It's not a big deal, is it

summary

A friend gave birth to a child not long ago. Although the child is full-term, its size and weight are relatively small. It's a full-term baby. So, it's nothing? Let's talk about it.

It's not a big deal, is it

First of all, small sample infants (also known as small for gestational age infants, intrauterine growth retardation) refers to a group of newborns whose birth weight is lower than the 10th percentile of the average weight of the same gestational age infants, or less than 2 standard deviations of the average weight. There are premature, full-term and expired small sample. The birth weight of full-term small sample infants (gestational age ≥ 37 weeks, < 42 weeks) is less than 2500g, which is the most common in small sample infants. Small sample infants may be the result of fetal intrauterine growth restriction, and some of them belong to healthy newborns with small growth and development. This kind of infant has enough gestational age, but the ability is low after birth, prone to meconium aspiration, hypothermia, polycythemia, hypoglycemia, intrauterine infection and other congenital abnormalities, especially development, neurobehavioral and mental retardation, and the mortality of small sample infant is 8 times of that of normal full-term infant, so the treatment of small sample infant has been paid attention recently.

Secondly, in addition to the symmetrical small children with obvious deformity, congenital syndrome and serious maternal diseases, most of the small children have the following characteristics: compared with the trunk and limbs, the head is relatively large, the face looks like "little old man", and the reaction is good. Emaciation with varying degrees of malnutrition, lack of subcutaneous fat in limbs, loose skin, wrinkles, easy to desquamate. The skull bone suture can be widened or overlapped, the anterior fontanel is larger, the toenail, skin and umbilical cord can be yellow green due to meconium contamination in amniotic fluid, and the umbilical cord is often thin. There are many wrinkles on the sole of the foot and scrotal folds, but the testicle of the baby boy has dropped, and the labia major of the baby girl can cover the labia minor. Physiological jaundice was not obvious. Physiological weight loss was not obvious. Most of the nerve reflexes were good.

Finally, full-term children should pay attention to postnatal care, especially in the usual time to watch the child's situation, if there is perinatal asphyxia immediately after birth resuscitation. Keep warm, too. If possible, put them in the incubator to keep the body temperature in the normal range and reduce the energy consumption. Open milk as soon as possible to prevent hypoglycemia. Pay attention to monitoring blood glucose, timely detection of hypoglycemia, and give treatment. Patients with energy deficiency can be given partial intravenous nutrition. Symptomatic polycythemia hyperviscosity syndrome, such as venous hematocrit > 0.7 (70%), can be treated with partial exchange transfusion. If the situation is serious, transfer to NICU for further treatment if necessary.

matters needing attention

The development of full-term small sample infants is relatively slow during pregnancy. Therefore, during pregnancy, pregnant women should pay attention to health care, strengthen the monitoring of the fetus, and avoid all factors that are not conducive to the growth of the fetus.