Women's Health and Education Center (WHEC)

Newborn Care

List of Articles

  • Sudden Infant Death Syndrome
    Significant new information has been forthcoming in recent decades on sudden infant death and apnea during early infancy. Sudden Infant Death Syndrome (SIDS) also known as Sudden Unexpected Infant Death (SUID) and Sudden Unexpected Death in Infancy (SUDI), are the terms used to describe unexpected death of an infant less than 12 months of age. The cause of death that cannot be explained after thorough investigation, death scene examination, and review of clinical history. Back-to-Sleep position for every sleep time campaign, has helped educate millions of caregivers, parents, grandparents, aunts, uncles, babysitters, childcare providers, health care providers, and others, about ways to reduce the risk to reduce SIDS and other sleep-related causes of infant death. Tummy Time describes the times when you place your baby on his or her stomach while your baby is awake and while someone is watching. Tummy Time is important. Newborn safety should be routinely taught in obstetrics curricula, and the Women's Health and Education Center (WHEC) has partnered with the United Nations (UN) and the World Health Organization (WHO), to disseminate updated literature and guidelines to health care providers regarding newborn safety.

  • Neonatal Jaundice: Part I
    Jaundice (hyperbilirubinemia) occurs in most newborns. Jaundice is benign in most newborns, but because of potential toxicity of bilirubin, newborns must be monitored to identify those who might develop severe hyperbilirubinemia, and in rare cases, acute bilirubin encephalopathy or kernicterus. Based on a consensus of expert opinion and review of available evidence, universal pre-discharge bilirubin screening is recommended. This can be accomplished by measuring the total serum bilirubin level (ideally at the time of routine metabolic screening) or transcutaneous bilirubin level and plotting the result on an hour-specific nomogram to determine the risk of subsequent hyperbilirubinemia that will require treatment. If an infant is discharged before 24 hours postnatal age, the bilirubin should be rechecked within 48 hours. These guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. Kernicterus in detail is discussed in Neonatal Jaundice: Part II. In every infant, the Women’s Health and Education Center (WHEC) recommends that clinicians: 1) Promote and support successful breastfeeding; 2) Perform a systematic assessment before discharge for the risk of severe bilirubinemia; 3) Provide early and focused follow-up based on the risk assessment; and when indicated 4)Treat newborns with phototherapy or exchange transfusion to prevent the development of severe hyperbilirubinemia, and possibly bilirubin encephalopathy (kernicterus).

  • Neonatal Jaundice: Part II
    The term kernicterus literally means "yellow kern," with kern indicating the most commonly afflicted region of the brain (i.e. the nuclear region). Historically, the term refers to an anatomic diagnosis made at autopsy based on a characteristic pattern of staining found in babies who had marked hyperbilirubinemia before they died. This document discusses overview, clinical management and management of kernicterus. Despite the lack of a clear-cut cause-and-effect relationship between kernicterus and the degree of hyperbilirubinemia. Laboratory investigations have demonstrated that bilirubin is neurotoxic at a cellular level. Prevention of hyperbilirubinemia is the best way to minimize the incidence of kernicterus. However, because some babies develop kernicterus with relatively modest bilirubin levels, no known absolute level of bilirubin below which the infant is completely safe is recognized. Additionally, because other factors contribute to the ability of bilirubin to cross the blood-brain barrier, management of these components must be appropriately considered. Any infant at risk for significant hyperbilirubinemia and possible neurotoxicity should be cared for in a nursery capable of rendering appropriate care for the hyperbilirubinemia and any contributing diagnoses. Developmental potential can be maximized by early identification of and intervention for neurologic deficits.

  • Newborn Male Circumcision
    Newborn male circumcision is a surgical procedure to remove the foreskin, the skin that covers the tip of the penis. In the United States, a large percentage of male newborns are circumcised. Although circumcision has known medical benefits, the procedure generally is performed for family, religious, or cultural reasons. Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision. However, these data are not sufficient to recommend routine neonatal circumcision. Circumcision is a safe and straightforward procedure but has its risks and potential complications. In the United States, it is often done before a new baby leaves the hospital. Possible benefits include a lower risk of urinary tract infections, penile cancer, and sexually transmitted diseases. There is a low risk of bleeding or infection. The baby might also feel some pain. The Women's Health and Education Center (WHEC) recommends that parents should discuss circumcision with their baby's healthcare provider. The World Health Organization's (WHO's) program for male circumcision and HIV prevention is also discussed. Parents should make their decision based on the benefits and risks, as well as their own religious, cultural, and personal preferences. As with most surgeries, the best outcomes are achieved by practitioners who are well trained, who perform the procedure under supervision until their experience is sufficient, and who follow correct protocol during the entire operation.

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