How to spot signs of illness in babies
Guide to determining the severity of symptoms in newborns
"My baby is acting differently than usual..."
"Is this an illness? Should I go to the hospital right now?"
In the heart of a mother gazing at her beloved newborn child,
Every small change seems like a big worry.
In fact, during the first year that a baby spends in the outside world after being born ,
This is a special time in your life when you will experience some of the most dramatic growth and change.
Among them, is it "part of the normal growth process"?
Is it a sign of a disease that really warrants concern?
It can be difficult to tell the difference, even for medical professionals.
But it's okay.
By the time you finish reading this guide,
"Oh, so that's what this symptom means!"
"So that's why doctors ask this question."
With this new discovery,
You will become a mother who can look after her child with confidence.
Under the supervision of a pediatrician who has examined over 10,000 babies over the past 30 years,
Only the most important knowledge
I will tell you this with my heart in mind as a mother.
The boundary between normal and abnormal in the newborn period
Danger signs to look for in the first 24 hours after birth
A reassuring normal reaction
"I wonder if this child is still alive..."
When you hold your newborn baby in your arms for the first time,
Many moms feel this anxiety.
It's so small and so quiet,
I'm confused by the way babies react, which is completely different from adults.
It's very natural.
In fact, from the moment a baby comes out of its mother's womb,
An amazing process of adaptation to sustain life has begun.
From the environment of floating in amniotic fluid,
To the outside world where there is gravity and you have to breathe air.
This change is so rapid that it takes an adult to return to Earth from space.
It's a dramatic change in the environment.
In this situation, "Danger signs that you should consult a doctor immediately"
"It's worrying, but it's actually a normal reaction"
It’s important to be able to distinguish.
First, the most important thing to pay attention to within the first 24 hours of birth
Let me start by talking about breathing problems .
A healthy newborn baby breathes about three times faster than an adult.
About 30 to 60 times per minute.
You may be surprised and ask, "Wow, it's that fast?"
A baby's lungs are still very small
Because the amount of oxygen that can be taken in with each breath is small,
It makes up for it by the number of times.
However, if you see the following breathing patterns:
Do not hesitate to contact a medical institution.
"Depression breathing" occurs when the center of the chest and the space between the ribs sinks in when you inhale.
Abnormal tachypnea of more than 70 breaths per minute
Apnea, where breathing stops for more than 20 seconds
Wheezing breathing sounds.
These are the tiny bodies of babies
It's like sending a signal saying "help me".
Next, we will discuss changes in skin color .
Cyanosis, in which the lips, nails, and tongue turn blue-purple,
This is an emergency sign of a lack of oxygen in the blood.
On the other hand, the tips of the hands and feet turn a little blue.
This is a common phenomenon in newborns who are not yet able to regulate their body temperature well.
It will improve if you warm it up.
The key points to distinguish are:
"Whether it extends to the center of the body, such as the face or chest."
Know your baby's feeding habits and overall condition
It's an important barometer.
Even a newborn baby
There is an instinctive reaction to breast milk or formula.
They refuse to drink at all, or if they do drink, they vomit immediately.
If your baby seems short of breath while feeding,
There may be some hidden problem.
On the other hand, some reactions may seem worrying but are actually normal.
There are many.
Neonatal jaundice is a yellowish skin color that appears on the second or third day after birth.
This is a normal phenomenon seen in many babies.
The Moro reflex, which occurs when a child is startled by a loud noise
The reaction of spreading both arms out,
It is a sign that the nervous system is developing normally.
In addition, the baby's weight will temporarily decrease for 3 to 5 days after birth,
This is also a normal phenomenon called "physiological weight loss."
What's most important is,
Know what your baby's normal behavior is.
Every day I hold him and talk to him,
The rhythm of breathing, the warmth of the skin, the tone of the crying
By remembering it with your body,
You will be able to notice changes that are "out of the ordinary."
This is more important than any other medical device.
It's an excellent early detection system.
Abnormal breathing in babies | Is it dangerous if it's more than 60 bpm?
How to distinguish between retracted breathing and normal breathing
"Isn't this child's breathing a little too fast?"
While watching the sleeping face of a baby in the middle of the night,
Have you ever suddenly become worried?
For those of us who are used to the gentle breathing of adults,
Baby's rapid, shallow breathing
It certainly looks worrying.
But in fact, babies' breathing
There are special rules that adults don't even think about .
By knowing that,
"Normal but worrying-looking breathing"
"Really urgent respiratory abnormalities"
You will be able to distinguish accurately.
First, here are some amazing facts about newborn breathing.
Babies breathe 30 to 60 times per minute.
This is about three times the rate of adults, which is 12 to 20 times.
Why is it so fast?
The reason is that a baby's lungs are as small as a fist.
The amount of oxygen you can take in with one breath
That's only about one-tenth the size of an adult.
In other words, "the number of times compensates for the lack of oxygen"
This is the basic breathing pattern of a baby.
What's even more interesting is that
This phenomenon is called "periodic breathing."
This is after breathing normally for 10 to 15 seconds.
This is a phenomenon in which breathing stops for 5 to 10 seconds.
When the mother saw him for the first time, she said, "He's not breathing!"
You might panic.
But don't worry.
During this time, the baby's complexion was good and his heart rate was stable.
A characteristic of this patient is that they remain completely normal even after breathing resumes.
This is due to the immature respiratory center of newborns.
It's a normal reaction.
So, what breathing problems should you be really worried about ?
What is it like?
The most important thing to watch out for is "depressed breathing."
This is because when you inhale, the center of your chest (sternum)
This is a phenomenon in which the spaces between the ribs and above and below the collarbone become concave.
For healthy babies,
My chest and stomach swell up like a balloon,
In retracted breathing, the rib cage is pulled inward.
Unnatural movements are observed.
This is a state of "trying too hard to breathe"
It's a sign of some kind of breathing problem.
Be careful if tachypnea (more than 70 breaths per minute) continues for more than 30 minutes.
Temporary rapid breathing
This often happens after crying or when it's hot.
If you continue to breathe abnormally fast even when you are resting,
Possible causes include pneumonia and congenital heart disease.
Conversely, slow breathing (less than 20 breaths per minute) is also a danger sign.
It is often thought that "breathing slowly is safe,"
In newborns, central nervous system abnormalities
There is a possibility of a serious infection.
Abnormal breath sounds are also an important indicator.
A normal baby's breathing is almost silent.
Wheezing and whistling sounds
The rumbling sound when breathing (Strider)
If you can hear it, it may be an airway problem.
The most important thing to observe when breathing is
"Seeing the whole picture of the baby."
Even if your breathing is a little fast,
His complexion was good, he was moving his limbs energetically,
If you are breastfeeding properly,
It's likely a temporary physiological fluctuation.
On the other hand, even if the respiratory rate is normal,
If your baby is lethargic or has suddenly decreased milk intake,
It needs to be observed carefully.
I'll show you how to actually observe it.
When the baby is sleeping peacefully
Try counting your chest movements for one minute.
At this time, it is important to measure accurately while watching the second hand of the clock.
In addition, in a comfortable environment with a room temperature of around 25 degrees,
It is most accurate when observed while wearing light clothing.
If you experience any of the following symptoms:
Contact a medical professional any time of the day or night.
Tachypnea of 70 breaths or more per minute for 30 minutes or more
Retracted breathing and labored breathing,
Apnea for more than 20 seconds
cyanosis (blue-purple discoloration),
Abnormal breath sounds.
These are the tiny bodies of babies
It's an important SOS sign.
[Q&A (first half)] Determining the urgency of fever
38°C for under 3 months, 39°C for under 6 months
Q: My 2-month-old baby has a fever of 37.8 degrees.
The temperature hasn't reached 38 degrees yet, but is it okay to keep an eye on it?
A: We are sorry, but if your baby is under 3 months old,
If you have a fever of 37.5 degrees or higher, we recommend that you contact a medical institution.
This is not just a numerical rule,
There is medical evidence that it can save your baby's life .
Why is the first three months of life so important?
In fact, babies at this age
There is a special circumstance called the "immunity gap period."
Antibodies received from the mother (maternal antibodies)
It starts to decrease gradually from around 3 to 6 months of age,
A baby's own immune system is still immature.
In other words, during the period when a normal cold does not cause a high fever
Having a fever means
The possibility of a serious infection should be suspected.
Q: What specific diseases are you worried about?
A: The most concerning thing about fever in babies under 3 months old is:
Bacterial meningitis, sepsis, and urinary tract infections.
These conditions progress quickly and may become severe if proper treatment is not given.
It can be life-threatening or leave permanent damage.
In particular, bacterial meningitis
Symptoms may worsen rapidly within a few hours of onset,
It is a disease where you don't have the luxury of time to "wait and see."
That's why a fever of 38 degrees or higher in babies under three months old
The "three-month rule"
It is considered an emergency regardless of the time of day or night.
Q: My 5-month-old baby has a fever of 39.2 degrees.
It's the middle of the night, but can you wait until morning?
A: A fever of 39 degrees or higher in a baby under 6 months old
We recommend that you visit the clinic on the same day (even at night).
At this stage, the immune system is not yet fully developed.
This is because there is a high risk of serious infection.
However, there is no urgency like less than three months,
First, contact the Pediatric Emergency Helpline (#8000),
We recommend that you seek the advice of a medical professional.
Q: What other symptoms besides fever make it more dangerous?
A: If you have the following symptoms in addition to a fever,
Regardless of age, the urgency is extremely high.
difficulty breathing or abnormal breathing patterns,
Weak and unresponsive,
convulsions and seizures,
Repeated vomiting and inability to drink fluids
A rash spreading all over the body
Lips and nails are blue-purple (cyanosis).
These symptoms may indicate that the infection is becoming more serious or
This may indicate the presence of other serious underlying diseases.
What is particularly important is
The key is to identify the differences between your baby and other babies .
Even with a fever, he is in a good mood,
If your baby is able to breastfeed normally and is crying and laughing appropriately,
If the body temperature is the same but the baby is lethargic and unresponsive,
The level of urgency is completely different.
Q: When can I use fever reducers?
A: Before using a fever reducer, be sure to check the following:
If the age and temperature do not meet the above emergency criteria,
Are there any other worrying symptoms?
Are you hydrated?
Is there any change in the level of consciousness?
Do you have any instructions from your doctor?
Antipyretics can help relieve symptoms, but
It does not cure the underlying disease.
Especially in the case of serious infections,
Antipyretics temporarily reduce fever
You risk missing important signs of illness .
Finally, we will explain how we handle your case at night and on holidays.
Pediatric emergency telephone consultation (#8000)
This is a reliable service that can be used 24 hours a day from anywhere in the country.
When you call,
Baby's age, temperature, time of fever onset,
Other symptoms, differences from usual,
When I consulted with them about my water intake,
You'll get better advice.
What's most important is,
Trust your "mother's intuition."
Numbers and standards are important, but
"Something seems different than usual" "Something seems strange"
This feeling is also important to medical professionals.
It is a valuable piece of information for making decisions.
Identifying illnesses from a baby's crying
High-pitched or weak crying: signs of illness
The crucial difference between normal crying
"This cry is different from usual..."
A mother's intuition is sometimes more accurate than any medical device.
A baby's cry is a sound that comes from a small body that cannot yet speak.
It is the most important means of communication,
It is also a valuable source of information about your health.
In fact, the baby's cry
Did you know that there are characteristics that can be analyzed scientifically ?
Pitch, intensity, rhythm, duration.
These elements combine to
It tells us about the baby's physical and emotional state.
First, let's understand the characteristics of normal crying .
A healthy baby's cry usually sounds like "Waah, Waah."
It has a relatively low pitch and is powerful.
When a baby is hungry, it cries intermittently in short rhythms.
When he's sleepy, he cries with a slightly nasal "Feen, feen" sound.
When the diaper is wet and uncomfortable, he makes a "Eeek, Eeek" noise.
It sounds like a pleading tone.
What these cries have in common is that
"Strength that is full of vitality."
The act of crying itself is a
It's an activity that requires intense energy, like full-body exercise.
If you are healthy, you will naturally have a powerful voice.
On the other hand, abnormal crying to be aware of includes:
It has clear characteristics.
A high-pitched cry is one of the most important warning signs.
The sharp metallic sounds of "high-pitched high-pitched" and "high-pitched high-pitched"
This may indicate increased intracranial pressure or a central nervous system abnormality.
Especially high-pitched crying combined with fever
as a sign of a serious infection such as meningitis
It is highly valued in the medical field.
Why does crying change with brain abnormalities?
in the part of the brain that controls crying (brain stem)
When inflammation or pressure occurs,
The movement of the vocal cords becomes abnormal,
It will end up sounding completely different from usual.
This is from the baby's small body
It's an urgent message saying "Help me!"
A weak cry is also a worrying symptom.
A weak cry like "Funyaan" or "Unyaan"
If your baby stops crying quickly as if he or she is tired,
Your overall condition may not be good.
Serious infections, dehydration, congenital heart disease, etc.
This is a symptom that occurs when you are physically exhausted.
Another important indicator is a change in crying patterns .
Crying for significantly longer than usual
No matter what I do, he won't stop crying
On the contrary, I cried less than usual.
The crying voice lost its intensity.
These changes may be a sign of some kind of health problem.
Particular attention should be paid to
"A state of being expressionless and not crying."
Babies are naturally creatures that cry when they are uncomfortable.
That's why they don't cry even though they're hungry.
No reaction to wet diaper
If your child doesn't respond to stimuli that would normally make them cry,
There is a possibility of a decreased level of consciousness or serious illness.
The important thing to note when observing crying is
"Compared to a normal baby."
Even if the child has a high-pitched voice, it is normal if it is a characteristic of the child that he or she was born with.
Even if your baby's crying is a little weak, there is no need to worry if it is normal.
What's important is ``change.''
A cry that was clearly different from usual,
A sound you've never heard before,
A sudden change in crying pattern.
When you notice these things,
Also check other symptoms (fever, feeding status, mood, etc.)
It is important to make a comprehensive judgment.
Finally, we will tell you about other things to observe besides crying.
The baby's facial expression, limb movements,
The level of tension in your body is also important information.
Even though they are crying, they are still moving their arms and legs energetically.
Is your face red and you're crying hard?
Will his expression return to normal when he stops crying?
Through these observations,
It gives you an overall picture of your baby's condition.
Vomiting and diarrhea | Early detection of dehydration
Determine by urination frequency and skin firmness
Dehydration risk and when to take action
"My baby hasn't been peeing as usual since he threw up..."
This is the anxiety many mothers feel after vomiting or diarrhea.
In fact, babies have smaller bodies than adults.
The flow of water is very rapid ,
They have a special constitution that makes them prone to dehydration.
Why are babies prone to dehydration?
By knowing the reason,
"I see, so how do you manage your baby's fluid intake?
It was so important!”
You will probably make some discoveries like this.
Approximately 75% of a baby's weight is water.
(Adults: about 60%)
In addition, per kilogram of body weight
They need about three times as much water as adults.
The metabolism is also very active.
This means that babies should always drink plenty of fluids.
It is circulating in the body.
Therefore, even if you lose a small amount of fluid due to vomiting or diarrhea,
It can quickly throw your whole body off balance.
So how can you detect dehydration early ?
The surest and easiest way is to
Observing the frequency and amount of urination .
A healthy baby will pee at least 6-8 times a day.
It is normal for the amount of milk produced to be so large that the diaper becomes heavy.
As dehydration progresses, the first thing you'll notice is a decrease in the frequency and amount of urination.
No urination for more than 6 hours
The diaper is lighter than usual
If your urine is dark yellow,
Please observe carefully as this may be an early sign of dehydration.
The next important thing is,
This is a check for "skin firmness (skin turgor)" .
This is a reliable diagnostic method that is also used in clinical settings.
When you gently pinch the skin on your baby's chest or stomach and release it,
If it returns to normal immediately, it is normal.
If it returns slowly over two seconds, it's a sign of dehydration.
This is due to a lack of water in the body
This occurs due to loss of skin elasticity.
Observing the inside of the mouth is also very helpful.
A healthy baby's mouth is always moist,
There is also plenty of saliva.
As dehydration progresses, your mouth becomes dry,
Your saliva may become sticky or thin.
Also, your normally moist lips may become dry and chapped.
It is an important indicator of dehydration.
The condition of your eyes can also indicate the extent of your dehydration.
The baby's eyes look sunken,
Your eyes are weaker than usual,
If you don't cry (if you cry, you don't cry much),
Moderate to severe dehydration is suspected.
In addition, overall vitality is also an important factor to consider.
Mild dehydration can keep your pet in a good mood,
If the condition becomes moderate or severe, the patient will become lethargic and unresponsive.
You become disinterested in things that would normally interest you.
The severity of dehydration can be classified into three levels :
Mild dehydration (loss of 3-5% of body weight)
Slightly less frequent urination, slightly dry mouth,
There is a slight decrease in skin turgor.
At this stage, the condition can be improved by rehydrating at home.
Moderate dehydration (loss of 6-9% of body weight)
Not being able to urinate for more than 6 hours, skin turgor is clearly reduced,
Sunken eyes and bad mood.
At this stage, intravenous treatment at a medical institution is often required.
Severe dehydration (loss of more than 10% of body weight)
Lethargy and slow response, significant loss of skin firmness,
Sunken eyes, dry lips and tongue.
This is a life-threatening emergency.
We will also tell you what to do if you notice symptoms of dehydration.
If your pet is only mildly dehydrated, give it small amounts of fluids frequently.
Breast milk or formula is best,
If vomiting continues, give oral rehydration solution (OS-1, Aqualite, etc.)
Feed one spoonful at a time, 5 to 10 minutes apart.
If you give a large amount at once, it may cause vomiting again.
The golden rule is "small amounts, frequent."
However, if you experience the following symptoms:
Do not hesitate to visit a medical institution.
No urination for more than 12 hours
Weak and unresponsive,
There is a noticeable decrease in skin turgor,
dry lips and tongue,
Vomiting continues despite giving fluids.
The most important thing is,
Know your baby's normal state .
How often you urinate, how your skin feels,
Your usual mood and energy level.
By observing these things on a daily basis,
You can quickly notice any changes that are "different from usual,"
This can help prevent severe dehydration.
[Q&A Intermediate] Determining the risk of skin abnormalities
Risk classification for rash, jaundice, and cyanosis
How to distinguish it from infant eczema
Q: My one-month-old baby has red bumps on his face.
Is this normal baby eczema or a sign of illness?
A: Skin changes that appear from the neonatal period to infancy include:
This is one of the most worrying symptoms for mothers.
In fact, baby's skin
It acts like a mirror that reflects what is happening inside the body .
Correct readings can provide important health information.
First, let's understand the characteristics of normal infant eczema .
The red dots that appear around 1-2 weeks after birth are
This is a normal phenomenon that is often referred to as "neonatal acne."
This is due to the influence of the mother's hormones.
This occurs due to a temporary increase in sebum secretion in babies.
It often appears on the cheeks, forehead, and chin,
The baby is in good spirits and does not have a fever.
Q: What kind of rashes require immediate medical attention?
A: A rash with the following characteristics may be an emergency.
A rash that spreads rapidly throughout the body is of greatest concern.
If it was only on your face in the morning but has spread to your whole body by the evening,
There is a possibility of an allergic reaction or infection.
A rash accompanied by a fever is also a symptom requiring urgent treatment.
For important diseases such as Kawasaki disease, measles, and rubella,
It presents with a characteristic rash and fever.
A rash that resembles bleeding spots (petechiae) is a particularly dangerous sign.
This is a red, dot-like rash that is 1-2 mm in diameter.
The color does not fade even when pressed with your finger.
There is a possibility of serious diseases such as thrombocytopenia and vasculitis.
Q: How long should I monitor my newborn for jaundice?
A: There are two types of neonatal jaundice : "physiological jaundice" and "pathological jaundice."
It is very important to distinguish between them.
Physiological jaundice appears on the second or third day after birth,
It starts on the face and gradually spreads to the rest of the body.
This will improve naturally within 1 to 2 weeks of birth.
On the other hand, the following may be signs of pathological jaundice:
Jaundice appears within 24 hours of birth
Severe jaundice even after 2 weeks of age
Jaundice accompanied by poor feeding and lack of vitality
Stool is whitish in color (possible biliary atresia).
In particular, a change in the color of your stool is an important sign that you should not overlook.
Normal baby stool is yellow to green,
White or grayish stools may indicate a problem with bile flow.
Early treatment is necessary.
Q: My baby's lips and nails look bluish.
Is this cyanosis?
A: When determining whether cyanosis is central or peripheral, it is important to distinguish between the two.
Peripheral cyanosis, in which only the tips of the hands and feet turn blue,
This is a common phenomenon in newborns whose body temperature regulation is immature.
It will improve if you warm it up.
On the other hand, the lips, tongue, and nail beds (the pink part at the base of the nails)
Central cyanosis, which causes a bluish-purple color, is an emergency.
This is a condition in which the oxygen level in the blood is low,
Causes include heart disease, lung disease, and serious infections.
The key to distinguishing is if the condition does not improve even after heating,
It extends to the central part of the body (face, chest),
If breathing or feeding difficulties are present,
Seek medical attention immediately.
Q: What other things should I look for besides skin symptoms?
A: When assessing skin symptoms,
It is important to assess the overall condition of the body .
Even if there is a rash, the baby is in a good mood.
If the baby is nursing well and has no fever,
In most cases, there is no need to worry.
On the other hand, even mild skin symptoms
Lethargy, decreased milk intake,
If you have symptoms such as fever or difficulty breathing,
More careful observation and medical consultation are needed.
It is also important to keep a record of your symptoms over time .
When did it start and how did it spread?
What other symptoms did you have?
If you record what triggered it,
It is very helpful for doctors to make a diagnosis.
Taking photos with your smartphone
It's a good way to objectively record changes in symptoms.
Finally, the most important thing about skin symptoms is
Pay attention to the speed of change .
Symptoms that change slowly over days to weeks
Symptoms that suddenly worsen over a few hours are an entirely different level of urgency.
Symptoms of sudden changes include:
We recommend that you do not hesitate to consult a medical institution.
Checking the severity of breastfeeding and feeding disorders
Emergency consultation line if you have not taken the medicine for more than 24 hours
Warning signs of poor breastfeeding and weight loss
"Since yesterday, my baby has suddenly started drinking less breast milk..."
"Even though this is the time when he would normally want to drink, he doesn't want to drink at all."
Changes in your baby's feeding habits
This is the first sign of illness that many mothers notice.
In fact, breastfeeding behavior is a baby's
It is an important indicator that can be called a "barometer of vitality."
It is the most sensitive indicator of overall health.
Because the act of breastfeeding is
This is because it is a complex activity that requires advanced skills.
Breastfeeding involves sucking reflexes, swallowing reflexes, and coordination with breathing.
Nervous system, digestive system, respiratory system
Everything should be working properly.
In other words, changes in breastfeeding indicate a problem somewhere in the body.
It's often the first sign.
First, let's understand normal feeding patterns .
Newborn babies are fed 8 to 12 times a day,
Drink thoroughly over 10 to 30 minutes at a time.
Breast milk is easy to digest, so feed it every 2-3 hours.
For milk, it is common to feed every 3 to 4 hours.
A healthy baby will cry when he is hungry,
When I brought the nipple close to my mouth, I started to suck it aggressively.
Once satisfied, he will naturally remove his mouth from the nipple.
So, what are some feeding problems to watch out for ?
Refusal to feed for more than 24 hours is the most urgent situation.
For newborn babies, not getting nutrition for more than 24 hours can be devastating.
It can cause hypoglycemia and dehydration
It becomes a life-threatening condition.
Especially in newborns within the first week of life,
Even if you don't breastfeed for 12 hours or more
Consultation with a medical institution is required.
A sudden decrease in breastfeeding is also an important warning sign.
I was drinking vigorously until yesterday,
My sucking power is weak today, I get tired and stop midway,
He seemed satisfied after just a few drinks.
These symptoms may be due to infection, heart disease,
It may appear as an early symptom of metabolic disorders.
You should also be aware of any abnormal symptoms during feeding .
I get short of breath while drinking,
Pale complexion during feeding,
Vomiting a lot immediately after drinking
My baby becomes exhausted while breastfeeding.
These include congenital heart disease, gastrointestinal abnormalities,
It may indicate a neurological problem.
We will explain how to determine the urgency of breastfeeding abnormalities.
Immediate medical attention is required (urgency: high)
No drinking for more than 24 hours
Difficulty breathing or pale complexion during feeding
Repeated fountain-like vomiting after drinking
He becomes listless and unresponsive after feeding.
It is recommended to visit the doctor on the same day (urgency: medium)
Significant decrease in milk intake for more than 12 hours
Continued drinking less than half of what you normally drink
I get tired easily while breastfeeding,
There is significant weight loss.
Can be seen within a few days (urgency: low)
The amount of milk she is drinking has decreased slightly, but she is in a good mood.
Temporary refusal to breastfeed but still taking in fluids
The pace of weight gain has slowed somewhat.
Weight change is also an important indicator for assessing feeding status.
Physiological weight loss in the neonatal period is normal up to 7-10% of birth weight.
More weight loss than that,
If your baby does not start gaining weight after one week of age,
This could be due to poor feeding or some other illness.
Even if it's difficult to measure your weight every day,
The weight when you hold it,
Frequency of diaper changes,
From the fleshiness of the limbs
You can roughly feel the weight change.
We will tell you what to do if you notice any abnormalities in your baby's feeding.
First, check the feeding environment.
Is the room temperature appropriate? Is the environment quiet?
Is the baby in a relaxed state?
Check to see if external factors are causing the baby to refuse to breastfeed.
In the case of breastfeeding, the mother's physical condition and
Medications you are taking, dietary details, etc.
It may affect breastfeeding.
In the case of milk, the temperature, consistency,
Also check the size of the nipple hole.
If the milk intake is reduced for a short period of time,
Try giving small, frequent feedings.
Don't try to give too much at once,
At your baby's pace
It is important to continue breastfeeding patiently.
However, do not hesitate to visit a medical institution in the following situations:
refusal to feed accompanied by fever or other symptoms,
If there is significant weight loss,
If your urination frequency has decreased significantly,
Your baby's energy and responsiveness is noticeably reduced.
Finally, I would like to share some important points.
Breastfeeding is a bond between mother and baby
It is also an important time for communication.
It's not just about getting nutrients,
It's a precious time to feel love and security.
If you notice any changes in your baby's feeding,
Comprehensive observation of the baby's overall condition
It is important not to miss any "unusual" changes .
This is the first step towards early detection and appropriate treatment.
Level of consciousness | How to assess lethargy
Reading from responses to stimuli and eye movements
Warning signs of decreased level of consciousness
"Usually when I call out to him he turns around, but today he's been slow to respond..."
"Even when I hold him, he seems a bit exhausted."
Changes in the baby's level of consciousness
Although it is hard to see,
It is one of the most important early symptoms of serious illness.
It is relatively easy to determine whether an adult is conscious or not,
For babies who cannot yet speak,
How do you assess the level of consciousness?
In fact, babies need to eat according to their age.
There is a "normal response pattern"
Knowing this will change your level of consciousness
It can be detected early.
Understand normal reactions during the newborn period.
Healthy newborns exhibit the Moro reflex in response to loud noises.
They show a sucking reflex when something touches their mouth,
In response to painful stimuli, they cry and move their arms and legs.
When they are 1 to 2 months old,
I began to look at people's faces,
When you talk to it, it will start to follow you with its eyes.
At 3 to 4 months of age,
When you call out to them, they turn around and smile.
You can see reactions such as reaching out for things that interest them.
These seemingly "natural" reactions
In fact, it is evidence that the higher functions of the brain are working normally.
It is an important indicator of the level of consciousness.
So, what are the signs of a decreased level of consciousness to look out for?
I will explain in detail.
The most important indicator is a slowed response to stimuli .
Even if I call your name, you won't turn around
Even when I hold him, his body is relaxed.
Does not cry in response to painful stimuli (such as blood sampling)
He doesn't react to treatments that he would normally dislike.
These are important signs of a weakened central nervous system.
Eye movements and changes in facial expression are also important points to observe.
Usually, he looks around restlessly,
Today, I'm staring at one point and not moving.
My eyes can't focus,
The blinking rate is significantly reduced.
In addition, a lack of facial expression is also a characteristic symptom of a decreased level of consciousness.
Although he usually shows a rich expression,
If the person continues to be expressionless and unresponsive, you should be careful.
Changes in muscle tone are also an important indicator.
When a healthy baby is held,
There is moderate muscle tension,
The head and limbs do not dangle.
When the level of consciousness decreases,
Loss of muscle tone throughout the body
It's like a "squishy doll"
It may be a sensation.
The level of consciousness was assessed
"Comparing with usual" is the most important thing.
Even in the same "slow response" state,
Babies who are naturally quiet,
The meaning is completely different for babies who are usually active.
What's important is,
Changes from "the child's usual state"
It's about determining.
We will explain how to determine the urgency of a decreased level of consciousness.
Highest level of urgency (immediate emergency response)
He doesn't respond when I call his name,
No response to painful stimuli
The whole body is weak and there is no muscle tone.
Breathing is shallow and irregular.
High urgency (see a medical institution immediately)
Significantly slower than usual reaction time
Even when I hold my baby, I can't use my body strength.
My eyes can't focus,
Expressionless and unresponsive.
Medium urgency (visit within a few hours)
I feel less energetic than usual,
There is a reaction but it is slow
Not in a bad mood but not energetic
It is combined with other symptoms.
It is also important to understand the main causes of decreased level of consciousness.
Infections (meningitis, sepsis, etc.) are among the most common causes.
Decreased level of consciousness combined with fever
It needs to be observed especially carefully.
metabolic disorders such as hypoglycemia and electrolyte abnormalities,
Traumatic diseases such as head trauma and cerebral hemorrhage,
Cerebral blood flow insufficiency due to congenital heart disease
This can cause a decrease in level of consciousness.
We will explain in detail how to observe at home.
First, try calling out as you normally would.
Calling their name, singing songs, clapping hands, etc.
Check your reaction to stimuli that you would normally react to.
Next, try touching your body lightly.
Gently pinching the limbs, tapping the cheek, etc.
Observe the reaction to mild stimulation.
The feel of the baby when you hold it is also important information.
Is there any difference in the tension in your body compared to usual?
Make sure your head doesn't hang down.
Also pay close attention to eye movements and facial expressions.
Whether your eyes meet or follow something,
Check for any changes in facial expression.
We will tell you what to do if you suspect a decrease in consciousness level.
First, lay them down in a safe place,
Keep the airway open and check breathing.
Avoid strong stimulation and speak gently
Keep checking for reactions.
Check your temperature and see if you have any other symptoms.
Please observe at the same time.
And contact a medical institution immediately
It is important to communicate exactly what you observed.
The most important thing is,
Maintaining your baby's "normal" state on a daily basis
It's important to observe carefully .
Usual reaction patterns, richness of facial expressions,
By knowing the tension of your muscles,
Even the slightest change will not be overlooked.
The mother's feeling that "something is different from usual"
Medical professionals also place great importance on
This is valuable clinical information.
[Q&A Part 2] Dealing with convulsions and seizures
How to distinguish between febrile convulsions and dangerous convulsions
Emergency measures if the condition continues for more than 5 minutes
Q: My 8-month-old baby suddenly had a seizure while he had a fever.
His limbs were shaking violently and his eyes were looking up.
Is this a febrile seizure? What should I do?
A: The mother's surprise and anxiety when she witnessed the seizures
I think it's immeasurable.
First, take a deep breath and calm down.
With proper treatment, most seizures can be prevented
It improves the condition without leaving any major after-effects.
The situation you are describing is likely to be a febrile seizure .
Febrile convulsions occur in children between the ages of 6 months and 6 years.
This is a relatively common phenomenon that occurs with sudden fever.
In Japan, about 7-8% of children
It is said that everyone experiences this at least once in their lifetime.
Q: How do you distinguish between a febrile seizure and a dangerous seizure?
A: It is difficult to distinguish between different types of seizures.
This is very important for taking appropriate action.
We will explain the characteristics of typical febrile seizures .
It lasts for less than 5 minutes and stops naturally.
Symmetrical spasms throughout the body
After the seizure, the patient loses consciousness but gradually recovers.
accompanied by a fever of 38 degrees or higher
No recurrence within 24 hours.
On the other hand, dangerous seizures have the following characteristics:
lasts for more than 15 minutes or occurs repeatedly within 5 minutes,
Seizures that occur on only one side of the body (focal seizures)
Poor recovery of consciousness after a seizure
Convulsions without fever,
First onset before age 6 months or after age 6 years.
If these characteristics are observed,
Meningitis, encephalitis, epilepsy, etc.
There is a possibility of more serious illness.
Q: What are the specific steps to take if a seizure occurs?
A: The appropriate steps to take during a seizure are as follows:
First and foremost, make safety your number one priority.
Lay it on a flat, safe surface
Remove any hazards in the surrounding area.
Turn your face sideways,
Prevent aspiration if vomiting occurs.
Then start recording the time .
Note the time the seizure started,
Measure the duration accurately.
If it lasts for more than 5 minutes,
Call an ambulance immediately.
It's also important to know what you should never do .
Do not put fingers or objects in your mouth
Do not press down on the body too hard
Do not call the child's name loudly or shake them violently.
Don't try to force them to take medicine.
These actions may actually increase the risk.
Q: What is the first course of action if the seizure lasts for more than 5 minutes?
A: Convulsions that last for more than 5 minutes
This is called "status epilepticus"
It can cause serious brain damage.
Immediately call 119,
Continue taking the following measures until emergency services arrive:
Maintain an open airway and keep the patient facing to the side
Monitor breathing carefully
Take your temperature and try to reduce it if possible
The convulsion should be observed and recorded in detail.
When the ambulance arrives,
Time of onset and duration of seizures
The state of convulsions, the progression of fever,
Past history of seizures
It's important to communicate accurately.
Q: Are there any points to observe after a seizure?
A: Observation after the seizure:
This is extremely important in determining subsequent treatment strategies.
Check if the person has regained consciousness.
In a typical febrile seizure,
Consciousness returns to normal in about 10 to 30 minutes.
If you are unconscious for more than an hour,
There is a possibility of more serious illness.
It is also important to check motor function.
limb movements, facial expressions,
Are there any differences between the left and right eyes in eye movements?
Observe whether there is any change from usual.
You also need to be aware of the possibility of recurrence.
Febrile convulsions occur within 24 hours
Recurrence is rare, but
Careful observation is required as long as the fever persists.
Q: Is it possible to prevent recurrence of febrile seizures?
A: It is difficult to completely prevent febrile convulsions, but
There are ways to mitigate the risk.
Early treatment of fever is important.
If you experience a fever of over 38 degrees,
Take appropriate fever-reducing measures.
However, regarding the use of antipyretics
It is important to consult with your doctor before doing so.
Stay hydrated and drink plenty of water.
It is also important to prevent dehydration.
In addition, by preventing infectious diseases
It also reduces the chance of fever
It has an indirect preventative effect.
If you have experienced a febrile seizure once,
Consult your doctor
Prophylactic anticonvulsant use
It may be something to consider.
Finally, I would like to tell you something important.
The majority of febrile seizures
It has a benign course and leaves no sequelae .
With proper treatment and observation,
You can watch over your child's healthy growth.
However, if you have any concerns
Do not hesitate to consult a medical institution
We recommend that you get a professional evaluation.
Mom's calm judgment and appropriate response
It is the most important factor in keeping your child safe.
Characteristics of illnesses by age and precautions
Risk of illness at 0-3 months, 4-6 months, and 7-12 months
Attention symptoms by developmental stage
"I wasn't worried when he was 2 months old, but when he turned 6 months old, he suddenly started getting fevers..."
As your baby grows, he or she may become susceptible to diseases and
Did you know that the symptoms you need to watch out for change?
In fact, your baby's immune system and bodily functions
It changes dramatically with age ,
Each period has its own unique risks and precautions.
By understanding this change,
"I see, this symptom is more likely to occur at this time of year.
There was a reason for this!"
There must be new discoveries.
We will start by explaining the characteristics of the 0-3 month period (neonatal period to early infancy) .
At this stage, babies are able to absorb the immunity (transfer antibodies) they received from their mothers.
Because they are protected, they are less likely to catch common colds and viral infections.
However, this is why it is so important if you develop a fever or other symptoms of infection .
The most important thing to watch out for during this time is bacterial infections.
Caused by E. coli, group B hemolytic streptococcus, listeria, etc.
Meningitis, sepsis, and urinary tract infections are life-threatening diseases.
Symptoms are nonspecific, including fever, poor feeding, and lack of vitality.
It manifests as difficulty breathing.
Therefore, a fever of 38 degrees or higher in babies under three months of age
Emergency medical attention is needed at any time of the day or night.
This is also the time when symptoms of congenital disorders become apparent.
Difficulty in breastfeeding and cyanosis due to congenital heart disease,
Vomiting and abdominal distension due to gastrointestinal malformations,
Metabolic disorders such as impaired consciousness and developmental delay
It is often discovered during this time.
The period between 4 and 6 months (mid-infancy) is a time of great change.
The maternal antibodies gradually decrease,
Because the baby's immune system is still developing,
This is the period known as the "immunity gap" when people are most susceptible to infection.
At this time of year, cold symptoms suddenly become more common.
Frequent upper respiratory tract infections such as runny nose, cough, and fever
Respiratory syncytial virus, human metapneumovirus,
Caused by parainfluenza viruses, etc.
It also increases the risk of bronchitis and pneumonia.
You should also be aware of digestive symptoms that may occur when starting solid food.
Eczema, vomiting, diarrhea due to food allergies,
Also, gastroenteritis caused by new foods
Symptoms specific to this period appear.
Hand, foot and mouth disease, herpangina, exanthema subitum, etc.
Due to increased opportunities for group living and going out
Viral infections are also on the rise.
The period from 7 to 12 months (late infancy) is a period in which a baby's range of movement expands.
He was able to crawl and walk,
This will increase their exploratory behavior, making them want to put everything in their mouths.
The risk of accidents and poisoning increases dramatically.
This is also the time when accidental ingestion is most common.
Accidental ingestion of small toys, buttons, coins, medicine, etc.
It may cause choking or poisoning.
There is also an increase in head injuries due to falls.
In the case of infectious diseases, due to increased attendance at daycare centers and opportunities to go out,
Hand, foot and mouth disease, herpangina, rotavirus gastroenteritis,
There will be an increase in outbreaks of norovirus gastroenteritis and other illnesses.
During this period, febrile seizures become more likely to occur.
It often occurs with sudden fever after 6 months of age,
Families experiencing this for the first time will be very surprised.
We will tell you the key points to identify symptoms at each age.
During the 0-3 month period, it's important to pay attention to subtle changes.
Fewer milk intake than usual, weaker crying
Your body temperature is different from usual, your skin tone is bad, etc.
It is important not to overlook even the slightest changes.
At 4-6 months of age, it is important to understand the typical symptoms of infection.
The color and characteristics of the runny nose, the sound and frequency of the cough,
Fever patterns and accompanying symptoms
Close observation will help determine the severity.
Between 7 and 12 months, it's important to look out for changes in behavior.
Movement is slow compared to normal activity,
Changes such as lack of interest or appetite
It's a significant sign of poor health.
We will also explain the recommended time for consultation based on age.
At 0-3 months, fever, poor feeding, lack of vitality,
If you experience breathing problems or changes in skin color,
Even if it seems minor, you should seek medical attention early.
At 4-6 months of age, the severity of the fever and the baby's overall condition are assessed comprehensively.
If you have a persistent fever of 38.5 degrees or higher,
If your baby has poor feeding, difficulty breathing, or a decreased level of consciousness, you should see a doctor.
For 7-12 months, consider the combination and duration of symptoms.
If it is a single mild symptom, you can wait and see,
If you experience multiple symptoms at the same time or if they last for more than three days, consider seeing a doctor.
Finally, here are some important points that are common to all ages.
At any age, check your baby's usual behavior.
The most important thing is to be observant.
Knowing their usual mood, activity level, appetite, and sleep patterns
This allows you to detect age-specific risks early on.
Also, build a good relationship with your family doctor,
Precautions and measures according to age
It is also important to consult in advance.
Understand the health risks that change as your baby grows,
By making appropriate observations and taking appropriate measures,
You will be able to enjoy raising your child with peace of mind.
How to decide whether to seek emergency medical care at night or on holidays
Use of #8000 and the correct criteria for emergency outpatient care
"My baby suddenly developed a fever in the middle of the night...can I wait until morning?"
"My child seems unwell on a holiday, should I go to the emergency room?"
If your baby is unwell at night or on holidays,
This is a very stressful and difficult situation for many families.
In fact, for nighttime and holiday visits
"Emergency clinic now," "#8000 consultation and decision," "Family doctor the next morning"
There are three clear criteria for making a decision:
Understanding this will help you to
You can seek medical attention at an appropriate medical institution.
First, I will explain the criteria for determining whether to refer a patient to the emergency room immediately .
If you experience any of the following symptoms:
Regardless of the time of day or day, go to the emergency department immediately.
If your baby is under 3 months old and has a fever of 38 degrees or higher,
If the seizure lasts for more than 5 minutes,
If breathing difficulty or retractions are observed,
If the level of consciousness is clearly decreased,
If cyanosis (lips or nails are blue-purple) is observed,
If you have not been able to drink any fluids for more than 24 hours.
These symptoms can be a life-threatening emergency.
Professional medical attention is required immediately.
Next, we will explain in detail how to use the Pediatric Emergency Telephone Consultation Service (#8000) .
#8000 is available to pediatricians and nurses at night and on holidays.
This is a nationwide abbreviated number for telephone consultations.
Consultation hours vary by prefecture,
In most areas, from 7 PM to 8 AM the next morning.
On weekends, it is available from 9am to 5pm.
To effectively use telephone consultations,
It's important to organize your information in advance.
Baby's age and weight, current symptoms and start time,
Changes in body temperature, feeding and eating conditions,
Frequency of urination and defecation, differences from usual,
Past allergies, medical history, and names of medications currently being taken, if any.
Once you have this information ready, call
You can get more accurate advice.
The counselor will assess the severity of the symptoms.
"Visit the emergency room now" "Visit your family doctor the next morning"
They will advise you on one of the following: "At-home observation."
You should also understand the symptoms that can be treated by your "next morning doctor."
If you have the following symptoms,
With appropriate treatment at home, you can wait until morning to see how it goes.
If your baby is over 3 months old and has a mild to moderate fever and is in good general condition,
If your baby has a mild runny nose or cough that doesn't interfere with feeding or sleep,
Mild diarrhea and vomiting without dehydration
If you have a mild rash and no changes in your general condition,
If your child is in a bad mood but is still hydrated.
However, these symptoms can also worsen rapidly,
Continued observation is required.
We will explain how to deal with this at home at night and on holidays.
When dealing with a fever, keep the room temperature at an appropriate level (20-22 degrees),
Dress lightly to avoid overheating.
Hydrate frequently in small amounts,
Follow your doctor's instructions when using fever reducers.
When dealing with vomiting and diarrhea, the most important thing is to prevent dehydration.
Oral rehydration solution, one small spoonful each
Feed every 5-10 minutes.
Giving a large amount at once may cause vomiting again,
It is important to follow the principle of "small amounts, frequent doses."
To deal with respiratory symptoms, use a humidifier to keep the indoor humidity at 50-60%.
Rest your upper body in a slightly upright position.
If your nose is stuffy,
Use a nasal aspirator to remove mucus from the nose.
We will also tell you what to be careful of when visiting the emergency room .
Please call before your appointment to let us know your symptoms.
Please confirm the necessity of your visit and the appropriate time to visit.
In many emergency departments, patients with mild symptoms are put on hold before those with severe symptoms.
You may need to wait a long time.
Items you should bring include your insurance card, medical card,
Your medicine notebook, the medicines you normally take,
Necessities such as clothes and diapers
Prepare bottles and milk (if needed).
At the time of consultation, organize the progress of symptoms in chronological order,
It is important to be prepared to explain in detail any changes from normal.
Here are some basic principles to follow when you're unsure of what to do .
The most important thing is to "ask for advice when in doubt."
Consultations to #8000 are free of charge.
You will be treated by medical professionals with specialized knowledge.
There is no need to be hesitant and think, "I wonder if it's okay to ask about something like this."
Also, respect your "mother's intuition."
The feeling that "something is different than usual" or "something is strange"
This is important information that medical professionals also value.
Finally, we will explain our preparations for night and holiday operations.
Check the location and contact details of local emergency medical facilities in advance.
It is important that all family members are aware of the existence of #8000 and how to use it.
In addition, we build good relationships with our family doctors,
By discussing emergency procedures in advance,
You will be able to remain calm and make appropriate decisions when the time comes.
With proper preparation and knowledge, you can feel safe even at night or on holidays.
You can protect your baby's health.
Learn about danger signs through real-life examples
Symptoms that are easy to overlook and successful examples of early detection
"I can't believe it was my child... but I'm glad I noticed it then."
Learning from real experiences,
Important points that are difficult to notice through theory alone
You can discover.
Here, I have 30 years of experience as a pediatrician.
Based on memorable cases and the experiences of many families,
Danger signs that are easy to miss
We will share with you the observation tips that led to early detection .
[Case 1] 2-month-old boy: "The importance of low-grade fever and poor feeding"
"He was just a little feverish, and not drinking as much milk as usual.
But somehow it feels different from usual..."
The baby was seen with a slight fever of 37.8°C and mild poor feeding.
At first glance, the injury appeared mild, but considering the baby was less than three months old,
After further testing, it was discovered that he had a urinary tract infection.
The key points to learn from this case are:
In babies under three months old, caution is required even if the fever is less than 38 degrees.
The importance of a mother's intuition that "something seems different than usual."
With proper treatment, he recovered without any sequelae.
[Case 2] 6-month-old girl: "Early symptoms of meningitis that are easily overlooked"
"At first I thought it was just a common cold.
But her crying was different from usual, and high-pitched...
Plus, holding him doesn't make him feel any better."
The baby's symptoms included a fever of 38.5 degrees, a runny nose, and a slight cough.
However, there was a high-pitched cry that was clearly different from usual,
No matter how much I held him or tried to soothe him, his mood didn't improve at all.
Further testing revealed that he had the early stages of bacterial meningitis.
Early detection led to a complete recovery with appropriate antibiotic treatment.
The key points in this case are the change in the quality of the crying and
This is important when normally effective reassurance methods don't work.
[Case 3] 9-month-old boy: "Distinguishing between febrile seizures and dangerous seizures"
"I panicked when I had my first seizure,
I was glad I checked the time by looking at the clock.
It stopped after three minutes and then everything went back to normal."
The convulsions were accompanied by a fever of 39.2 degrees.
The family calmly measured the time and observed the convulsions.
The patient had a generalized convulsion for three minutes, after which he regained consciousness.
A typical febrile seizure was diagnosed.
The key points of this case are that it is important to record the time even during a seizure.
It is important to observe how the patient regains consciousness after a seizure.
[Case 4] 4-month-old girl: "Early detection of dehydration"
"I had constant diarrhea, but I kept a note of how many times I had to pee.
When I realized I hadn't had a bowel movement for over six hours, I went to the doctor straight away."
I had diarrhea from gastroenteritis for two days.
Your family members are recording your urination frequency.
He was diagnosed with early signs of dehydration.
Although he was suffering from mild dehydration, he was able to recover with early intravenous treatment.
This prevented the progression to severe dehydration.
The key points of this case are the effectiveness of recording the number of urinations and
The importance of making decisions based on objective indicators.
[Caution: Cases where people regretted taking a wait-and-see approach]
On the other hand, there are also cases where people think, "If only I had gone to see a doctor a little earlier..."
"I thought it was just a cold, so I waited for three days to see how it went,
In fact, I had pneumonia.
I was wondering why you were breathing a little fast..."
In this case, the patient had a mild cough and slight fever,
An important sign was overlooked: increased respiratory rate.
"He was crying a lot at night and I thought he was just tired.
But he had an ear infection and was in pain."
Crying at night that is more intense than usual is not just a change in the child's growth process.
It could be a sign of pain or discomfort.
Here are some tips for early detection .
What all successful cases have in common is that they are "well aware of the normal situation."
Usual crying, mood swings, activity levels,
By observing their appetite, sleep patterns, etc. on a daily basis,
Even the slightest change will not be overlooked.
It is also important to keep objective records .
By recording body temperature, feeding amount, urination frequency, and changes in symptoms,
This will allow you to provide more accurate information when consulting your doctor.
It is also important to be aware of "combinations of multiple symptoms."
Even if symptoms appear mild on their own,
When multiple things overlap, they can have important meanings.
Finally, what can be gained from these experiences?
Here's the most important lesson .
"Trust your mother's intuition."
Many successful cases, even without medical knowledge
The feeling that something is somehow different
This leads to early detection.
It is also important to "consult when in doubt."
Even if you feel like you might be wondering, "I wonder if it's okay to consult about this?"
Hearing the opinions of experts will help you make the right decision.
By "keeping records," you can objectively grasp changes in symptoms,
This will provide more useful information when consulting or visiting a doctor.
Based on these experiences and lessons learned,
Observe your baby closely on a daily basis
Being sensitive to changes
I hope you will develop your powers of observation.
Protecting your baby's health
Not advanced medical knowledge
It is a daily, careful observation based on love.
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