Newborn-Adaptation-Final-PPTssssssssssssss.ppt

Newborn adaption

1. NEWBORN ADAPTATION
TO EXTRAUTERINE LIFE

2. INTRODUCTION
•The immediate postpartum period is a time
of significant physiological adaptation for both
the mother and baby.
•The newborn must adapt from being
completely dependent on another for life
sustaining oxygen and nutrients to an
independent being, a task accomplished over
a period of hours to days.

3. CONT.,.,
•Successful transition from fetal to neonatal life requires a complex
interaction between the following systems:
•• Respiratory.
•• Cardiovascular.
•• Thermoregulatory.
•• Immunologic.

4. RESPIRATORY
•Establishing respirations is critical to the newborn’s transition, as lungs
become the organ of gas exchange after separation from maternal
uteroplacental circulation.
•Over 90% of newborns make the transition from intrauterine life to
extra uterine life without difficulty, requiring little to no assistance
(NRP, 2010).

5. CONT.,.,
•However, for the 10% of newborns who do require assistance, about
1% require extensive resuscitative measures to survive.
•All personnel who care for newborns immediately after birth should
have skills in neonatal resuscitation and maintain their Neonatal
Resuscitation Program (NRP) status.

6. RESPIRATORY ADAPTATION
•The initiation of breathing is a complex process that
involves the interaction of biochemical, neural and
mechanical factors (Alvaro & Rigatto, 2005). Pulmonary
blood flow, surfactant production, and respiratory
musculature also influence respiratory adaptation to
extrauterine life.

7. CONT.,.,
•Umbilical cord clamping decreases oxygen concentration,
increases carbon dioxide concentration, and decreases the
blood pH. This stimulates the fetal aortic and carotid
chemoreceptors, activating the respiratory centre in the
medulla to initiate respiration.

8. CONT.,.,.
•Mechanical compression of the chest during the vaginal
birth forces approximately 1/3 of the fluid out of the fetal
lungs.
•As the chest is delivered, it re-expands, generating a
negative pressure and drawing air into the lungs.

9. CONT.,.,
•Passive inspiration of air replaces fluid. As the infant cries, a
positive intrathoracic pressure is established which keeps
the alveoli open, forcing the remaining fetal lung fluid into
the lymphatic circulation.

10. •In order for the respiratory system to function effectively,
the infant must have:
- adequate pulmonary blood flow
- adequate amount of surfactant
- respiratory musculature strong enough to support
respiration

11. CARDIO VASCULAR

12. CONT.,.,

13. NORMAL TERM CORD BLOOD
VALUES:

14. THERMOREGULATION
•Large body surface area compared to mass
•Types of heat loss:
 Conduction - direct skin contact.
 Convection - body to cooler air.
 Radiation - body to cold object.
 Evaporation - water to vapor.

15. CONDUCTION:

16. CONVECTION:

17. RADIATION:

18. EVAPORATION:

19. GOAL: Keep baby in a neutral thermal
environment: where the baby's metabolic
rate, and therefore O
2
consumption, is
minimal, but the body temperature remains
within the normal range.

20. THE LIVER: HEPATIC FUNCTIONS
•Conjugates bilirubin.
•Stores fetal iron.
•Stores liver glycogen for energy.
•Coagulation.

21. LIVER ADAPTATIONS:
•Iron content stored in liver.
•Low carbohydrate reserves.
•Main source of energy is glucose.
•Liver begins to conjugate bilirubin.
•Lack of intestinal flora results in low levels of vitamin K.

22. COAGULATION & VITAMIN K
•The absence of normal flora in newborn gut needed to
synthesize Vitamin K results in low Vitamin K levels until
5th day of life
•every newborn gets injected with Vit. K to prevent bleeding
problems.

23. CONT.,.,
•
Dose:
•1mg (0.5ml) IM >1500 gm
•0.5mg(0.25ml)IM<1500 gm

24. GI ADAPTATION - COOLCOOL FACTS...
•BEFORE BIRTH, baby has already swallowed and
peristalsis begins
•stomach holds 50-60 ml (2 ounces)
•GI tract mature 36-38 wks. gestation
•By 24 hours, the intestines are air filled
•Saliva is hardly produced until 3 months
•Babies regurgitate due to immature sphincter
•Newborns lose 5-10% body wt. in 5-10 day
•insensible water loss & low caloric intake

25. POOP!POOP!
•Meconium
•Transitional
•Fecal
•Breastfed

26. IMMUNOLOGIC ADAPTATION:
•IgG- Active acquired immunity (35 wks)
•Provides bacterial and viral protection for
4-8 months
•IgM- produced by fetus starting 10-15 wks
•Elevated levels indicate infection in uter.o
•IgA- passive immunity from colostrum.
•Protects respiratory, GI and eyes.

27. REACTIVITY STATES IN THE
NEWBORN
•
First period of reactivity - first 40 min. Baby is alert, responsive,
eager to explore the world
•
Sleep period - 1-3 hours after birth. May continue for 3-6 hrs.
Baby is in a deep sleep, difficult to arouse. Resp. rate &
heart rate decrease.
•
Second period of reactivity – 3-6 hours after birth. Baby is
awake, respirations are rapid, irregular, and may have
periods of apnea. May cough and regurg mucus, etc. Keep
bulb syringe handy. Heart rate again increases.

28. THAT’S IT!!
Aren’t babies a miracle????