The arrival of a new baby is both a challenging and rewarding experience.
This can be particularly true for parents whose newborn has a health
problem.
"There is no way to completely prepare yourself for the
discovery of a birth defect or for complications during delivery," admits Nancy
Chescheir, MD, associate professor of obstetrics and gynecology at the
University of North Carolina at Chapel Hill.
"It's important for parents to know as much as they can going into the labor
and delivery room so they can be prepared if they need to make decisions," Dr.
Chescheir says. Prenatal testing and education can provide valuable information
to help prepare you for your newborn's arrival. Read on for important facts
about common newborn health problems and tips to prepare you to make informed
decisions about your baby's health.
Common Newborn Problems
Certain birth defects,
such as spina bifida, Down syndrome, congenital
heart disease, exposed bowel, or cleft lip, can
often be diagnosed prenatally. Other birth defects cannot be detected before
birth and are noted for the first time in the delivery room. In addition,
complications such as meconium
aspiration (when a newborn inhales a mixture of meconium - the baby's
first feces, ordinarily passed after birth - and amniotic fluid during labor and
delivery) can occur.
If a birth defect is discovered prenatally, your obstetrician will prepare
you by rehearsing what will happen in the period following delivery. Parents can
find out what to expect in the period following delivery
and can visit intensive or special care units before birth to become familiar
with the environment and meet the neonatal team. This team may include a
neonatologist, a pediatric anesthesiologist, or pediatric surgeon, as well as
neonatal nurses and nurse
practitioners.
A very common problem affecting premature infants is
immature lungs. Some preemies lack enough surfactant, a chemical that
prevents the air sacs from collapsing when a baby exhales. Surfactant isn't
reliably present in the fetal lungs until after 34 weeks' gestational age, so
many premature babies require devices to assist their breathing, keep their air
sacs open, and promote air exchange. One of these is a ventilator, a breathing
machine that is hooked up to a small plastic tube that goes into the baby's
windpipe to aid in breathing.
Synthetic surfactant is now routinely given (down a breathing tube) to very
premature babies right after birth. These infants are able to breathe on their
own much sooner than in the past, and sustain less lung damage because they
do not require long-term ventilator use.
Other problems are less severe. It's not uncommon for preemies
or even full-term infants to develop jaundice in
the first 2 to 3 days after delivery. It usually disappears in about 5 to 7
days. Almost 80% of premature babies develop jaundice within the first 5 to 7
days. Jaundice occurs in healthy babies when a baby's immature liver initially
can't dispose of excess bilirubin (a yellow pigment produced by the
normal breakdown of red blood cells) in the blood.
In some cases, your doctor may order tests to determine
bilirubin levels and whether treatment is necessary. The most common treatment
involves exposing the baby to special ultraviolet lights that help to break down
the extra bilirubin to help the baby's liver process it. This treatment can
often be done at home with rented equipment.