POSTNATAL CARE OF HEALTHY NEWBORN

Healthy newborn baby is a boon to the society and the country. Effective care of a child after birth can reduce the mortality and morbidity both. So proper care of the newborn baby is a prime duty of pediatrician as well as parents.

Healthy newborn means :

• Birth weight > 2500 gm
• Gestational age > 37 weeks
• No any complication at birth and no need of resuscitation
• No any postnatal illness such as respiratory distress, septicenia, shock etc.

Immediate care at birth :

• Establish airway, breathing, circulation (ABC of resuscitation).
• Manage the temprature of the baby (Prevent hypothermia as well as hyperthermia).
• Receive the baby in pre warm linen.
• Cord clamping under aseptic conditions.
• Identify the gender to the mother.
• Wipe the baby and transfer to another prewarm linen.
• Immunization of baby with Vitamin K injection.
• Clothing of baby and put the baby with the mother (Rooming in with mother).

Temperature :

• Baby has limited ability to produce the heat, especially in first 12 hours.
• Subcutaneous fat is less in the newborn baby.
• Baby has larger body surface area per unit body weight.

So the newborn baby are prone to develop hypothermia.

Steps to prevent hypothermia:

• Place the baby under a radiant warmer.
• Immediately dry the baby with a prewarmed linen and remove the wet linen.
• Availability of room heater
• Provide skin to skin contact or Kangaroo Mother Care (KMC).
• Delay the bathing of the baby.
• Initiate breast feeding.
• Always touch the baby with warm hand and linen.

Immunization :

• Intramuscular (IM) administration of Vitamin K injection –
  • 5 mg if birth weight < 1000 gm
  • 1 mg if birth weight > 1000 gm
• Vaccines of BCG, Hep-B and OPV (Oral Polio Vaccine) should be given at birth.

Ayurvedic aspect of Postnatal care

Mukh Vishodhana (Cleaning of oral cavity):

• One should wrap the finger,(nails already cutted) with the well washed cloth and cleanse the mouth, palate, lips, throat(pharynx, larynx) and tongue of the newborn baby & then cover the head(anterior fontanel) or palate (Talu) by tampon soaked with Sneha (Ghrita).

Garbhodaka Vaman (Removal of swallowed amniotic fluid):

• According to Acharya Charaka, this process has been advised to perform with the saindhava lavana and ghrita.
• Now-a-days, this process has been replaced by the aspiration of amniotic fluid from the stomach, followed by the proper stomach wash with normal saline at birth.

Nabhinala Chedana (Cutting of Umbilical cord) :

• According to Acharya Charaka – 8 angula from umbilicus
• According to Acharya Sushruta – 8 angula from umbilicus
• According to Acharya Vagbhatta – 4 angula from umbilicus
• If there is Nabhipaka (pus formation in the unbilicus) then dusting of powder of Lodhra, Madhuk, Priyangu, Devdaru and Haridra should be done.

Jaatkarma :

Newborn should make to lick the following Ayurvedic formulations :

• According to Acharya Charaka – Madhu (Honey) + Ghrita with chanting of mantra.
• According to Acharya Sushruta –
  • 1^st day – Madhu (Honey) + Ghrita + Swarna (Gold particles)
  • 2^nd & 3^rd day – Lakshamana siddha Ghrita (Ghrita treated with a herb called lakshmana)
  • 4^th day – Madhu (Honey) + Ghrita.
• According to Acharya Vagbhatta –
  • 1^st day – Madhu (Honey) + Ghrita + Swarna (Gold particles)
  • 2^nd & 3^rd day – Lakshamana siddha Ghrita (Ghrita treated with a herb called lakshmana).
  • 4^th day – Ghrita or Navneet (Butter).

Stanapana (Breastfeeding) :

It is described in every Ayurvedic text as an important part of postnatal care.

• According to Acharya Charaka – should start from 1st day of life.
• According to Acharya Sushruta – should start from 4th day of life.
• According to Acharya Vagbhatta – should start from 4th day of life.

Abhyanga with Bala taila (Massage with Bala oil) :

• Promotes healthy growth and development of the baby.
• Increases strength.
• Improves weight gain by better thermo regulation.
• Nourishes the baby & improve skin texture.

Postnatal care of a newborn baby is very crucial for his growth and development. Ayurveda mentioned the postnatal care with a very scientific approach which is known as Jatamatra Paricharya. The method of postnatal care in Ayurveda and in Modern science are different but the ultimate goal is to give best postnatal care to the newborn baby. Including Ayurvedic concept in postnatal care of the baby such as Abhyanga (Massage), Swarna Prashana etc. helps in the optimal physical and mental growth of the baby.