on the importance of sound, light and handling.

The Department is well supported by state of the art incubators and warmers, making sure that the child feels safe and secure. The department is well established to handle cases of premature, precious deliveries and twin deliveries, along with ensuring all aspects of infection control and quality.

To support the mother post delivery, Paras Bliss offers a range of specialized care programs that aim at counselling, training and orienting the new mother & family on important aspects associated with infant care. Lactation Counselling, Toddler Care , Baby Massage are few specialized programs that train the mother to provide the right care and support to her child.

INCUBATOR CARE

The procedure undertaken to provide protection and care to neonates or ill and premature babies by using an incubator is what Incubator Care refers to. Newborn babies need to have a body temperature ranging in between 36.5 to 37.2 degree Celsius. They tend to lose body heat through various processes like convection, conduction and radiation. The babies born with a low weight or as a result of premature birth have higher risks of hypothermia, hypoglycemia, asphyxia, hypotonia, respiratory distress and so on. Hence it becomes essential to provide them with a thermo neutral environment which is what incubators do.

What are incubators?

Incubators are devices that are brought into use for the intensive care of infants which keeps them away from pathogens while keeping them warm. Such devices maintain an optimal temperature required by the baby along with humidity, oxygen and carbon dioxide levels. An incubator such as a transport incubator generally consists of an inbuilt oxygen supply unit, mini ventilator, IV pump, cardio-respiratory unit and pulse oximeter. Various types of incubators include closed, open, portable, non-portable, double-walled etc.

When or why is it required?

An incubator care facility may be required in the following conditions:
When the infant is not able to generate the required body heat, It is born early, It has an infection, It is acutely ill and requires to be kept under observation, For transporting it from health unit or hospital to another, If the infant has undergone some surgery and needs special care, When an infant runs the risk of getting infection or abnormal heat loss

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  • Kangaroo mother care (KMC) is a simple and safe method of caring for low birth weight babies. It includes early, prolonged and continuous skin- to -skin contact with the mother/father or any care giver and exclusive breast feeding. KMC is initiated in the hospital and continued at home as long as the baby needs and likes it. During KMC babies are held naked between the breasts of the mother (mimicking a kangaroo’s pouch) and should be covered with a blanket to avoid heat loss. KMC should be given for atleast 6-8 hours a day; gradually increased upto 24 hours a day. KMC benefits the baby with more stable sleep patterns, temperature stability, better weight gain, better maternal-baby bonding, along with reduction in early mortality and morbidity. Kangaroo care integrates the family into the neonatal intensive care team.

  • Welcoming a newly born baby is so exciting! But there are some newborn etiquette which have to be ensured.

    • Avoid too many guests. This allows mother- baby dyad to bond and learn breastfeeding techniques.
    • Guests with flu like symptoms should avoid visiting the newly born till they are symptom free.
    • Handling of the baby by the guests should be reduced to minimum.
    • Proper hand washing/disinfectants to be used before touching the baby and his/her surroundings.
    • Hands of the care giver should be warm and the baby should be well-clothed and covered.
    • Firm and steady grip should be maintained over the baby’s trunk.
    • Avoid kissing the baby to prevent droplet infection.
    • Stay of the guests should not be more than 30 minutes to 1 hour.
    • Use soft, gentle voices and try to be as calm as possible.
    • Don’t wear perfume.
    • Put your cell on silent.

  • Care of a normal baby at home is of utmost importance especially during first few weeks and includes:

    • Exclusive breastfeedingfor the first 6 months of life.
    • Keep umblical cord open and dry.
    • Eyes of the baby must be cleaned with a sterile swab soaked in sterile water.
    • Baby to be bathed once in 3-4 days with lukewarm water during early weeks of life.
    • Watch for jaundice for first few days of life.
    • Vaccinations advised by paediatrician should be followed.
    • Babies should preferably be placed down for sleep on their back.
    • Oil massage with coconut oil/olive oil can be a daily routine.
    • DO NOT apply kajal/surma in eyes or put oil in ear or boric acid in nostrils.

  • Follow-up is needed for most babies, with varied aims. Babies with an uneventful hospital stay have to be watched for jaundice 24-48 hours after discharge, if discharged within first 3 days of delivery.

    Babies who have been sick due to any reason, will be followed up for assessment of their brain functions, hearing and visual assessment. Biggest risk factors among them are probably gestational age and birth weight. Such conditions include, but are not limited to prematurity, low birth weight, Asphyxia, shock, need for ventilation, infections, jaundice, heart diseases and congenital malformations.

  • Infants especially newborns are susceptible to hearing damage from loud noises because their skulls are thinner. Exposure to excessive noise during pregnancy may result in high-frequency hearing loss in newborns, and may be associated with prematurity and intrauterine growth retardation. Loud noises can cause hearing loss by damaging parts of the inner ear; the area responsible for hearing.

    Safe Levels: Safe levels can vary according to the duration of the exposure and the loudness level. Noises less than 80 decibels should not cause hearing damage. This is the equivalent to noise in a restaurant or in city street traffic. A normal conversation is about 60 decibels.

  • Your baby can travel soon after birth. Most airlines prefer babies to be at least two days old, but after that, it’s up to you. Young babies generally make good travellers if they feel cuddled and secure and are fed regularly. The movement and activity often helps them sleep, too! By three months, the baby is more likely to be ready to travel. If you are flying, a front carrier or baby sling is an ideal way to transport your baby. Being carried close to the mother or father will make baby feel safe.

    Baby carriers also make travelling much easier on trains and buses. If your baby is very young, a travel system with a car seat that fits on to the push chair chassis may be the best option. In this situation, a lightweight, umbrella-folding pushchair is a useful alternative.

  • Sudden infant death syndrome (SIDS), also known as cot death or crib death, is defined as the sudden death of an infant younger than 1 year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy, thorough examination of the death scene, and review of the infant’s and family’s clinical histories

    Prevention: –

    • Baby to sleep on his back; on a firm mattress
    • Room-sharing without bed-sharing is recommended
    • Keep soft objects and loose bedding out of the crib
    • Pregnant women should receive regular prenatal care
    • Avoid smoke exposure during pregnancy and after birth
    • Avoid alcohol and illicit drug use during pregnancy and after birth
    • Breastfeeding is recommended
    • Consider offering a pacifier at nap time and bedtime
    • Avoid overheating
    • Infants should be immunized as per schedule.
    • Avoid commercial devices marketed to reduce the risk of SIDS

  • Pneumonia is one of the leading causes of morbidity in both western world and developing countries including India. It kills one child every 15 seconds. Despite these sobering statistics, there is good news: solutions exist to prevent and treat pneumonia, and ultimately save young lives and significantly reduce the burden of families and society

    Preventive strategies for pneumonia in children include:

    Immunization:

    •  It’s the most effective way to prevent pneumonia
    • Vaccinate your baby against Hemophilus influenza(Hib)
    • Pneumococcus, Measles and Whooping cough (pertussis)

    Adequate nutrition: It’s a key to improve baby’s natural defences, Research studies suggest exclusive breastfeeding for the first 6 months of life is effective in preventing pneumonia and also reduces the duration of illness and hospital stay.

    Healthy environment:  Addressing indoor and outdoor air pollution and encouraging good hygiene in crowded places goes a long way in promoting health in general and pneumonia in particular.

  • It is advised to consult the baby’s doctor/paediatrician before giving over the counter drugs to the baby as the doses of these drugs depend on the body weight, and hence cannot be generalized to all babies. Too small doses will be ineffective, and higher doses can cause harmful side effects, and possibility of drug toxicity. Most governing bodies in Paediatrics including American Academy of Paediatrics (AAP) advises against giving OTC cough and cold medicines which includes decongestants and cough suppressants to children younger than 6 years old.

  • Your baby’s eyes are not very sensitive to light in the first month of life. In fact, the amount of light required for a 1-month-old infant to be aware that light is present (called the light detection threshold) is 50 times higher than that of an adult. So, normal lights can be kept on during the day, but lights should be switched off at night to facilitate biological/circadian rhythm, which promote baby’s growth.

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