CUIDADOS EN CASA DEL RECIEN NACIDO

Posterior al nacimiento del primer hijo surgen muchas dudas acerca de los cuidados en casa del recién nacido. Como padres debemos de ir conociendo con el tiempo al niño y sus patrones en relación a la alimentación, sueño y evacuaciones.

A continuación se mencionan algunas características que son de esperar en los recién nacidos y que se catalogan como normales.

DORMIR:

Al principio su bebe no sabrá distinguir entre el día y la noche, y se va a estar despertando cada 2 o 3 horas para alimentarse. Los padres puede empezar tempranamente a enseñarle al bebe que la noche es para dormir y el día para jugar. Procure que las tomas nocturnas pasen lo más desapercibidas posibles, con una luz tenue, no alargando demasiado los cambios de pañales y volver a acostarlo en cuanto lo haya alimentado y cambiado. Durante el día si su siesta se prolonga por más de 3 o 4 horas, despiértelo y juegue un rato con él. La mayoría de los recién nacidos dormirá la mayor parte del día (18-20 horas).

Él bebe debe dormir en su propia cuna o moisés durante la noche en la habitación de sus padres, este debe dormir SIEMPRE boca arriba (primeros 6 meses de vida), en un colchón que sea firme evitando dejar espacios entre este y la cuna. Se deben evitar el uso de cobijas gruesas, almohadas, gorros, guantes, peluches, etc. Colóquele ropa abrigada para dormir sin nada más que lo cubra. Si va a usar una cobija que sea delgada, estírela y meta los extremos debajo del colchón para evitar el riesgo de que la cobija le cubra la cara. Se puede inclinar el colchón a 30 grados con cuñas especiales disponibles en el mercado para disminuir la severidad y frecuencia de regurgitaciones o vómitos.

CUIDADOS DEL OMBLIGO:

El ombligo ha de lavarse diariamente con agua y jabón como parte del baño diario. Su caída ocurre normalmente entre los 5 y 15 días de vida. Para favorecer esta y prevenir infecciones, debe ser secado tras el baño, posteriormente aplicar alcohol de 70 grados una vez al día y mantener el pañal por debajo del cordón. No se deben utilizar fajeros ni otras lociones. Si se torna con muy mal olor, secreción amarillenta o enrojecimiento de la piel alrededor de este, es necesario consultar al pediatra. Una vez que se ha caído se debe seguir aplicando alcohol hasta que este perfectamente seco.

MICCION:

El RN debe tener su primera orina en las primeras 24 hrs de vida y posteriormente tendrá en promedio de 6 a 8 por día, esta suele ser de color amarillo claro a oscuro. El número de veces que orine por día nos dará una idea de que tan bien se está alimentando, mientras su hijo moje por lo menos cuatro a cinco pañales por día quiere decir que recibe una adecuada cantidad de leche materna.

EVACUACIONES:

El 95% de los recién nacidos sanos de término presentan su primera deposición (meconio) en las primeras 24 hrs de nacido y el restante 5% lo hacen en las primeras 48 hrs. Esta tiene características especiales ya que suele ser muy espesa, color verde-negro y se mantendrán con estas características las primeras 24-48 horas, posteriormente se tornan cada vez más amarillentas hasta que al final de la primer semana toman un color amarillo-mostaza con pequeños grumos, semilíquidas y se van a presentar usualmente posterior a cada alimentación. Sin embargo con la presencia de 3-4 deposiciones en 24 hrs es un buen indicador de que hay una adecuada ingesta de leche materna.

BAÑO:

Se recomienda que durante la primer semana y mientras no se halla desprendido el muñón umbilical se realice un baño rápido en cama con una esponja fina, jabón neutro y agua tibia (36-37 C). No es necesario darle un baño diario durante la primer semana sin embargo este suele ser un momento del que los padres y el bebe disfrutan por lo que no hay problema si lo desea hacer a diario o 2-3 veces por semana. Es importante utilizar jabones líquidos neutros (sin perfume ni colorante) e iniciar con limpieza de las partes mas limpias (cara) y por último las más sucias (genitales). Se puede utilizar el mismo jabón líquido para lavar el pelo.

Una vez que se ha desprendido el muñón umbilical se pueden realizar baños diarios en tina, sumergiéndolo en agua tibia, con una mano sosteniendo la cabeza por detrás de las orejas, sobre una esponja para que no se resbale y con su otra mano le aplica el jabón masajeándole suavemente. Lo mejor es hacerlo antes de su comida de la mañana, en una atmosfera templada y sin corrientes. Lávese bien las maños y límpiese las uñas antes de comenzar.

CIRCUNSCICION:

La circuncisión tiene beneficios médicos potenciales y ventajas como lo son: menor incidencia en infecciones del tracto urinario, menor riesgo de desarrollar cáncer de pene, menor incidencia de enfermedades de transmisión sexual, así como ciertos riesgos mínimos y desventajas como hemorragias o infecciones. El procedimiento no es esencial para el bienestar del niño en ese momento. Se recomienda que la decisión de realizarla o no la tomen los padres en consulta con el pediatra previo al parto y esta debería realizarse en las primeras 2 semanas de vida por el neonatólogo o cirujano pediatra. Si se realiza en los primeros días de vida los cuidados de esta son sencillos y consisten en mantener la zona operada lo más limpia posible, en caso de que el pene se ensucie con materia fecal, lávelo suavemente con agua y jabón antibacteriano cuando le cambie los pañales y posteriormente lo cubre con una gasa vaselinada. De ser necesario el médico le indicara una crema antibacteriana.

Dr. Joaquín Acuña Mora
Pediatra Neonatólogo

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