The advice of a pediatrician in the face of the vagaries of birth

• Sophie Bert-Vignon, pediatrician for twenty-five years, accompanies parents and their babies to the maternity ward of the Dijon University Hospital.

• This Thursday, she is publishing a manual for new and future parents:

  The Secret Life of Newborns

  .

• From life

  in utero

  to returning home, she deciphers the different stages: vaginal birth, cesarean section, breastfeeding, care, sleep ..., and the many unforeseen events that new parents may encounter when adopting the baby's point of view.

It's crazy how one can impatiently wait for a first cry… and quickly get bored of those who arrive next. New parents are bombarded with questions and injunctions when their newborn baby arrives. It's not easy to measure the immense upheaval this tiny being is going through, to understand why he cries, if he has eaten enough ... 

This is why the pediatrician Sophie Bert-Vignon has chosen, in her essay

to slip into the skin of babies, combining practical advice and patient stories. “Even when everything is going well during pregnancy, it's impossible to predict how things will turn out. The birth to the baby

it's a bit of a triathlon, she added. The stay in maternity is shorter and shorter and the parents find themselves alone. Supporting them well means less desolation and personal devaluation! “His guide therefore details several important stages, from birth to cruising speed, thirty days later.

asked this pediatrician from the Dijon CHU maternity hospital on six common hazards that future parents can experience.

Prematurity

For late premature babies [born between the 8th and 9th month], we need to have a careful look, and maternity stays are longer.

, breathing and heart rate become regular at 35 weeks.

The ability to coordinate swallowing and breathing is acquired by the end of the 8th month.

We are therefore at a turning point.

But from one baby to another, it can be very variable.

From birth, ensure that the premature baby manages the flow of milk as well as maintaining good breathing.

He can also fish by lack of endurance: he takes the breast or the nipple of the bottle well, but in reality, he sucks three strokes and there is no one left.

The breastfeeding lasts, but the quantity drunk is insignificant.

As long as he breathes well, his blood circulation is regular and he knows how to eat, he can come home.

Cesarean

There are two types of cesarean section.

The one decided urgently, because the delivery does not go as we would have liked.

Or that the baby may not be able to cope with labor.

In this case, he may be very tired at birth, he will need to be more stimulated, more helped.

Second scenario: the cesarean section outside of labor, scheduled.

There the baby is taken by surprise.

During labor, he secretes the hormones he will need to adapt to his new life.

There it will run out.

This is why he may have more difficulty taking his first breath: he must first get rid of the fluid that fills the lungs.

Weight loss

It is normal for the baby to lose weight during the first few days.

First of all because he loses water: the newborn was a small aquatic being, with waterlogged tissues!

It must be dehydrated to adjust to its conditions of existence in the open air, in particular to promote the rearrangement of all the blood circulation.

Then, he will empty his intestine by eliminating the meconium. It is the poo that has accumulated during fetal life, all black, odorless and sticky. The third parameter mainly concerns breast-fed babies. For the first few days, he will only drink colostrum, which is very small rations. The baby often returns to the breast, but in reality he drinks an average of 20 g. But nature has planned everything: full-term babies have reserves to last these few days. From the moment the flow of milk arrives, they will regain weight. For babies who take a bottle directly, it's a little different, because they have large quantities available. They do not know how to adjust. We must remain vigilant because if they drink too much, it will overflow ...

As much as this weight loss is physiological, at one point it has to stop.

For monitoring, we have two benchmarks.

We are concerned if the newborn loses more than 10% of its weight (300 g if it is 3 kg).

What if the weight loss continues on the fourth day.

Jaundice

Unlike adults, it is not a disease in the newborn.

He has a lot of red blood cells because he used to live in a low oxygen environment.

A bit like those who live in the mountains.

At birth, he arrives in a much more oxygenated environment, so he must destroy his red blood cells.

It is the liver that eliminates hemoglobin.

However, it may not be able to manage: the hemoglobin is then transformed into bilirubin, yellow, which gives the baby this golden color.

Usually this happens around three or four days of life.

To help him, we do phototherapy.

Be careful, this is not UV, it will not make him tan!

It was an English nurse who discovered by chance that newborns sleeping near daylight turned less yellow than others.

We are therefore going to put it under lamps that concentrate the light.

This turns bilirubin into another compound that is easier to eliminate by the kidneys and intestines.

Jaundice affects one in two babies.

And an average of one in ten babies needs light therapy.

We know that he can manage this bilirubin up to a certain threshold.

Because if it passes into the brain, it can have serious consequences.

Difficult breastfeeding

Breastfeeding is a learning experience in its own right for mothers, who are preparing for it.

On the other hand, what is less known is that the baby is fully involved.

And that it's a big effort for him.

, he swallows the amniotic fluid as soon as he opens his mouth, so it is a big adaptation to suck! 

Sometimes they don't understand what is expected of them, are too tired.

This requires support and sometimes adjustment.

By mixing with baby bottles, for example.

It is important to be well guided.

The correct positioning of the baby's body and his mouth is an essential prerequisite.

Otherwise, he may have trouble catching the breast, and breastfeeding becomes painful for the mother.

Complex transit

At birth, many organs are not ripe.

Especially the intestine.

The latter can contract strongly and in an anarchic manner.

The intestinal flora is put in place during the first months of life, and will contribute to the digestive comfort of the baby.

Breast milk evolves and works to counteract this immaturity, while formula is the same at three days of life as at four months.

Regarding small, often effective means, what babies like is to have their tummy warm and secure.

If we no longer recommend lying down on his stomach at night, we can lay him down like this on the bed when you are next to him, or carry him lying on his arm.

Belly massages in a clockwise direction [to be in the direction of the intestines], in order to facilitate digestion, may provide relief… or not.

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