Doctor Neonatologist - Consultation, Specifics Of The Profession

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Neonatologist

Neonatologist is a pediatrician who works in departments for premature and newborn babies in hospitals and maternity hospitals.

The work of a neonatologist is very delicate and responsible, as he deals with the smallest children - from birth to the 28th day of life. In this period, it is necessary to identify those diseases that can subsequently turn into chronic forms and even make a person disabled. Therefore, neonatologists try to carefully examine babies.

Despite the fact that the neonatologist deals only with infants, he is a general practitioner, since by the nature of his work he is faced with a variety of diseases of systems and organs. In addition, a neonatologist is also a diagnostician and obstetrician.

What diseases are within the competence of a neonatologist?

• Diaper rash;
• Vomiting;
• Umbilical hernia, wild meat, belly button bleeding;
• Jaundice of newborns;
• Cholera infantile;
• Diarrhea;
• Bronchitis;
• Short frenum of the tongue;
• Constipation;
• Blenorrhea in newborns (purulent inflammation of the eyes);
• Thrush;
• Rashes in babies;
• Hypothyroidism (decreased thyroid function);
• Phenylketonuria (congenital metabolic disorder).

What organs are examined by a neonatologist?

• Lungs and heart. With the help of a phonendoscope, the neonatologist listens to the child's lungs and determines the frequency of his breathing, rhythm and heart sounds;
• Head. At the consultation, the neonatologist determines the size of the fontanelle of the small patient, probes (palpates) the bones of the skull and determines whether there is edema (birth tumor);
• Neck. The neonatologist probes the collarbones, as it is necessary to make sure that they were not damaged during childbirth. Also, the doctor palpates the sternocleidomastoid muscles, since with the muscle torticollis, the muscle can be shortened;
• Genital organs. In boys, a neonatologist probes the testicles and checks to see if they have descended into the scrotum. In girls, the doctor examines the labia majora, which should cover the small ones;
• Tummy. The neonatologist necessarily probes the newborn's tummy and checks the size of the spleen and liver. At the consultation, the neonatologist asks the mother if the child had a bowel movement. On the first day, the child leaves meconium (original feces), viscous and thick, olive or dark green in color.

In addition, the neonatologist checks the infant's muscle tone. As a rule, infants have physiological muscle hypertonicity, which determines the baby's posture: the arms are bent and pressed to the sides, the head is tilted toward the chest, the hands are clenched into fists, the legs are bent at the hip joints and knees. The doctor determines the muscle tone by flexing and unbending the arms and legs of the child.

The legs in the hip joints should be easily divorced, and the folds on the legs should be symmetrical. If the legs are difficult to divorce, the neonatologist may suspect joint dysplasia.

Also, the neonatologist evaluates the basic reflexes during examination.

When should a mother seek advice from a neonatologist?

• When a newborn has bleeding from the navel, umbilical hernia, wild meat. If blood from the umbilical cord appears in the first hours after childbirth, this indicates a poorly tied umbilical cord. Usually, this bleeding is not long lasting. It happens that blood appears 3-5 days after birth, during the fall of the umbilical segment. Sometimes, after the umbilical cut has fallen off, a piece of red meat can be seen in the navel sitting on a thin leg. This phenomenon is called wild meat. In such cases, you should contact a neonatologist.
• If a newborn has a hernia, which often occurs as a result of a badly tied umbilical cord or from a strong cry of a child and gas.
• If the child has diaper rash. Its most frequent localization is in the buttocks, genitals, lower abdomen, behind the ears, in the axillary and groin areas, and skin folds. There are three degrees of diaper rash: a mild degree, when there is moderate redness of the skin without violating the integrity, an average degree, when there is bright redness with visible erosion, and a severe degree, when a weeping redness of the skin with the formation of ulcers is noticeable. Diaper rash is easily infected, so do not delay, but you should seek the advice of a neonatologist.

What tests will the neonatologist ask for?

• Rh factor analysis;
• Blood group analysis;
• Neonatal screening.

In the maternity hospital for newborns, the neonatologist must take a blood sample, which is applied to a special test strip. Test strips are examined in the laboratory for VH and PKU. If there is a suspicion of any disease, parents receive an urgent notification with a request to contact an endocrinological dispensary (VG) or a medical genetic consultation (PKU) for re-examination. Upon final confirmation of the diagnosis, appropriate treatment should be prescribed immediately.

If the baby does not have any pathologies, the parents, as a rule, are not notified.

Neonatologist's advice

From birth, the baby should have the following reflexes:

• Grasping - if you put a finger in the baby's palm, he will squeeze it tightly. Sometimes even he can grab his finger so hard that the child can be lifted slightly;
• Search engine - if you start stroking the child in the area of the corner of the mouth, then he will turn his head towards the stimulus;
• Automatic gait reflex - if the baby is taken under his armpits and placed on a flat surface, he will raise his leg, as if he is about to take a step;
• Proboscis - if you touch the baby's lips with a finger, he will pull them out with a tube;
• Crawling reflex - if you put the child on his tummy and put his palms on his feet, he will start to push off and try to crawl;
• Babinsky's reflex - if you lightly tickle the child's heel, he will begin to unbend and spread his toes.

After a consultation with a neonatologist, a pediatric nurse will tell a young mother how to take care of the umbilical cord and skin, how to wash and wash the baby, how to dress and apply it to the breast.

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