First 1000 days…..

The sunrise is waiting in your horizon when you are ready to give birth to your baby. Pregnancy counseling for the normal labor, Lamaze and breathing exercises help the natural delivery process. Expectant mothers are given breastfeeding counseling and pain medication options are discussed. Labor pains can be reduced with medications and epidural injection (injection given to your back spinal space)
Immediately after birth the baby is kept skin to skin contact with mother and breastfed within the first golden hour. The first milk is called colostrum and its rich in nutrition (even though it is in small quantities) and immunity properties for disease resistance. Practices such as giving honey/ sugar water should not be done as it is dangerous to the baby.
The mother should be encouraged to take plenty of water at least 2 litres and a balanced diet containing milk, fruits, vegetables, dhals and meats for ensuring good milk production abhorring food fads and ignore the myths of so-called gaseous/ cold food items.
The first time mothers are assisted with exclusive breastfeeding especially in the first few days since breast milk quantity increases only after the second day. Mothers milk is best for the baby, only in exceptional scenarios formula feeding is suggested by your doctor. Cows milk should never be given to newborns. Bottle feeding is to be avoided as it causes nipple confusion and baby may refuse to breastfeed. Babies breastfed have optimal growth no overweight, better disease resistance and intelligent quotient.

Newborn babies sleep up to 16 to 18 hrs a day and should kept warm and breastfed roughly every 2 hrs or on demand.
Babies can be bathed every day and head bath weekly once after gentle massage. Massage should be done by parents or grandparents with coconut / olive / badam / mustard oil to improve digestion, increase mother / caregiver bonding, stimulate breathing and relieve gas. Do not instill oil into nose / mouth or blow air as it causes infection and breathing problems. A normal breastfed baby passes urine at least 6-7 times / day, stooling differs from once in 2-3 days to 8-10 times a day as long as baby is feeding well and no tummy distension.
The umbilical cord should be kept dry and it usually falls by 7-10 days. smelly cord or discharge or delayed fall indicates infection to consult your doctor.
Some common problems faced by mothers are flat nipples, cracked nipples, and breast engorgement. Flat nipples can be improved with syringing it out or in severely inverted nipples use a nipple shield. To avoid cracked nipples make the baby suckle the entire dark area around the nipple, apply breast milk after feeding and avoid tight undergarments. Breast engorgement and pain is prevented with frequent feeding and expressing the excess periodically.

                                                   Dr. Divya Srirangarajan,
                                                   Paediatrician & Paediatric Emergency Care Specialist

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