During pregnancy, the bond between mother and fetus is abruptly interrupted at birth, beginning the newborn’s adaptation to life outside the womb. Initially marked by crying or screaming, this reaction is essential for the newborn’s survival.
The separation from the placenta is a pivotal process, transitioning the newborn from an aquatic to an aerial environment. This adaptation to terrestrial life is influenced by factors like the birth mode (spontaneous, vaginal, or cesarean), gestational age, fetal pathologies, labor complications, and immediate postnatal care. Immediately after birth, a multitude of changes occur simultaneously.
Birth is a miraculous event, involving significant biochemical and physiological transformations due to the transition to extrauterine life. The intrauterine environment, safe, protective, sterile, and with a constant temperature, is starkly different from the extrauterine environment characterized by varying temperatures, air currents, strong light, and significant microbial load. The newborn transitions from dependence to independence, with crying as the primary communication method for expressing hunger, pain, discomfort, or fatigue.
In the fetus, nutrition is supplied by the placenta, and the digestive system is relatively inactive. However, sucking and swallowing reflexes start during pregnancy. The sucking reflex appears at 20 weeks of gestation, but nutritive sucking occurs after 30 to 34 weeks. The fetus swallows amniotic fluid, increasing from 15 milliliters per day at week 20 to 450 milliliters per day at week 40. Sucking and swallowing coordination develops after 32 weeks of gestation. After birth, the newborn’s stomach holds about 30 milliliters, necessitating 8 to 12 meals per day.
A healthy newborn sleeps about 18 to 20 hours daily, waking every two to three hours for breastfeeding. If not fed within 10 to 20 seconds, a newborn’s whimper can escalate into an intense cry, known as the “cry of hunger.” Newborns exhibit high reflexes due to the cerebral cortex’s immaturity. These reflexes decrease and disappear around 4 to 6 months of age. Reflexes related to feeding are more pronounced near mealtimes.
In some hospitals, a rooming-in system allows mothers and children to be hospitalized together, fostering natural bonding. Experienced medical staff can anticipate newborns’ needs and distinguish different cries. Typically, newborns wake every three hours for feeding, but some may sleep longer or wake more frequently. The staff understands each baby’s needs, including whether they require supplemental feeding with milk formula.
Neonatology involves examining newborns and treating their pathologies. Screenings detect congenital anomalies, sometimes causing stress and fatigue in newborns. These screenings include various tests like heart ultrasound and audiological testing. Sleep cycles should consist of 3 hours followed by 30 minutes of breastfeeding. Disruption in this cycle can cause fatigue, making the child weepy, drowsy, and restless. Especially in environments with many stimuli, newborns can tire quickly and need a quiet environment to rest.
Mothers typically breastfeed every three hours, but this may not always suit the newborn’s needs. The cry of pain, often observed during medical procedures, is a critical aspect of newborn communication. This sharp, intense cry is accompanied by physiological indicators like tachycardia and tachypnea.
Newborns may also experience discomfort after feeding, particularly if they consume a large amount of milk quickly. This discomfort manifests as a specific type of crying, with behavioral and physical indicators. Similarly, complaints related to defecation result in a persistent, low-intensity cry, often with body movements.
In summary, a newborn’s transition to extrauterine life involves complex physiological, biochemical, and behavioral adaptations. Understanding these aspects is essential for effective neonatal care and parental bonding.
