Transitional (boundary) states of newborns. Skin of the newborn: simple erythema, physiological peeling, toxic erythema, miliaria

7. Sexual crisis. The point is that during prenatal development the fetus receives constant hormonal stimulation by the mother's sex hormones, at birth its own endocrine system the child begins to work more actively and there is a transient sexual crisis. One of the manifestations is engorgement of the mammary glands (both in girls and boys) with a maximum increase on the 7-8th day, usually disappears by the end of the month. From the engorged mammary glands, one should not try to squeeze out the secret, because. this leads to their infection and the development of mastitis. In the first 2 days of life, the vaginal mucosa may become inflamed. Abundant grayish-whitish discharge appears from the genital slit, which disappears on its own on the third day. It is recommended to wash girls with a weak solution of chamomile, St. John's wort, succession. These herbs have disinfecting properties. You should not wipe the genitals with force. The mucous membrane of newborns and children is very delicate and can be easily injured, which can lead to both infection and the formation of adhesions that will have to be removed surgically. More rare manifestations of a hormonal crisis are: swelling of the external genitalia - labia, penis, scrotum, which can last 1-2 weeks or more, darkening of the skin around the nipples and scrotum skin. Dropsy of the testicle is the accumulation of fluid between its membranes, while the size of the scrotum is increased in size. It sometimes goes away only at the end of the first month of life on its own and does not require treatment.
8. Physiological violations of the heat balance are associated with the imperfection of thermoregulation of newborns, who cannot maintain a constant body temperature and react to any changes in it indoors or outdoors. Until your baby is born, he is in conditions of constant temperature and humidity, but after birth, the baby's body has to cope with maintaining a constant body temperature. Due to the peculiarities of the structure of their skin, rich in blood vessels and capillaries and poor in sweat glands, the child quickly overheats or hypothermia.
When a newborn releases more fluid than he receives during feeding, this is expressed by anxiety, dry mucous membranes, fever up to 38 ° C and above, and thirst. If the body temperature rises, immediately call a doctor, undress the child and wipe the skin with a half-alcohol solution, drink the baby plenty of sweet tea or boiled water. Do not try to bring down the temperature with pharmacological preparations on your own! If the temperature of the child, on the contrary, is lowered, which most often happens in the first hours of his life, he should be quickly wrapped in sterile diapers (ironed if the birth took place at home) and placed on the changing table under the lamp. constant temperature the body is established, as a rule, by the middle of the first day.

This article does not list all transitional states of newborns, however, the most obvious and common features are presented. One way or another, the doctors of the Tigrenok medical center recommend that parents contact a pediatrician as soon as possible after discharge from maternity hospital. This is especially true in those cases when there was any pathology during pregnancy or childbirth, or if you have any doubts about the health of your baby.

What are transitional states in a child? How do they appear? What should parents know about transitional states of an infant?

What are transitional states in newborns

The state of the newborn, which reflects the process of the child's adaptation to life, is called the physiological or transitional (transient, borderline) state. Transition states a newborn may be accompanied by some painful phenomena that pass relatively quickly. But in the presence of certain circumstances, such as pathologies that developed during fetal stay, late deadlines birth and some other problems can lead to more serious deviations in health.

After being born in an environment that is different from the one in which the child was a long period time, he is faced with new temperature, tactile, visual, and sound stimuli that he needs to get used to.

Physiological transition states include:

Albuminuria, which is manifested by a violation of the activity of the kidneys, and therefore protein in the urine occurs in almost all newborns in the first days of life.

Physiological jaundice, which is observed in 2/3 of newborns due to the immaturity of the liver enzyme systems and increased production of bilirubin. Usually on the 23rd day of a baby's life, he develops icteric coloration of the skin, and sometimes even the mucous membranes of the eyes. These symptoms disappear within 10 days.

Difficulty breathing, which is associated with insufficiently expanded lungs of the baby, which usually straighten out completely already on the fifth day of life.

The change in the skin is manifested due to the reaction of the skin to the removal of the original lubricant, but disappears by the end of the first week. Physiological peeling is especially pronounced in post-term children.

The birth tumor, which most often occurs on the head, since by the time of birth it was closer to the exit from the uterus, disappears in about 12 days. It happens that at the site of the birth tumor, small-point hemorrhages appear, which disappear on their own.

Toxic erythema is reddish, slightly dense spots, sometimes with vesicles in the center. Toxic erythema occurs in 20-30% of newborns and is located mainly on the legs and arms around the joints, on the buttocks, chest, less often on the abdomen, face. Such allergic reaction does not require treatment, although with abundant rashes, the baby should drink plenty of water and consult a doctor.

Uric acid infarction of the kidneys, which is caused by a metabolic disorder in the kidneys and the deposition of salt crystals uric acid occurs in almost all newborns. The symptom is cloudy, brick-yellow urine. If by the end of the first week after birth this phenomenon does not go away, by the end of the second week it is already considered pathological.

Sexual crises are usually associated with changes in hormonal balance and occur in most newborns. They can manifest themselves in engorgement of the mammary glands with their maximum increase on the 7-8th day, disappears by the end of the first month of life. Another manifestation of a sexual crisis may be inflammation of the vaginal mucosa, which appears on the second day. Copious discharge grayish-whitish color disappear on the third day. It is recommended to wash girls with a weak solution of potassium permanganate (potassium permanganate). You can also use decoctions of chamomile, St. John's wort, succession, as herbs have disinfecting properties. Much less often, a manifestation of a hormonal crisis is swelling of the external genitalia, labia, penis, scrotum, which can last more than 12 weeks.

Transient decrease in temperature, transient fever, which are a physiological violation of the thermal balance and are associated with imperfect thermoregulation of newborns.

Physiological dyspepsia, or transient catarrh - this phenomenon is based on hypersensitivity the secretory-motor system of the intestine to irritations, such as food debris and products of enzymatic and bacterial cleavage. The enzymatic work of the stomach and intestines of the newborn has not yet been established and has not adapted to new nutritional conditions, and the increased permeability of the walls gastrointestinal tract, functional and morphological incompleteness of the neuromuscular apparatus are physiological prerequisites for the development of dyspepsia in newborns.

Physiological weight loss of the newborn is typical for children 3-5 days after birth. The baby loses 5-8% of its birth weight. Most babies regain weight by the end of the first, beginning of the second week.

In some newborns, transient states specific to this age are observed, depending on changes in the conditions of the external and internal environment that occur after birth.

These conditions, being physiological, are observed only in newborns and never recur in the future. However, these conditions border on pathology and, under unfavorable conditions, can turn into painful processes.

The most common are the following physiological conditions.

The skin of a newborn is covered with a cheese-like lubricant - ver-nix caseosa. This lubricant consists of almost pure fat, glycogen, extractives, carbonic and phosphate salts, as well as cholesterol, odorous and volatile acids. Her color at normal conditions grayish white. If it has a yellow, yellow-green or dirty gray color, then this indicates intrauterine pathological processes(hypoxia, hemolytic processes, etc.). As a rule, the cheese-like lubricant is not removed in the first 2 days, as it protects the body from cooling and the skin from damage, contains vitamin A, and has useful biological properties. And only in places of accumulation (inguinal, axillary folds) the lubricant undergoes rapid decomposition, so here the excess must be carefully removed with sterile gauze dipped in sterile vegetable oil.

In a full-term baby, yellowish-white dots are often noted on the tip and wings of the nose, slightly rising above the skin. Their origin is explained by the excessive secretion of the secretion of the sebaceous glands, especially in recent months intrauterine development of the fetus. By the end of the 1st week or the 2nd week, they disappear when the epidermis changes and the ducts open.

Neonatal erythema, or physiological catarrh of the skin, develops as a result of skin irritation to which it is exposed in new conditions. environment, while the skin becomes brightly hyperemic, sometimes with a slight cyanotic tint. Hyperemia is observed from several hours to 2-3 days, then small, rarely large peeling appears, especially pronounced on the palms and feet. With abundant peeling, the skin is lubricated with sterile oil (castor, sunflower, olive, fish fat). In the absence of erythema in a newborn in the first hours and days of life, it is necessary to find out the reason for this: it is absent in pulmonary atelectasis, intrauterine toxemia, due to various pathological conditions of the mother during pregnancy, intracranial hemorrhages.

Physiological jaundice usually appears on the 2-3rd day after birth and is observed in 60-70% of newborns. General state children good. In this case, a more or less pronounced icteric staining of the skin, mucous membranes of the oral cavity and somewhat less sclera appear. Due to the strong redness of the skin in the first days, jaundice may not be noticeable at first, but it is easily detected if you press a finger on any area of ​​the skin. Stools of normal color, urine does not contain bile pigments. From the side internal organs no deviations from the norm are observed. Children are actively suckling.

The appearance of jaundice is due to the emerging imbalance between the enzymatic capacity of the liver (glucoronyl transferase deficiency) and the increased breakdown of red blood cells (the number of which is increased during fetal development). The immature enzymatic system of the liver is not able to provide processing and excretion a large number bilirubin.

Physiological jaundice lasts for several days, and its intensity gradually decreases, and by the 7-10th day, rarely by the 12th, it disappears. Much less often, jaundice lasts 2-3 weeks. A protracted course of jaundice is often observed in children born prematurely or in severe asphyxia, who were injured during childbirth.

The prognosis for physiological jaundice is favorable. Treatment is not required. With severe jaundice, children are given a 5–10% glucose solution, an isotonic sodium chloride solution–50–100 ml / day with 100–200 mg of ascorbic acid. With jaundice that appears very early, a rapid increase in the color of the skin and a long course, it is necessary to doubt its physiological nature, thinking first of all about hemolytic disease newborns, and show the child to the doctor.

Physiological mastitis - swelling of the mammary glands is observed in some newborns, regardless of gender. It is caused by the transfer of estrogen hormones from mother to fetus during prenatal period. Swelling of the mammary glands is usually bilateral, appears in the first 3-4 days after birth, reaches its maximum value by the 8-10th day. Sometimes the swelling is insignificant, and in some cases it can be as large as a plum or more. The swollen glands are mobile, the skin over them is almost always of normal color. A liquid that resembles colostrum may come out of the nipple. As the body releases from maternal hormones, the swelling of the glands also disappears. Any pressure is strictly prohibited because of the danger of injury, infection and suppuration of the glands. Physiological mastitis does not require treatment.

Catarrhal vulvovaginitis occurs in some newborn girls. It occurs under the influence of follicular hormones of the mother. In the first days after birth, flat epihelium is secreted along with the glandular tissue of the cervix in the form of a mucous, viscous secret, sometimes there may be bloody issues from the genital slit. In addition, there may be swelling of the vulva, pubis and general swelling of the genital organs. TO normal phenomena, arising under the influence of mother's hormones, is sometimes observed in boys swelling of the scrotum. All these phenomena can be observed on the 5-7th day of life and last 1-2 days. special treatment it is not required. Girls should only be washed more often with a warm solution of potassium permanganate (dissolved with boiled water in a ratio of 1:5000-1:8000), squeezing it out of cotton wool.

Physiological weight loss is observed in all newborns and is 3--10% of birth weight. The maximum weight loss is observed by the 3-4th day of life. In most newborns, body weight is restored by the 10th day of life, and in some - even by the end of the 1st week, only in a small group of children the initial body weight is restored only by the 15th day. Overheating, cooling, insufficient air humidity and other factors increase the loss of body weight. The amount of physiological weight loss is also influenced by the course of childbirth, the degree of full-term and maturity, the duration of jaundice, the amount of sucked milk and the resulting fluid. Physiological weight loss in newborns is due to the following circumstances: 1) malnutrition in the early days; 2) the release of water through the skin and lungs; 3) loss of water with urine and feces; 4) discrepancy between the amount of received and released fluid; 5) often regurgitation amniotic fluid, slight loss of moisture during drying umbilical cord. With a loss of more than 10% of the initial body weight, it is necessary to clarify the reason for this. It must always be remembered that often a large drop in body weight is one of the initial symptoms one disease or another. Significant weight loss can be prevented by following following conditions: proper care, early attachment children to the chest - no later than 12 hours after birth, the introduction of a sufficient amount of fluid (5--10% relative to the child's body weight).

Uric acid kidney infarction occurs in half of newborns and is manifested in the fact that a large amount of uric acid salts is excreted in the urine. Urine becomes cloudy, more brightly colored, and on the days of the greatest drop in body weight takes brown shade. When standing in the urine, a significant precipitate appears, which dissolves when heated. A large amount of uric acid salts in the urine can be judged by the reddish color of the sediment and by the reddish-brown spots remaining on the diapers. All this is associated with the release of urates as a result of uric acid infarction of the kidneys, which is based on the increased formation of uric acid in the body of a newborn due to increased decay of cellular elements and protein metabolism. With the appointment of a large amount of fluid and with the release of a large amount of urine, the infarction disappears approximately within the first 2 weeks of life. As a rule, it does not leave consequences and does not require treatment.

Physiological conditions also include transitional stools after the release of meconium from the intestine.

Meconium - the original feces, which is formed from the fourth month intrauterine life. It is a dark olive, viscous, thick, odorless mass, which consists of secretions of the germ digestive tract, separated epithelium and swallowed amniotic fluid; the first portions of it do not contain bacteria. By the 4th day of life, meconium is completely removed from the intestine. The transition to normal milk stool in a child occurs when proper feeding not right away. Often this is preceded by the so-called transitional chair. At the same time, the stools are rich in brownish-greenish mucus, watery, sometimes foamy. Newborns often have accumulation of gases and distention of the intestines, which causes anxiety for the child, the frequency of bowel movements fluctuates sharply, and the type of bowel movements changes. The chair is 2-6 times a day, homogeneous, the color of mashed mustard, mushy consistency.

What are neonatal transition states?

In newborns, adaptation to extrauterine life conditions is manifested by a number of changes, characterized as transitional, physiological. These include: physiological loss of the body; physiological skin erythema, peeling, toxic erythema, physiological jaundice; hormonal or sexual crisis: breast engorgement, metrorrhagia, etc.

How does physiological weight loss manifest itself?

Physiological decline body weight develops mainly due to starvation in the first days of life. Maximum loss weight is observed on the 3rd-4th day of life and usually does not exceed 6% of the initial weight (maximum 10%). The initial body weight is restored in half of the newborns by the 6-7th day of life, in 78-85 % - by the 10th day; all healthy newborns should regain their original weight by day 14. Premature (III-IV degree) and those born with a large body weight, as well as sick children, slowly restore their original body weight.

How does physiological skin arrhythma manifest itself?

Physiological erythema is observed in almost all newborns in the first week of life. In premature babies, it can last up to 2-3 weeks. Physiological peeling of the skin occurs on the 3rd-5th day of life in children with especially bright erythema when it fades. A very abundant peeling is observed in post-term children. Treatment is not required.

Toxic erythema occurs in 20-30 % newborns and occurs on the 2-5th day of life: bright pink, slightly dense spots with grayish-yellow papules or vesicles in the center are more often located in groups on the extensor surfaces of the limbs, on the buttocks, chest, less often on the face and abdomen. Rashes are sometimes plentiful, sometimes single; palms, feet, mucous membranes are never affected. The rash disappears without a trace within a few days. Treatment is not required.

How does physiological jaundice in newborns manifest itself?

Physiological jaundice is observed in 60-70 % newborns. Icteric coloration of the skin appears on the 2nd-3rd day of life, by the 4th-5th day it intensifies, by the end of the week or in the middle of the 2nd week it disappears. At the same time, the child's condition does not suffer, the color of urine and feces does not change.

Jaundice that persists in a newborn for more than 2 weeks or intensifies is a sign of pathology. The appearance of jaundice, regardless of severity, in a child after discharge from the hospital is always a sign serious illness. In such cases nurse must show the child to the doctor on the same day (call a doctor at home, referral and delivery of the child to the hospital - depending on the circumstances).

What is a hormonal crisis in newborns?

The hormonal crisis includes conditions observed in 2/3 of all newborns, especially in girls. These include breast engorgement, vaginal bleeding, and swelling of the external genitalia. Gland engorgement (physiological mastopathy) begins on the 3rd-4th day of life and increases to the maximum on the 7th-10th day, then it gradually decreases and disappears by the end of the month. The enlargement of the mammary glands is always symmetrical, the skin over the enlarged gland is not changed. Sometimes it is possible to highlight the contents of a whitish color, similar in composition to colostrum. Treatment is not required, but with very severe engorgement, warm sterile dressing or a compress with camphor oil to prevent irritation.

Bleeding from the vagina (metrorrhagia) usually occurs on the 5-8th day of life in 5-10% of girls. The duration of vaginal bleeding is 1-3 days, the volume is 0.5-1 ml. Treatment is not required.

Edema of the external genitalia lasts 1-2 weeks, sometimes longer, disappears on its own, without treatment. They are observed in 5-10% of newborns.

The book contains complete information about the neonatal period, which occurs with deviations from the norm. The features of nursing and feeding are described in an accessible language premature babies and children with various diseases. A separate chapter is devoted emergency care with some pathological conditions newborn. This book intended for a wide range of readers.

Book:

Chapter 2 Transient states of newborns

Transient states of newborns

Reactions that reflect the process of adaptation (adaptation) of a child to new living conditions are called transitional (borderline, transient, physiological) states of newborns. These conditions are called borderline not only because they occur at the border of two periods of life (intrauterine and extrauterine), but also because they can take on pathological features depending on the course of childbirth, care, feeding, the presence of diseases and others, and also not appear or proceed imperceptibly when these unfavorable factors are eliminated.

Transitional states are the result of stressful influences and adverse environmental factors in which the child enters after birth. With the stress that childbirth is for a newborn, not a single organ, not a single function remains indifferent, but the severity of the changes is determined by the presence of predisposing factors.

It should be noted that not all border states develop in every child, some of them - only in premature babies.

At present, in obstetric institutions, some preventive actions: reduction of cooling, starvation, fluid loss and other factors that help reduce the manifestations of these conditions.

Ancestral catharsis characterized by the fact that the child in the first seconds of life does not respond to pain, sound, light stimuli, he has no muscle tone. At this moment, there is a sharp increase in the level of endorphins (“pleasure hormones”) in the blood, which is a protective reaction against birth stress.

Syndrome "just born baby". At the time of childbirth, the child is instantly immobilized for a few seconds, then a deep breath appears. During the next 5-6 minutes the child is active. The respiratory rate of a newborn in the first week varies from 30 to 60 beats per minute.

Imprinting- this is an imprint in the memory of a newborn distinguishing features vital stimuli and objects affecting him, including his mother.

Physiological weight loss observed in almost all newborns in the first 3-4 days. It is associated mainly with the dehydration of the child; imperceptible loss of water with respiration, excretion of water with urine, insufficient intake of water and starvation of the child with insufficient feeding are also important. A large loss is observed in preterm infants and in children with high birth weight.

Normally, weight loss does not exceed 6-10% and largely depends on the volume of food and liquid administration. Recovery of body weight occurs by the 6-8th day of life.

Premature and overweight babies are slower to regain their original body weight. Main factors quick recovery body weight are the optimal thermal regime, early breastfeeding, free drinking, depending on the needs of the child. In the first 5 days of life with a sufficient amount of milk, the additional administration of liquid (boiled water or 5% glucose solution) should be about 6 ml / kg per day of the child's life; from the 6th day - about 40-50 ml / kg / day with an increase in its volume at an air temperature above 24 ° C (an additional 5 ml / kg is given per day for each degree of temperature increase). The total amount of liquid added to the sucked milk should not exceed 60–70 ml/kg/day.

Transient disturbance of heat balance arises due to the imperfection of the processes of thermoregulation and adaptation of the newborn and premature baby with inadequate care. Newborns easily overheat and cool down under suboptimal conditions. The ability to maintain daily fluctuations in body temperature appears only at the end of the neonatal period.

transient fever. On the 2-4th day after birth, some children develop transient fever - an increase in body temperature to 39-40 ° C. This phenomenon is associated with an increased intake of protein and a lack of water. Elevated temperature lasts 3-4 hours and has little effect on the well-being of the child. Sometimes temperature rises are noted for several days. There may be anxiety of the child, refusal of the breast, thirst, dryness of the mucous membranes and skin.

With transient fever, physical cooling is carried out (the child is left without diapers), boiled water or a 5% glucose solution in an amount of 50–70 ml is drunk, and body temperature is systematically measured.

Transient decrease in body temperature more common in preterm infants and in children with oxygen starvation, birth trauma, neonatal diseases. The normal skin temperature in a newborn is 36.0-36.5 °C, the temperature in the rectum is 36.5-37.5 °C. To prevent hypothermia, the newborn is wrapped in sterile heated diapers (to stop heat loss with evaporation), placed on a heated table under a radiant heat source, maintaining the air temperature (especially for premature babies) necessary to preserve normal temperature skin.

Transient skin changes to one degree or another are observed in almost all newborns of the 1st week of life. At the birth of a child, his skin is edematous, with reddish tint, sometimes somewhat bluish, covered with a more or less thick layer of grayish-grey primordial lubricant white color which can be easily removed.

The skin of a newborn is soft, tender to the touch, velvety, easily vulnerable.

The skin of a premature baby is abundantly covered with lanugo (primary hair), especially on the forehead, shoulders and shoulder blades. The hair on the head is short and sparse. Eyebrows are often missing. If a premature baby is placed on its side, then the upper half of his body turns pale, and the lower half turns red. The dividing line runs exactly along the middle of the body, along the line passing through the middle of the forehead, through the nose, chin, along the white line of the abdomen. If the child is turned to the other side, the pale side becomes red and vice versa. This phenomenon can also be observed in full-term newborns.

The lines on the palms and soles, on the fingers are well expressed in full-term newborns, less distinct than in subsequent years, but they retain their location forever. In premature newborns, the severity of the lines depends on the period of intrauterine development.

Physiological catarrh of the skin. Reactive redness of the skin occurs after the removal of the original lubricant, the first bath. In the first hours of life, redness may be bluish. The intensity and duration of the physiological catarrh of the skin depends on the degree of maturity of the child. Usually on the 2nd day it becomes brighter, by the middle - the end of the 1st week it fades. In premature babies and newborns from mothers with diabetes redness is more pronounced and lasts longer (2-3 weeks).

After its disappearance, peeling of the skin occurs, which is especially abundant in post-term children and slightly pronounced in premature ones.

Physiological peeling of the skin- big or fine peeling, which occurs on the 3rd-5th day of life in children with a particularly pronounced physiological catarrh of the skin after its extinction. More often it happens on the tummy, chest, it is especially abundant in post-term children and does not require treatment.

birth tumor- this is swelling of the presenting part of the fetus due to venous plethora. A generic tumor in the presentation of the head can capture the area above several bones of the skull and not be interrupted in the area of ​​​​the sutures; most often it is located in the region of the crown and back of the head, but it can also have other localization. At facial presentation a birth tumor occurs on the face, with a frontal tumor - on the forehead, with a gluteal tumor - in the buttocks, thighs and external genital organs. When limbs prolapse, the tumor captures the prolapsed arm or leg.

The tumor of the presenting part decreases rapidly and completely disappears after 24-36 hours (2-3 days). Sometimes, at the site of the birth tumor, there are small punctate hemorrhages, which usually disappear on their own by the end of the 1st - the beginning of the 2nd week. With large hemorrhages, they must be protected from infection. Treatment is not required.

Toxic erythema. In 20-30% of newborns, during the 1-5th day of life, small, white rashes appear on a reddish base. These benign rashes, called toxic erythema, are usually localized on the face, abdomen, trunk, extensor surfaces of the limbs, buttocks, sometimes in the back and scalp, are less commonly observed on the chest and disappear, as a rule, after a week. This is an allergic reaction. Elements of toxic erythema never occur on the palms, feet, mucous membranes. Within 1-3 days, new rashes may appear, although more often after 2-3 days the rash disappears without a trace. The condition of the children is not disturbed, the body temperature is normal, but with abundant rashes, the child is restless.

Treatment is usually not required, but with abundant toxic erythema, it is advisable to additionally drink a 5% glucose solution, use antiallergic drugs. These children have a predisposition to allergic diathesis.

Transient jaundice. Yellowness of the skin is observed in 60-70% of newborns, appears on the 2-3rd day after birth. Transient jaundice is associated with a number of factors: a shortened life of red blood cells; reduced functional ability of the liver, increased flow of the bile pigment bilirubin from the intestine into the blood.

Its duration is no more than a week, in premature babies - no more than 2 weeks.

Transient jaundice is relatively rare in children with intrauterine meconium. In premature babies, due to the immaturity of the liver, jaundice is more common and more pronounced. Does not require special treatment.

Expansion of the sweat glands. Extended sweat glands look like thin-walled vesicles with curdled or transparent contents that appear at the birth of a child. They are found in the area of ​​the neck fold, on the scalp, less often on the shoulders, chest. Bubbles are easily removed with a cotton swab with alcohol, the skin remains intact. No recurrences are observed. The general condition of the children is not disturbed.

Milia- these are whitish-yellowish nodules 1-2 mm in size, rising above the level of the skin; localized more often on the wings of the nose, bridge of the nose, in the forehead, very rarely throughout the body. They represent sebaceous glands with profuse secretion and clogged excretory ducts. It occurs in about 40% of newborns. If there are signs around the nodules mild inflammation, then it is necessary to treat them with a 0.5% solution of potassium permanganate.

Rejection of the umbilical cord and healing umbilical wound depend on the regenerative properties of the child's body, on the method of processing the umbilical cord at birth. Currently, such a method of processing the umbilical cord is widespread, in which a metal bracket is applied to the stump of the umbilical cord, which, using a special clamp, squeezes the vessels of the umbilical cord. The stump of the umbilical cord is left without a bandage and is treated daily with alcohol and a 5% solution of potassium permanganate. Rejection of the umbilical cord stump usually occurs by the end of 3 days. Complete healing of the umbilical wound ends by the 10-19th day of life.

Earlier healing in Lately occurs after cutting off the umbilical cord residue on the 2nd day in the hospital.

sexual crisis observed in 2/3 of newborns, more often in girls. The occurrence of a sexual crisis is explained by the body's reaction to its rapid release from maternal sex hormones (estrogens).

It is clinically manifested by an increase in the mammary glands in boys and girls. On the 4-6th (maximum 7-8th) day after birth, engorgement appears, sometimes redness, discharge like milk secretions from enlarged mammary glands. Skin over swollen mammary glands are not changed. Bleeding from the vagina occurs in 5-10% of girls, lasts 1-3 days, the volume is 1-2 ml. Occult blood in the vaginal mucus can be found in almost all girls.

The general condition of the child is not disturbed. Both mammary glands increase simultaneously, have a tight elastic consistency, mobile, painless. Bleeding is not accompanied by anatomical changes in the genital organs.

The manifestations of a sexual crisis also include redness of the skin around the nipples and scrotum, swelling in the lower abdomen, in the genital area, dropsy of the testicles. In premature and low birth weight infants, sexual crisis is rare and its severity is insignificant.

Treatment of a hormonal crisis does not require. By the end of the 1st - the beginning of the 2nd week, its manifestations decrease, then gradually disappear. Do not squeeze out the contents of the mammary glands, this can lead to infection and the development of mastitis.

In the future, children who have undergone a hormonal crisis develop better physically and get sick less.

Swelling of the external genitalia lasts 1-2 weeks or longer, but goes away on its own without treatment; observed in 10% of newborns.

Transient states of the lymphatic system are manifested by characteristic changes in the immune system.

In addition, some newborns have lymphedema of the hands and feet, which looks like a pasty swelling, which sometimes lasts for a long time, and then disappears without treatment.

Transient states muscular system in full-term children are characterized by an increase in the tone of the flexor muscles.

In premature infants after birth, on the contrary, there is a decrease muscle tone disappearing after a few hours.

Transient changes in the analyzer system

During the first 5-6 minutes after birth, the pupils of the eyes are dilated, despite the bright light; characterized by moderate photophobia.

The eyes of a newborn are almost constantly closed, the pupils gradually narrow. Premature babies may have small lens opacities that disappear without treatment.

Transient state of the heart and circulation

After birth, a transient increase in the size of the heart, muffled tones, and an increase in heart rate are noted.

These changes reach a maximum after 30–60 minutes, remain without significant dynamics for several hours, and then gradually disappear.

Transient changes in the circulatory system do not require special treatment.

Transient state of the respiratory system

Gasps (breathing flash) - the first respiratory movement after birth, characterized by a deep breath and labored exhalation.

Most often, in preterm infants, 4–8% of all respiratory movements occur in the first 3 hours after birth. This helps to expand the lungs.

Transient increase in breathing("wet lung syndrome") is observed in the first 3-5 days after birth. This is due to a delay in absorption. amniotic fluid from the lungs, more common in children born by operations caesarean section, since there is no compression mechanism chest when passing through birth canal, which contributes to the extrusion of fluid from the lungs, as well as in premature babies.

Clinical manifestations are characterized by increased breathing (70-80 breaths per 1 min), the presence of groaning exhalation, swelling of the wings of the nose, retraction of the intercostal spaces and general cyanosis of varying severity.

Treatment is to ensure an adequate supply of oxygen. Due to the risk of milk getting into the trachea and bronchi, feeding through a tube is recommended if breathing is more than 70-80 breaths per 1 minute. In most cases, transient increased breathing goes away on its own.

Transient changes in the digestive system. Transient dysbacteriosis is a transitional state that develops in all newborns. Normally, in an uncomplicated pregnancy, the fetus is sterile. Mother's milk contributes to the development of bifidoflora and the displacement of pathogenic microflora or a sharp decrease in its number. Transient dysbacteriosis does not require treatment. At artificial feeding the process of formation of bifidoflora is delayed, which leads to the predominance of Escherichia coli. Physiological neonatal dyspepsia is also observed in all newborns in the middle of the 1st week of life. A transitional chair appears. After 2-4 days, it becomes homogeneous, yellow, mushy.

Transient features of kidney function. In the first 12 hours after birth, only 2/3 of newborns urinate, 8-10% excrete the first portion of urine only on the 2nd day.

In 25–30% of full-term newborns and in 10–15% of premature infants, the so-called uric acid infarction of the kidneys is observed in the first week - the deposition of uric acid in the kidneys in the form of crystals.

Urine at the same time has a yellow-brick color, unclear, leaves spots on the diaper of the same color. This condition passes by the end of the 1st or 2nd week.

The detection of such changes in urine from the middle of the 2nd week is a sign of pathology.