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Doctors

photo of Dr. Bezawada Prashanth Babu

Dr. Bezawada Prashanth Babu

Consultant Neonatology & Paediatrician

photo of Dr. G. Manisha Reddy

Dr. G. Manisha Reddy

Consultant Pediatric Surgeon & Urosurgeon

Health Blogs

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04 January, 2022

What are the Signs of a Sick Baby? The Symptoms of Conditions That Require Neonatal Treatment.

Authored By:

You may be filled with energy and enthusiasm while bringing your baby home from the hospital. However, having a newborn and taking care of him or her in the initial few months can be a stressful and daunting task. One of the major reasons behind worrying is that the baby may get sick often. But how will you know when your newborn gets sick? Since initially, you do not know the normal behavior of your infant, identifying the newborn signs or newborn symptoms can be difficult. Generally, the newborn signs can be subtle even when the infant is suffering from a serious illness. Since the immune system of the infants is not so strong, you must identify the newborn signs and symptoms and evade any infections. Here’s a guide that will help you to know the newborn symptoms and conditions that require neonatal treatment in your infant. Newborn symptoms that may require neonatal treatment. Differentiation between the normal and abnormal conditions in newborns is crucial.  You should watch out for any of the newborn signs that require neonatal treatment and call your doctor when necessary. So here’s a glance at some of the newborn signs that will help you to evade any infection in your infant. Abdominal distention. Generally, the abdomen of a baby feels soft between feedings. However, if you feel that your infant’s abdomen is hard or swollen then there could be a problem with gas or Constipation. The swollen stomach can even lead to an intestinal infection or problem in case your child hasn’t had a bowel movement for more than a day or two. Blue baby Generally, newborns may have mildly blue hands, feet, face, tongue, or lips, in case they feel cold or cry hard. However, if you see that the blue coloring persists in your baby for several days along with feeding and breathing issues, then it might be time to visit your doctor. Such newborn signs can be a symptom of an infection or signify an issue in the heart or the lungs.  Coughing while feeding.  Initially, the newborns may cough while they learn to feed. However, in case your newborn coughs regularly whenever he or she is trying to eat, then it could be a symptom of a problem in the digestive system or the lungs of the child. Amplified crying. Generally crying is a normal symptom in newborns.  When you see your newborns crying, you can check whether they are warm, fed, and have a clean diaper.  But in rare situations, the newborns may cry and shriek out in different sounds for abnormally long periods. This could be a newborn sign of an illness and hence, you should call a doctor. Jaundice The mild yellowish tinge in the infants, known as mild jaundice is completely harmless. However, if the build-up of bilirubin in the baby’s blood is heightened, then jaundice may be harmful. If you notice your baby developing jaundice to a high extent, then you should call the doctor. *Information shared here is for general purpose. Please take doctors’ advice before making any decision.

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23 November, 2021

Newborn Sleep

Authored By:

Newborn Sleep  Sleep patterns in newborn babies is different from that of children in that they usually sleep for most of the time in a day. Often this will be hard for the new parents to know what normal sleep pattern of their newborn baby is and how long a baby will sleep. How are sleep patterns in newborn? Newborn baby sleep for most of the time in a 24hour period and wakes up in between for feeding every few hours. There will not be any fixed schedule for the newborn sleep and their day and nights are little confusing. Most of the newborn babies sleep for about 16 to 18hours duration in a 24hour period. They sleep mostly in the day time and will be awake during night time. This could be probably due to sleep pattern during the stay in their mother’s womb. They usually start to learn the day and night rhythm by about 6 to 8weeks of age. But the sleep patterns can vary and some babies may not sleep during night time through their initial few months. Newborn baby will wake up for feeds atleast once in every 2 to 3 hours. Parents need to closely watch for the changes that happen in the sleep patterns of the newborn as their sleep duration will gradually decrease and awake period increases through their first year of life. How can we identify the sleep readiness of the newborn baby? The following signs can help you to know the readiness for sleep. Fussiness Excessive Yawning Not interested in the surroundings Redness of the eyes What are the different alert phases in a newborn? Newborns also differ in their alertness as well. Quiet & alert phase: Phase where the baby is awake, not crying, calm and interested in the surrounding. Active & alert phase: Phase where the baby is active and attentive to sounds. Crying phase: This follows active and alert phase. Baby can be easily over stimulated, and cries out loudly. Baby can be held and swaddled to calm down. How can you help the baby to fall asleep? When the newborn baby shows signs of sleep readiness, they can be held in your arms, make the environment comfortable, calm and quiet. Swaddling also help them to feel safe and help in falling asleep.  What sleep positions are best for a baby? Putting the baby on his or her back is safest. Prone position (placing baby on tummy) and side sleeping positions has an increased risk of sudden infant death (SIDS) as per research. What are the things to keep in mind while making a newborn sleep? As per American Academy of Paediatrics (AAP) recommendations on infant bedding: Baby should be placed on his or her back on a firm surface Avoid pillows, soft toys, comforters in the baby’s bed Tuck a thin blanket only upto baby’s chest Baby’s face should remain uncovered.

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13 October, 2021

Fever In Newborn

Authored By: Dr. Aravinda Lochani T

Normal body temperature is 98.6 F or 37 C (+/- 0.5 C). Any body temperature greater than 99.5 F or 37. 5 C is termed as fever in newborns. Fever is the body’s defense mechanism that helps to fight infection or inflammation. How to measure fever: By using a digital thermometer in the axilla (armpit) or with the help of an infrared thermometer which measures the skin temperature (usually measured from the forehead) Causes of fever:  Dehydration (due to poor feeding) Hot environment or proximity to sunlight Wrapping the baby in too many clothes Infection Postvaccination Maternal fever at the time of delivery Symptoms: The baby may be irritable, appear flushed, have either fast breathing or decreased breathing efforts, have dull activity, abnormal tone, and decreased intake of feeds Untreated fever or infection may lead to seizures and has increased risk of mortality.  What to do when your baby has fever: First unwrap the baby and keep the baby in a normal environment (25-28 C). Try to give breastfeed/expressed breast milk as spoon feed to the baby. Recheck the temperature after 20-30 minutes.  If baby’s temperature is normal and baby is feeding adequately, ensure frequent feeds. A properly fed baby sleeps comfortably between two feeding sessions, passes urine 8-10 times in a day and gains weight consistently. If the baby is still having a temperature of > 99.5 F, or having any other symptoms mentioned above, approach the doctor as early as possible for complete evaluation of dehydration/ infection.  KEEPING BABIES WARM (PREVENTING HYPOTHERMIA) Normal body temperature in adults is maintained by metabolism (through brown fat stored inside the body) as well as by shivering. Babies, before they were born, lie inside the mother’s womb, where the amniotic fluid keeps the baby warm. Normal body temperature of newborns measured in the axilla(armpit) is between 36.5 C- 37.5 C. After birth babies tend to become hypothermic due to the cold environment and also because of not able to generate appropriate shivering response. Low body temperature leads to dull activity, poor feeding, increased risk of infections and also increased risk of mortality. How to avoid hypothermia (or low body temperature) in term babies: Immediately after birth baby should be dried fully with a clean towel and placed on the mother’s chest/ abdomen. Breast feeding should be initiated within 1 hour of birth and baby should be roomed in with the mother throughout the day. Breast feeding should be encouraged every 2nd hourly, in the first few postnatal days. Avoid bathing the baby until the cord falls off. Keep the baby always covered with cap, socks, mittens and dress. Keep the baby wrapped properly all the time. Maintain the room temperature between 25- 28 C. Avoid placing the baby near open window or doors where there might be exposure to cold air/draught. The palms and soles of the baby should be as warm as the chest when the skin temperature of the baby is felt by the back of the parent’s hand.  If the soles of the baby feel cold compared to chest, baby is in cold stress and needs to be clothed and wrapped properly If for any reason, baby’s skin feels cold, or baby is dull with decreased intake of feeds, contact the health care personnel. PREMATURE INFANTS: Premature infants are more vulnerable to low body temperature because of: A higher skin surface area compared to weight.Thin skin with no subcutaneous fat which leads to evaporative heat loss.Less brown fat and poor vasomotor control. Inability to establish full feeds at birth due to gut immaturity Therefore premature babies need to be cared for in the Neonatal Intensive Care Unit (NICU), where the babies will be placed under radiant warmers to maintain body temperature. Very premature babies are usually placed inside incubators where the humidity of the baby’s environment can also be controlled to prevent evaporative heat losses through the skin. Premature babies, if they need respiratory support are provided with heated and humidified air through bubble CPAPs or ventilators.  Kangaroo mother care, initiated as soon as the baby is stable also keeps the baby warm.

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20 August, 2021

Newborn Screening

Authored By:

Protect your Newborn What is newborn screening (NBS)? Newborn screening refers to identification of the newborn babies and protect them from serious disorders which is treatable, but may not be visible at birth. This screening should be performed after 48 hours of the child’s birth. Why should a baby have newborn screening? Newborn screening is the only way to identify babies with serious disorders, who needs diagnosis and treatment. These disorders can cause injury to brain, nervous system and other organs and in rare cases, the condition may be untreatable. Early treatment will help in proper growth and wellbeing of the baby. An affected baby looks healthy at the time of birth because symptoms are not visible until weeks or months later. Once the signs and symptoms begin to show, the adverse effects can become permanent and may even cause death. It is important that these disorders are detected as early as possible. A simple blood test can give you critical information to protect your newborn against these disorders. What disorders can be detected by this screening? Phenylketonuria/ Amino Acid Disorders: This disorder prevents a baby to break down certain amino acids in their blood such as phenylalanine, ammonia and amino acids and accumulation can result in medical complications. Treatment with special diets and supplements can help the baby to prevent mental retardation, seizures, organ damage and death. Congenital Hypothyroidism: This disorder is caused by the lack of thyroid hormone, which leads to poor mental and physical growth. If treated early with thyroid medication, the child will grow and develop normally. Galactosemia: This disorder occurs when galactose cannot be breakdown in the baby’s body. Galactose is found in breast milk and other milk products. If the galactose level is high it can be life-threatening and cause damage to the brain and liver and can occur as early as one week after birth. When started early, a special milk-free diet can prevent these problems. Organic Acid Disorders: This disorder is caused when a baby is unable to convert amino acids into energy. It affects the metabolism of the baby and damages the heart, muscles and other organs. Treatment with a low-protein diet and supplements can help prevent vomiting, seizures, coma and death. Fatty Acid Oxidation Disorders: This disorder is caused when a baby is unable to convert fat into energy. This leads to accumulation of toxic fatty acids and affects the metabolism of the baby. Treatment with a low-fat diet, dietary supplements, and avoidance of fasting can help prevent low blood sugar, coma and death. Hemoglobin Disorders: These disorders are caused by defective formation of hemoglobin. Some of these disorders can be mild but some may be severe enough to require repeated transfusions and even bone marrow transplants. Early diagnosis is associated with better outcome. G6PD deficiency: The deficiency of this enzyme can cause prolonged and/or severe jaundice in babies. In this deficiency use of certain drugs can cause severe side effects. So early identification helps in preventing these complications. Biotinidase deficiency: This enzyme deficiency cam lead to neurological disorders and seizures in babies. Treatment with biotin supplements after early identification can prevent neurological issues. When and how this screening is done? A few small drops of blood is taken from the newborn baby’s heel which is collected by the experienced hospital staff within 48-72 hours of your newborns birth. What if we have no family history of any disorders? Parents with no history of these problems or already have healthy children can also have children with these disorders. Most newborns with these disorders come from families with no previous history of any particular conditions.

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15 November, 2020

Know everything about Still Births, precautions and care

Authored By:

Stillbirth is the sudden death of a growing fetus in the womb after week 20 of the mother’s pregnancy. The reasons go unexplained for almost one-third of the cases. However, the other two-third may be caused by problems with the placenta or umbilical cord, high blood pressure, infections, congenital disabilities, or poor lifestyle choices.Rarely, the baby may die during the time of labour. Although prenatal care of pregnancy has considerably improved over the years, the reality is stillbirths still happen and often go unexplained. As per the National Health Policy, IMR of the country was 33 per 1,000 births and is highest when compared to other nations.  What Needs To Be Done?  The causes of stillbirths are, at times unknown. A stillbirth occurs in families irrespective of ethnicities, races, and to the women of all ages. But there are necessities that a woman can do before and during pregnancy to lower the risk of infant loss: Monitor the baby’s pattern of movements. These movements help us recognise if they become unwell, indeed. Active or passive smoking has a tremendous effect on stillbirths. Quitting or tarrying away from the smoke during the first trimester itself has shown promising improvements in pregnancy care.  Always prefer to sleep on side during the third trimester of pregnancy. This includes, day time naps and regular night sleeps.  Key Moments to Understand Baby Movements  There are some key elements to remember about a baby’s progress: Babies DO NOT move less towards the end of the pregnancy. It is a misconception to avoid.  Never use any hand-held monitors, or phone apps to check your baby’s heartbeat.  You’ll feel the movements of your baby until you go into labour, and throughout your labour as well. Role of Prenatal and Antenatal care  Prenatal and antenatal care plays a vital role in recognising, treating and preventing pregnancy care. They tremendously help you in keeping an eye on the baby’s growth and improvements. These visits also play an essential role in recognising the emergency pregnancy conditions like pre-eclampsia and urinary tract infections which cause adverse effects on the baby. *Information shared here is for general purpose. Please take doctors’ advice before making any decision.

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