First few hours after birth

Question 1

Why do neonates struggle with thermoregulation?

• how do babies keep warm?
• how do babies lose heat?
• how to prevent hypothermia

Answer 1

babies have a large SA and so get cold easily

• keep warm via non shivering thermogenesis (breakdown of stored brown adipose tissue )
• heat is lost by radiation, conduction, convection and evaporation

Question 2

describe the impact of birth on glucose homeostasis in the newborn?

• normal glucose level?
• what drug gives increased risk of hypoglycaemia?

Answer 2

prior to birth is regulated by mum via placenta
interruption to this supply after birth
there is a drop in insulin and an increase in glycogen

• 2.6
• labetolol

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Question 3

benefits of breast feeding?

-factors that can prevent breast feeding?

Answer 3

reduced risk of breast and ovarian cancer for mums
give babies substrate for normal bacterial colonisation

-baby needs normal rooting & sucking reflexes
mum needs oxytocin, PRL and the let down reflex
unwell baby/premature as not strong enough

Question 4

at what point is it normal for babies to be anaemic?

Answer 4

8-10 weeks

Question 5

why are babies at risk from jaundice?

• why is this dangerous?
• treatment?

Answer 5

pathways for conjugating bilirubin are immature and so the breakdown of RBCs causes pathways to be overwhelmed

• unconjugated Hb is fat soluble and can cross the BBB, this can cause a bilirubin encephalopathy- can be fatal
• phototherapy (blue light), changes the fat soluble bilirubin to water soluble so can be excreted