The normal rectal temperature of new born ranges between 35.50 C and 37.5o C. Since no single temperature measurement can determine the adequacy of the thermal protection, the serial recording of rectal, skin and air temperature during the care of the babies is helpful in determining the normality of any single temperature. Usually the skin temperature is the same or than the rectal temperature it is possibly duet to heat loss having been limited by environmental heating and further increase in thermal temperature results to fever which is possibly due to other heating and not sepsis.
On the other hand, if the skin is cooler than rectal temperature the fever could be due to hypermetabolism or due to infection. Thus it is very important to monitor even environment temperature. If the incubator temperature is more than 2 to 3o C cooler than the body skin temperature, it is likely that the infant is using up his energy stores in trying to maintain his body temperature, at a normal level. Thus all above reasons serve to understand the needs for knowledgeable use of thermal measurements in manipulations to the particular infant under special nursery care.
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.