Neonatal infection is one do the dreaded conditions of the neonatal period. Early diagnosis can often be made if the physician is aware of the possibility. Localizing signs are frequently absent. Low birth weight babies are especially prone to develop infection. The first indications are sudden reluctance of feed, vomiting, drowsiness or irritability, loss of weight or static weight. Later on baby develops a grayish pallor and looks anxious. He may develop diarrhea, abdominal distension, oedema, purpura, jaundice and convulsion. Fever may or may not be present.
A preterm infant may develop hypothermia and scleraema. As soon as there is suspicion of infection, the neonate should be sent to a hospital for management. Important investigations can be done are the white cell count, urine examination, for white cells, urine culture and sensitivity, blood culture, lumber puncture and X-ray of the chest. The baby should be treated with appropriate antibiotics. Neonatal infections are commonly cause by gram negative cilli and staphylococcal organisms. Ampicillin and gentamycin combination should cover the majority of cases.
In suspected staphylocaoccal infection, cloxacillin and gentamycin combination should be parenterally. The baby would require supportive treatment such as intravenous fluid, gestria suction and general measures to control hypothermia. To sum up, the cause of vomiting might be trivial in most neonates while other conditions might prove fatal. A general practitioner should be aware of these problems to handle each case according to its merits. An ill neonate with vomiting is a pediatric emergency.
Nappies must be thoroughly washed to remove all traces and ammonia and faecal bacteria which would otherwise cause irritation and possible infection. Special nappy sterility are now available which makes this process much easier and less time-consuming. With this method the nappies are soaked in the sterilizing solution for a specified length of time and then only the soiled nappies are washed with powder; the wet nappies are thoroughly rinsed. Whenever you wash nappies use pure soap flakes or powders. Avoid strong detergents as these will irritate the baby’s tender skin. If you have to use a fabric conditioner because the toweling has become stiff make sure that you rinse it all out; despite manufacturers’ instructions to the contrary, this too can cause irritation. Unless the nappies are very stained or have become rather grey, there is no need to boil them. Hot water is sufficient for both rinsing and washing after using sterilizing tablets. Never add colored clothing to the sterilizing solution – the color will run. Even if the clothing has been soiled, just remove the worst of the mess, rinse the item and then wash as normal.
Nappy Washing Routine: To balance the chores of feeding, changing and nappy washing, try to develop a routine whereby you wash the nappies in sufficiently large loads. The prerequisite of this routine is a large sufficiently large loads. The prerequisite of this routine is a large supply of nappies – I suggest no less than 24. In order to sterilize the nappies you will need two plastic bins: one for soiled nappies, one for wet ones. They should be large enough to hold at least six nappies, and they must have lids and strong, reliable handles. Special nappy bins are sold but any bin of a decent size with a lid is suitable.
Almost all babies bring up some milk, but some babies who are otherwise gaining weight satisfactorily have an increased tendency to vomit. These babies are usually highly active, cheerful, interested in their surroundings and exhibit rapid movement of arms and legs. This type of vomiting is usually more troublesome during the first few weeks of life, but it may continue as a nuisance for some months. The timing and frequency of vomiting are irregular. Typically no sooner has an infant has been cleaned up, varying amounts of milk may be already over-anxious. This mother should be reassured. Sometimes milk sedation of the infant may help; chloral hydrate 60 to 200 mg before each feeding is often helpful.
In some babies milk shoots out when the baby belches and this type of projectile vomiting may lead a doctor to diagnosis of cognetial pyeloric stenosis. Mothers usually exaggerate the quantity brought up . The weight gain is normal. The cause of excessive flatulence in breast fed babies is prolong sucking, which may either be because of insufficient milk at times or the baby may just keep on sucking longer than required. Babies fed on bottles sometimes gulp very rapidly and this might also cause vomiting. A teat with a very small hole and leads to excessive air swallowing and later to vomiting. Some mothers do not tilt the bottles properly, and the teat, instead of containing milk, contains a lot of air and some milk.