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Watch your baby's signals
Yesterday night shift, around 11 o'clock, a pair of young parents rushed to the hospital with a baby born 20 days old. Ask the reason, the baby from the evening, a burst of crying, do not eat or drink, like "carp to stand up".
The cloaked mother and the sweaty father tell a "family incident" caused by "wearing diapers". The doctor quickly put the baby on the examination bed. At this time, the baby is no longer crying, his eyes are open, his little face is red, and he can still see the traces of just crying.
The doctor conducts a detailed physical examination to find the cause of the crying...
Image source: Courtesy of the author
Almost every pediatrician's night shift has a déjà vu experience, a newborn or a small baby crying for unknown reasons, what is going on, and how should the mothers deal with it?
As the saying goes: a crying child has milk. Crying in newborns is a way for them to express their feelings and demands, part of normal nervous system development, and the frequency of crying in babies is also related to their degree of development.
In the first week after birth, crying is mainly concentrated in the evening;
Crying peaks from about 2 weeks after birth to 6 to 8 weeks after birth, with an average daily crying time of 110 to 118 minutes;
After 12 weeks of life, it decreases to 1 hour a day and disappears in about 3 to 4 months.
Baby crying is not necessarily related to life-threatening diseases, in fact, 95% of newborns cry, there is no physical or health problems, fatigue, hunger, post-stool discomfort can cause the baby to cry. Nevertheless, it is necessary to accurately identify pathological crying.
These conditions can cause the newborn to cry
Judging the cause of crying simply from the pitch, pitch, etc., is too empirical, and it is easy to be overly nervous or delay the disease. Let's take a look at several common disorders that cause newborns to cry, and how to deal with them.
1. Nasal congestion after upper respiratory tract infection:
Cause: when the nose is congested, the baby can only breathe with the mouth, when breastfeeding needs to close the mouth to suck the nipple, the baby can not breathe, can only give up the nipple to open the mouth to breathe, in this case, the baby is hungry can not eat milk, breastfeeding and can not breathe, can only cry loudly.
Treatment: At this time, the mother can use a wet towel to warm the baby's nose before feeding, or use saline to drip the nose, dilute and wash out the secretions and feed. You can feed it for a while to pull out the nipple, wait for the baby to breathe for a while and then continue to feed, do not wait for the baby to start crying and then deal with the snot, the more you cry, the more you do not eat.
2. Intersmobrary rash and diaper dermatitis:
Causes: Sweaty skin folds or failure to change diapers in time after defecation often causes interbrasion and diaper dermatitis, which is an important reason for newborns to cry.
Treatment: When the baby is crying, be sure to look at the skin from head to toe, especially the skin folds and whether the vulva is flushed and broken. Keep your skin clean and dry on weekdays, change your diaper frequently, wash your vulva after defecation, and then use a clean cotton cloth or disposable diaper. If flushing occurs, it can be washed with warm water, spray antibacterial lotion, and dry locally. Keeping your skin clean and dry is key to preventing such cries.
Diaper dermatitis, image source: Courtesy of the author
3. Improper feeding:
Cause: Due to too much feeding, or the premature addition of starchy foods, the baby cannot digest, produce too much gas or feed in the wrong way, the milk does not pass the pacifier, and the baby inhales too much air. Causes stomach swelling and discomfort, and the baby cries and is restless. The more you cry, the more you inhale the gas, which leads to crying.
Treatment: Advocate breastfeeding as much as possible, for various reasons can not breastfeed, try to use the same formula of dairy products. Pat the back on the back of the milk, lie on the side, and raise the upper body 30 degrees. Massage your baby's abdomen clockwise to promote emptying.
4. Lactose intolerance:
Cause: Lactose intolerance manifests diarrhea, yellow-green loose stool with milk flaps, foamy. Bloating, excessive exhaustion, increased bowel sounds, and frequent discharge of a small amount of stool. Newborns often cry due to abdominal discomfort and are ineffective with antibiotics or antidiarrheals.
Treatment: At this time, breastfeeding can be reduced, or ordinary formula can be replaced with lactose-free formula, which can achieve good results.
5. Cow's milk protein allergy:
Cause: Refers to the body's high responsiveness to cow's milk protein, which is one of the common food allergies in newborns. Milk contains a variety of proteins, of which α-whey protein, β-lactoglobulin are the main allergens that cause milk allergy. It is manifested by allergic rashes (urticaria, eczema, etc.), vomiting, diarrhea, flatulence, intestinal spasms, etc.
Treatment: Treatment is recommended for exclusive breastfeeding (mothers avoid cow's milk and foods that may be allergic), and infants who cannot breastfeed can choose appropriate hypoallergenic formula, deep hydrolyzed protein formula, or even amino acid-based milk powder.
6. Vitamin D deficiency rickets in the early stage (early stage):
Cause: More common in infants within 6 months of age, especially in infants within 3 months. Such as irritability, annoyance, sweating and irritating the scalp and shaking the head. Serum 25-(OH)D3 decreased, PTH elevated, transient blood calcium decreased, serum phosphorus decreased, alkaline phosphatase is normal or slightly higher.
Treatment: Oral vitamin D and sun exposure, with appropriate calcium administration, may improve symptoms.
There are several situations where an emergency visit to the hospital is required
01
Intussusception
Caused by a part of the intestine being inserted into the adjacent intestine, it is divided into primary and secondary, and newborns are mostly primary, and may also be caused by improper feeding and excessive swallowing of air caused by intestinal peristalsis disorders.
Paroxysmal crying, often accompanied by vomiting, pale face during shock, and jam-like or bloody stools 4 to 12 hours after onset. However, there are also only pale faces, mental atrophy, and soon enter a state of shock, at this time the crying is not obvious.
02
Incarcerated hernia
Inguinal hernias, umbilical hernias, and intra-abdominal hernias are generally reduced, and occasionally incarceration and intestinal obstruction occur, at which time, newborns have vomiting, bloating and other symptoms in addition to severe crying.
Therefore, if the baby who usually has a hernia, when the cause of the violent crying, especially with reduced mental reactions, abnormal face, etc., pay attention to check whether there are masses in the groin, vulva and umbilicus, if there is a mass that cannot be repaid continuously, it is necessary to urgently seek medical treatment.
03
other
Diseases of the central nervous system: crying is high-pitched, high-pitched.
Sepsis or neuromuscular disorders: crying is weak, or even not crying.
Bilateral recurrent laryngeal nerve injury: hoarseness, low or even silent crying.
Acute otitis media: often has symptoms of respiratory tract infections, crying accompanied by shaking of the head, scratching the ears with the hands, etc.
Doctors and parents face the crazy little thing of crying in the face of their babies, what should they do?
In general, hunger, fatigue, hot and cold stimulation, crying after defecation, generally the tone is not high, the degree is not intense, and it is easy to stop after lifting the cause. Unexplained newborns should be asked for a history of illness and feeding when they cry violently, followed by a complete physical examination to find the cause and treat the cause.
Doctor's support for parents
Support and psychological comfort for parents; excluding disease factors.
Parents are taught the normal form of crying, self-regulation and how to prevent infant shaking syndrome and avoid head injuries; the relationship between parents, children and caregivers is important and takes time to form and nurture.
Promote cooperation between caregivers and parents to empower parents who have lost faith.
No change in feeding practices, no change in formula;
Counseling for parents. If the infant is crying excessively, any possible problems are ruled out and the normal pattern of crying in the infant should be fully explained to the parents.
What parents should do
Implement regular daily care: the environment that includes sleep and feeding cannot be changed, and the child can sleep and play on his own. This does not mean that the schedule is fixed, but a relatively fixed approach.
Touch: Strokes are effective for babies younger than 6 months of age. Improve mother-child relationships, improve sleep and crying problems. It is especially effective for crying in babies aged 3 to 6 months.
Position: The prone position can better improve the problem of crying, but someone must be by the side to avoid accidents.
When the child cries excessively for a long time, holding up the crying child and comforting it is the normal behavior of parents, and studies have shown that "hugging" cannot reduce crying, but there is no negative impact, and there will be no problems such as parents worrying about developing bad habits.
In short, the baby cries, 95% have no health problems, and the doctor should remove the diseases that need to be treated after a detailed examination and give parents support and guidance. Parents should also have basic recognition skills, if the doctor determines that the baby does not have a disease that needs to be dealt with, then don't worry, hug the child, give him some comfort, do not worry about developing bad habits of the baby. Can't stand the child's crying, it is very simple, hard work for 2 to 3 months, the older ones will not cry.
Resources:
1. Practical Neonatology 5th Edition. Pediatrics 9th Edition.
Source of this article: Pediatrics Channel of the Medical Community
This article is written by Li Yuelan
Editor-in-Charge: CiCi