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新生儿的几种“反常”现象 哪些是不用担心的生理性表现呢?-
新生儿的几种“反常”现象 哪些是不用担心的生理性表现呢?

新生儿的几种“反常”现象 哪些是不用担心的生理性表现呢?

宝宝一出生为家长带来了喜悦,但伴随而来的是担惊受怕,真可说是含在嘴里怕化了,顶在头上怕摔了。孩子一旦出现些反常现象,更是惊恐不安,尤其是初为人父人母的家长。其实有些”反常”现象纯属生理性的。

1、生理性黄疸

新生儿的皮肤为粉红色,但大部分新生儿(30~50%的新牛儿和70%的早产儿)在出生后2~3天(最早2天,最迟5天)皮肤和眼结膜逐渐变黄,一般先见面颈部皮肤,然后遍及躯干与四肢,皮肤变黄,尿稍黄,不染尿布。黄疸的颜色在f{5生后第4-6天时最深。足月新生儿在第10~14天,早产儿在生后3周时黄色逐渐消退恢复正常。在此期问,小儿一般没有其它症状,情况良好,叫生理性黄疸。

新生儿发生理性黄疸对小儿身体无害,多喂些糖水,适当提早喂奶时间,使胎粪及早排出和减少排到肠道内的胆红素重新吸收,可在一定程度上减轻生理性黄疸的深度。

不过,如新生儿的黄疽出现得早,在生后24小时内出,并且黄疸很重,化验血中胆红素量超过每100毫升血清12毫克的指标,黄疸持续不退,时间超过2周(早产儿超过3周),或者黄疽消退后复又出现逐渐加重,就属于病理性黄疸。多由新生儿溶血症(血型不合),红细胞6一磷酸葡萄糖脱氢酶缺乏,新生儿败血症或其它感染、新生儿肝炎、先天性胆道闭锁畸形等疾病造成。为及时发现新生儿黄疸必须从婴儿一落生,每天都要在自然光线下观察其皮肤。观察时先用手指按压新生儿额头、胸、脚心等处,按压1~2秒钟,放开手指。这样可排除皮肤颜色的影响,观察到黄疸的真实情况。此外,还要观察眼泪及尿液是否发黄。轻轻摇动孩子,待其睁开眼睛后,观察巩膜(白眼珠)是否发黄。一旦发现巩膜、尿、眼泪发黄,就说明已超出正常黄疸的范围,应及时请医生诊治,以免耽误病情。

2、生理性体重减轻

婴儿出生后的头几天,往往比出生时体重下降,这就是平常说的“掉水膘”,医学上称“生理性体重下降”。一般减少出生的体重的3-9%,不超过10%,小儿正常进食后大约7-12天内可以恢复。(早产儿约要2-3周才能恢复)这主要是因为婴儿出生后排出了胎粪和小便;吐出较多羊水及粘液,生后最初几天补充量少,特别是母亲开奶迟,乳汁分泌量不足;通过呼吸出汗排出一些水分,尤其是夏季或室温过高,把婴儿捂盖得太严,出汗过多时引起的。这是正常现象,不是病。

但是,体重下降超过出生体重的10%,或者2 周后还没有恢复到出生时体蕺就要考虑足否因饮食不足、吐奶、稀便或其它新生儿疾病引起,应及时到医院就医

3、生理性贫血

由于胎儿在母腹巾处在低氧环境中,因此为获得更多的氧气供长发育需要,故血液中的红细胞数量多,个子大,血红蛋白含量也高。出生后,由于婴儿建立了自已的呼吸,血氧含最高,再加上红

细胞的寿命较短等原因,有大批红细胞在短时间内破坏,叫做生理性溶血。以后还要继续减少,但减少速度减慢了、

此时,小儿的生长发育是很快的,在出生后的半年内,每个月要长身高2.5厘米、体重增800克左右于生长发育迅速,血容量也要很快增加。造成血细胞棚对减少。不过这种情况不影响小儿的生长发育,叫做生理性贫血,以后随年龄增长,红细胞数及血红蛋逐渐上升,12岁左右基本达到成人水平。

4、脱水热

新生儿生后2-4天,外表正常,骤然体温升高到39-40℃。同时,小儿轻度烦躁不安、啼哭、尿少,其它情况良好,能吃奶、精神状态正常,体温升高持续1~2天可自然恢复。一般不需治疗,多喂几次葡萄糖水或白开水即可。一一般每两小时一次,每一次15-20毫升,很快就可退烧。如仍不退烧,可用75%的酒精兑一倍水,然后用布蘸配制好的酒精给小儿擦腋部、颈部、大腿根部血管处,体温会很快降下来。这在医学上叫新生儿脱水热

新生儿出生后,皮肤及肺部要蒸发水分,胎便及尿也逐渐排出。而刚出生的新生儿喝水喂奶均比较少,不能满足小儿的需要,丢失的水分也不能及时补充。如果再遇到炎热的环境,水分丢失更多,血中钠浓度升高,可直接影响到中枢神经系统的功能。

有些家长过于给孩子保暖,造成高温环境,同样可以引起新生儿脱水热。 对新生儿要注意饮足水分,尤其是夏季,更应注意,可以预防新生儿脱水热的发生。

5、生理性乳房肿胀

无论男孩还是女孩在出后3-5天常出现乳房肿胀、增大现象,小至蚕豆,大如鸽卵,有时还可以挤出乳白色液体,像奶汁一样。乳房增大以出生后8-10天最明显。出生2-3周后,这种现象自动消失,叫做生理性乳房增大。

新生儿乳房肿胀是正常现象,千万不要挤压乳房。因为新生儿抵抗力低,挤压乳房可使细菌从乳头进入体内,引起化脓性乳腺炎,造成乳房红、肿、热、痛,甚歪积脓、发生败血症,影响小儿的生长发育。

有一些家长认为初生女娃,一定要挤出奶来,将来生儿育女有奶吃。这是不对的。

6、新生儿阴道出血及分泌物

女婴出生后5~7天,细心的家长会发现在其尿布上有来自阴道的白色粘液,有时为血液,酷似“白带、月经”。但这种白带和月经是一过性的,只要1~2天就会自行消失,称为假白带和假月经。这是因为胎儿受母体内性激素的影响,阴道外皮和子宫内膜发生增生,小儿出生后来自母亲体内的激素的影响中断,增生的阴道上皮和子宫内膜脱落,从而出现“白带”、“月经”

家长发现自己的小儿出现这种现象,不要惊慌和恐惧,也不要治疗。这是正常的,很快会自然停止。

7、生理性腹泻

婴儿的消化能力比较弱,如果吃的食物超过他的吸收能力,就会发生腹泻。即使是母乳喂养.有时因母乳中含的某种营养成分超过婴儿的需要,也要发生腹泻,以便把过多的营养排泄掉,故大便次数增多,每天拉几次,甚至十几次。每次大便量不一定很多,其中含有少量水分,一般没有特殊腥臭味。这样的孩子尽管每天腹泻,从大便中排出一些营养成分,但还继续长胖,比同龄儿的体重还要多些。同时精神正常、无病容、发育好。这种腹泻叫做“生理性腹泻”,纯属母乳中某种营养过多造成的,如改喂牛奶后,一般都能治好。但“生理性腹泻”不影响孩子生长发育,从粪便中排出的一部分营养还比其它儿童吸收的营养多。因此,有“生理性腹泻”的儿童不必因此舍弃母乳而改成牛乳或其它代乳品。

另外,生理性腹泻不是细菌引起来的,也不是因消化有毛病造成的,故无需治疗。如使用药物治疗,还会引起毒性反应或副作用,给小儿带来损害:有生理性腹泻的小儿,大便次数多,要加强护理,以免引起臀红、感染或发生由细菌或病毒感染的病理性腹泻。

新生儿的几种“反常”现象 哪些是不用担心的生理性表现呢?

8“马牙”与螳螂嘴

婴儿生后四周左右,在上下牙龈边缘常出现一些芝麻大或半粒米大的乳白色颗粒状物,俗称马牙,医学上称上皮珠,是牙体的奠基组织。新生儿长有马牙,一般没有症状不影响生长发育,有时上皮珠较大,小儿可产生爱摇头、烦躁、咬奶头,甚至拒食等症状。这是由于局部发痒、发胀引起的。马牙不能及时脱落也是正常现象,千万不要用针挑破,或用未经消毒的东西去擦,以免发生感染。

婴儿为适应哺乳的吸吮动作,在口腔内两侧颊部各长有一块脂肪垫,而使颊部略微隆起。有些人把这种现象叫螳螂嘴,常常用布蘸淘米水去擦,或用刀割,并认为只有这样才能增加小儿的食欲。其实,螳螂嘴有利小儿吸奶,是正常的。刀割或用布擦,小儿粘膜很娇嫩,抵抗力又低,非常容易感染,甚至发生败血症,威胁小儿生命。故螳螂嘴一定不要进行“治疗”!

9、新生儿红斑及色素斑

新生儿红斑主要表现皮肤充血,手足微带青紫、这是由于新生儿皮肤柔嫩,表皮角化层发育不良,出生后接受空气阳光等刺激而引起皮肤充血现象。过一段时问便会自行脱屑消退。在新生儿的骶尾部常可出现-块青蓝色的色素斑,形状不规则,边缘清楚,压电不退色。这是皮肤深层组织的色素细胞堆积而产生的现象,约到5-6岁可自行消退,无需治疗。

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