The transition from intrauterine development to life in the outside world is associated with major changes in almost all organs and systems of the newborn’s body. And although these changes are inherent in nature, a certain time must pass for the baby to adapt to them - this is called transient states. There are several of them, and they develop individually in each baby. Many of these conditions have no clinical manifestations and do not cause obvious inconvenience to either the baby or his mother. But there are those that are noticeable to parents and often cause them concern. They will be discussed in this article.
Physiological weight loss
In the first few days of its life, every baby loses weight. This is a natural process that occurs because a lot of water comes out of the newborn’s body, and he has to use the reserves of nutrients received in utero. There is also relative starvation, which is associated with a deficiency of milk in the mother in the first days after childbirth. The norm is weight loss not exceeding 6-10% of the baby’s initial body weight. As a rule, by 8-10 days full-term babies and by 14 days premature babies gain the weight they had at birth.
After this, the child’s weight regularly increases. Pediatricians and parents closely monitor this indicator, as it indicates proper development.
Rapid restoration of a child's weight is facilitated by:
- early breastfeeding,
- free feeding mode,
- compliance with thermal conditions,
- prevention of hypogalactia in mother,
- rational baby care.
How is the disease diagnosed?
Typically, your doctor will order blood and urine tests to measure your creatinine and uric acid levels. Blood is taken from a vein. If the results are abnormal, a 24-hour urine test is performed. Typically, it also shows elevated uric acid levels. The patient is then prescribed a purine-restricted diet, followed by a repeat urine test. This approach helps determine whether uric acid diathesis is caused by:
- consuming large amounts of purines in food;
- hyperproduction of uric acid in the body;
- insufficiently effective removal of purine metabolic products from the body.
If you have symptoms of gout, your doctor will recommend testing your intra-articular fluid. A sample is taken using a thin needle. If uric acid crystals are found in the fluid, a diagnosis of gout is made.
Heat imbalance
Borderline conditions in newborns also include a transient disturbance of heat balance or metabolism. The baby's body temperature may fluctuate - increase or decrease, usually slightly. This is easy to explain. Thermoregulation processes are still immature and imperfect, very sensitive to environmental changes. A child's heat balance depends on any fluctuations in indoor or outdoor temperature.
Therefore, it is extremely important to ensure a suitable temperature in the room (20-220C for full-term babies, 23-240C for premature babies), protect them from overheating and drafts, and dress according to the weather.
Frequently asked questions about uric acid diathesis
What to do if you have uric acid diathesis?
First of all, consult a doctor. Now there are medications that effectively cope with the consequences of uric acid diathesis, such as gout and kidney stones.
What may be the primary symptoms?
It all depends on where in the body the uric acid crystals have settled. If the joints are affected, we are talking about gout. The first signs of this disease are pain, swelling and stiffness of the joint (usually the big toe). If the crystals have settled in the kidneys, there may be no symptoms for a long time, since kidney stones form gradually. This can be suspected by such signs as sharp pain in the lumbar region, frequent urge to urinate, and blood in the urine.
What are the most effective drugs?
Treatment should be prescribed by a doctor, since uric acid diathesis can lead to the development of diseases, the treatment methods for which differ significantly.
Sexual crisis
This condition is observed in 2/3 of babies. Most often girls experience this. Rarely – premature babies. This phenomenon is associated with the reaction of the newborn’s body to release from maternal estrogens.
Often in the first week of life in girls, and sometimes in boys, the mammary glands slightly enlarge, but no inflammatory changes are observed on the skin. As a rule, engorgement increases by the 8-10th day of life, and by the end of the first month it subsides. Sometimes a fluid resembling colostrum is released from the baby's mammary glands. This phenomenon is normal! Parents should not be afraid.
In most cases, all of the above treatment does not require. BUT! If the engorgement of the mammary glands becomes significant, and the skin over them is red and hot to the touch, the body temperature rises and the child behaves restlessly, then a consultation with a pediatrician is necessary.
Do not squeeze liquid from your baby's nipples! This can cause pain to your baby and lead to infection.
In the first days of life, girls often experience grayish-white mucous discharge (possibly mixed with blood) from the external genitalia. These are manifestations of transient vulvovaginitis. After a few days, the discharge disappears. All this is also a normal reaction and does not require treatment. Hygienic care and regular washing are required.
Skin changes
In the first week of life, transient changes in the skin occur in the vast majority of newborns. The most common ones are:
- Simple erythema or physiological catarrh
is reactive redness of the skin after removal of vernix and the first bath. The erythema intensifies on the second day and disappears by the end of the first week of life (in premature babies - after 2-3 weeks). - Physiological peeling of the skin
. It can be large-plate, small or pityriasis. As a rule, it occurs on days 3-5 of life. In post-term babies, very profuse peeling is observed. No treatment is required; skin peeling goes away on its own. - Birth tumor
. This is swelling of the presenting part of the body due to venous hyperemia, which disappears on its own within 1-2 days. Sometimes small pinpoint hemorrhages (petechiae) remain at the site of the birth tumor, which disappear on their own over time. - Erythema toxicum
. Occurs in many newborns on days 1-3 of life. On the skin - face, trunk and limbs - erythematous spots or papules appear against the background of erythema. Such rashes disappear within a week, but can sometimes persist during the first month of life. The condition of the children is not impaired and no treatment is required. - Milia
. These are white-yellow nodules up to 2 mm in size. Located on the face: wings of the nose, bridge of the nose, chin area, forehead. The formations are accumulations of sebum that have not reached the surface of the epidermis. No special treatment is required. If there are signs of inflammation around the nodules, we recommend treating the skin with an antiseptic solution.
Physiological conditions of newborns: normal or pathological?
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Neonatology in medical institutions of Chelyabinsk:
Maternity hospital of the South UGMU clinic Maternity hospital of the City Clinical Hospital No. 8 Maternity hospital of the City Clinical Hospital No. 9
When a little person is born, he experiences enormous stress. It passes through the birth canal, which in itself is not easy, and the birth may not be entirely successful. Then the newborn finds himself in a world where it is not as comfortable as in his mother’s belly. Therefore, during adaptation to the environment, the child may experience so-called “physiological states”. They are also called transitional, as they reflect the baby’s transition from intrauterine to extrauterine life. All these conditions are temporary and disappear with the end of the neonatal period (during the first month of life) and do not require treatment. Nevertheless, young mothers may be concerned about changes in the baby’s condition, so it is important to be able to distinguish the physiological conditions of the newborn from the onset of the disease.
CARE FOR A CHILD UP TO ONE YEAR OF AGE
Weight loss
On the 2-3rd day of a baby’s life, his weight decreases by 5-10 percent of his birth weight - this is a physiological loss of body weight. After all, in utero the baby received all the nutrients from the mother’s blood through the umbilical cord. To make adaptation to a different type of nutrition more favorable for the baby, early breastfeeding is recommended (in the first 30 minutes after birth). By 6-7 days the baby regains its original weight.
Transient fever
Simultaneously with physiological weight loss, a transient fever occurs in the newborn on the 3rd-4th day of life. There are several reasons for this transitional state. This is an insufficient intake of fluids into the child’s body (at this time the baby still receives colostrum, which is much thicker than “mature” milk and contains a large amount of protein). Also, the baby’s thermoregulation system has not yet been adjusted and the skin evaporates more fluid than the body receives from food and drink. The result is dry skin, mucous membranes and general dehydration of the body.
A transient fever manifests itself with an increase in body temperature to 38-40 degrees, the child becomes excited and restless. This condition lasts 1-2 days, and then the temperature returns to normal.
Antipyretic drugs have no effect for transient fever. Treatment consists of feeding the baby (you can give warm boiled water or saline) and creating a comfortable temperature and humidity. It is important that the child does not overheat or become hypothermic (you can use a humidifier).
Uric acid infarction
On the 5th-6th day of a newborn’s life, the mother may notice that the baby’s urine has become cloudy and orange-brown in color, and reddish spots remain on the diaper. This physiological condition is called uric acid infarction. It is associated with immaturity of metabolism, increased formation of uric acid and its salts and increased excretion in the urine.
Uric acid infarction resolves spontaneously as fluid intake (including breast milk) increases by 10-12 days of the baby’s life.
Physiological jaundice
This transitional state manifests itself in most newborns from 2-3 days of life - the skin becomes jaundiced; With physiological jaundice, stool and urine do not change color; the sclera does not turn yellow. The reasons for this condition are the enzymatic immaturity of the liver, which is not yet able to cope with the processing and excretion of bilirubin; it accumulates in the body, giving a yellow color to the skin. In order for bilirubin metabolism to normalize, it takes 1-2 weeks, so physiological jaundice “disappears” by the 10-4th day of life and does not require treatment.
At this time, the child’s well-being, as a rule, does not suffer. Jaundice that appears in the first days after birth, rapidly progresses and lasts longer than 14-16 days may indicate a serious deviation in the baby’s health. In any case, if there is anything alarming about the color of your child’s skin, regardless of age, be sure to consult your pediatrician.
Erythema of the newborn
This physiological condition is characterized by redness of the skin after removal of vernix lubrication by the end of the first day after birth. It is also called physiological catarrh and can intensify for 2-3 days. Erythema usually subsides by 4-5 days of life, followed by peeling. This does not affect the baby’s well-being in any way.
Sometimes it is possible to develop toxic erythema on days 4-5 of life. A rash appears on the skin in the form of small red spots and bumps, and bubbles with transparent contents may also appear on bright red inflamed skin. Toxic erythema is the result of an allergic reaction of the child’s body to environmental factors. It is important to prevent further development of toxic erythema: for this you need to ensure maximum cleanliness. Do not lubricate or open blisters on the skin - this will lead to the development of purulent inflammation. Under favorable and comfortable conditions for the baby, toxic erythema disappears on its own after 2-3 days.
Sexual crisis
In utero, the baby receives the mother's hormones through the placenta - estrogens, which are necessary for the proper development of the baby. After birth, the child no longer receives them. Visible changes in girls occur in estrogen-dependent organs: mammary glands, vagina and uterus, although manifestations of a sexual crisis are observed in children of both sexes.
The mammary glands increase in volume from 2-4 days of life and reach maximum engorgement by 7-8 days. Breast engorgement is always bilateral, symmetrical, the color and temperature of the skin near the nipples do not change, the mammary glands can increase up to 3 cm in diameter. Breast engorgement usually disappears by 2-3 weeks of life, sometimes it can persist until one month of age. This condition does not require treatment.
On the 3rd-4th day of life, newborn girls experience grayish-white discharge from the genital tract - this is the exfoliation of a large number of vaginal epithelial cells. They disappear in the second week of life. This condition also does not require treatment. You just need to wash the girl several times a day from front to back (that is, hold the child with her tummy up so that the water washes first the genitals and then the buttocks). You should not try to remove all the mucus from the genital slit, the main thing is that there are no excessive accumulations. It is important to follow the rules of hygiene when caring for a newborn girl, otherwise an infection may also occur. In case of heavy and prolonged bleeding, additional examination is necessary to exclude the disease. On the contrary, the absence of manifestations of a sexual crisis (vaginal discharge) may indicate a fusion of the labia in the baby. Therefore, any deviation from the physiological norm, any doubt a mother has about her baby must be resolved by a pediatrician.
In boys, on the 3-4th day of life, the appearance of the genital organs changes: the scrotum becomes swollen and increased in volume. By 7-8 days, these manifestations usually fade away, although in some cases the genitals take on normal size only by the age of one month. These changes do not require anything other than ordinary hygiene.
In a newborn baby, you can notice whitish-yellow rashes on the face - this is a consequence of blockage of the excretory ducts of the sebaceous glands, which work most actively during a sexual crisis. The rash is called milia and can be located on the forehead, wings of the nose, or chin. After a few days, the milia disappear on their own and do not cause concern to the baby.
As you can see, there are many physiological conditions in newborns, and most of them appear at the same time - on the 2-4th day of the baby’s life. It is in your power to provide your child with the greatest possible comfort, cleanliness, compliance with all hygienic rules of care and, of course, breastfeeding. Then your baby will easily and quickly adapt to the world around him.
Author: T.V. Karikh, pediatrician at HCMP.
Based on materials from the newspaper “On Health” (issue No. 5, May 2009)
Print version
Transient jaundice
Yellow coloration of the skin and sclera with physiological jaundice does not appear from birth, but on the 3-4th day, reaching a maximum on the 5-6th day. The physiological process of destruction of red blood cells and the release of indirect bilirubin from them, as well as the immaturity of the liver enzyme system, leads to the accumulation of indirect bilirubin in the blood and skin, giving the latter a jaundiced tint. Sometimes transient jaundice has a protracted course. In this case, it is necessary to observe a pediatrician with an examination to exclude pathological conditions.
Transient catarrh of the intestines
Transient intestinal catarrh (physiological dyspepsia of newborns, transient intestinal catarrh) and transient dysbiosis are transitional conditions that develop in ALL newborns.
On the 1st-2nd day of life, babies pass their first stool (meconium), which is a thick viscous mass from dark green to black. On days 3-4, transitional stool appears - heterogeneous in consistency and color (with lumps, mucus, green-yellow color). By the end of the first week, the stool is usually set in the form of a yellow mush.
Transient dysbiosis is associated with the inevitable colonization of the intestinal mucosa by bacteria after birth. In subsequent months, the presence of undigested lumps in the stool, and occasionally mucus, may also be the norm if the baby has gained good weight and is feeling well. This is explained by physiological lactose deficiency. Young mothers should discuss this issue with their pediatrician.
Uric acid infarction
Despite the menacing name, this condition should not cause concern for parents. Outwardly, it manifests itself as follows: in the first week of life, the baby produces cloudy, brick-yellow urine. This is explained by metabolic disorders in the kidneys and the deposition of crystals of uric acid salts in them. As a rule, by the end of the first week these phenomena disappear. If the color of urine does not return to normal by the end of the second week of life, you should consult a pediatrician for advice.
We have listed the main phenomena when faced with which young parents begin to sound the alarm. We hope that the article will be useful and you will be able to fully enjoy communication with your baby without worrying about transient conditions and knowing that this is a temporary phenomenon. Be healthy!
Causes of the disease
Uric acid is a substance that is formed when purines are broken down. Most of it dissolves in the blood, passes through the kidneys and is excreted from the body along with urine. An increase in uric acid levels can occur for the following reasons:
- the kidneys stop effectively filtering and removing uric acid from the blood;
- a person consumes a lot of foods high in purines (red meat, legumes, liver, seafood, alcoholic beverages, especially beer);
- the body produces too much uric acid.
In the latter case, the cause of increased levels of purine metabolic products is most often genetic disorders.
