Guidance and answer questions

Q.1 If a mother had a C-section when delivering the first child, can she have a normal labor when delivering the second child?

A

A C-section is still needed when a mother delivers the second child if she needed the surgery-assisted delivery due to pelvic stenosis, soft birth canal deformity or stenosis, as well as medical and surgical complications and other reasons such as heart disease when delivering the first child, and the above physical signs are still present during the next delivery. The C-section may not be necessary if the first C-section was performed due to abnormal fetal position, fetal distress in uterus and placenta previa but the signs are not found during the second pregnancy. Therefore, a mother can still select natural labor in case of no surgical signs during the second delivery.

Q.2What preparations should be made by an elderly parturient woman for the second delivery?

A

First, a physical examination should be performed. Currently, the main items of conventional pre-pregnancy checkups include: optional items, reproductive system examination, uterine anti-cancer scraping, liver function and HBV (6 items) detection, eugenic examination (4 items, rubella virus, cytomegalovirus, toxoplasma and herpes simplex virus) and hereditary disease examination. These pre-pregnancy check-ups must be properly performed for the families whose first child has a poor health status, such as the families whose child has ADHD and depression, and an evaluation should be performed. In addition, the following women should be paid particular attention to: women with a history of poor pregnancy and delivery, and women with pregnancy complications during the delivery of the first child.

Q.3Can a hypertensive woman get pregnant for the second child?

A

If a woman had hypertension of pregnancy without complications during the first delivery and soon recovered to normal, she can get pregnant for the second child. However, if she suffered from severe preeclampsia at that time and had functional impairment in eyeground, kidneys and liver, she needs to have herself evaluated about the appropriateness of getting pregnant at the hospital.

Q.4Will a woman have the same morning sickness during the second pregnancy as that during the first pregnancy?

A

The morning sickness will be different because the woman gets older and has a different physical status, which causes a difficult secretion of progestogen. Polyembryony, fetal macrosomia, and abnormal embryo (grape mole) etc. will cause the excessive secretion of progestogen and further result in intense gestation reactions.

Q.5 Which age is suitable for a woman to get pregnant for the second child?

A

Two factors should be mainly considered to judge whether a woman is suitable to get pregnant for the second child: one is the physical status, meaning a “second child” can be considered in case of no disease, especially the chronic disease, and a good health status; the second is age. Considering women’s physiological characteristics, mother-baby health and prenatal and postnatal care, the optimal child-bearing age for a woman should be 24 to 29 years, when she has excellent physical qualities, and a good ovarian reservation function; a woman aged above 30 Y only has a fertility of 60%; a woman aged above 35 Y only has a fertility of 40%; a woman aged above 40 Y, her fertility decreases to 25% to 30%. As for the mothers want the second child, they are advised to have the second child before 35 Y, so as to guarantee the mother’s recovery and the baby’s health. At this stage, women’s reproduction organ, skeletons and senior nervous system have been full-fledged, the reproduction functions are at the peak, their eggs have a high quality, the fetus will have a good growth and development, the incidence rate of miscarriage, premature labor, deformed infant and demented infant will be very low, and the delivered baby will be smart and healthy in most cases. At this stage, women have a good extensibility in soft birth canal, a strong uterine contraction and little chance of difficult labor, so the risk is also small. The age of 30 Y can also be a golden age for reproduction; in case of no other diseases and a good recovery, a 30-year old woman can also consider getting pregnant for the second child.

Q.6 Are pre-pregnancy checkups needed for the second child in case of no checkups for the first child?

A

As most woman who want a “second child” are mainly around the age of 35 Y, they have a relatively long history of sexual life, meaning a high chance for contact with pathogenic bacteria, and a certain underlying disease may exist; with the increase in age, their ovary reserve function decreases gradually. Therefore, the couple at the childbearing age who are preparing for the “second child” should have pre-pregnancy checkups, and chromosomes should be examined preferably if conditions permit. Studies have found: the probability for a fetus of the population aged above 35 Y to develop trisomy 21 is 1/35.  In order to get a proper pregnancy and deliver a healthy baby, a woman should receive pre-pregnancy checkups to guarantee the safety of the fetus.

Q.7What is the proper interval between two pregnancies?

A

The pregnancy interval varies according to different people, which mainly depends on the deliver mode of the first child. If the first child is delivered via vaginal birth, the woman is advised to wait until the breast feeding ends and the menstrual blood volume is recovered. Clinically, some woman can choose to get pregnant during the lactation period if conditions permit with taking family and work into consideration. If the first child is delivered via the C-section, getting pregnant after over two years is relatively safe to avoid the risks caused by no healing of the scar. However, some studies also suggest that, the risk of hysterorrhexis induced by the second pregnancy will be low in case that the recovery after the C-section is good and it has been over one year since the last delivery. Generally a longer interval means a better uterine recovery for the sake of safety, but the factor of age should also be considered. A short interval means an easier tendency in uterine during the delivery of the second child, causing massive hemorrhage and even posing a threat to the life of the mother and the fetus.

Q.8What preparations should the father do for the second child?

A

During the preparation for pregnancy, the father would better not to smoke, stay up late, be addicted to alcohol and should keep a good physical status. The father should keep exercising, not to work too hard. The exercise duration can vary according to the body status of different individuals and the proper duration is over three times per week with over 30 minutes each time. In addition, he should be more exposed to sunlight and breath more fresh air, which will benefit his endocrine equilibrium. He also needs to maintain a reasonable and balanced diet, and take sufficient nutrients, such as calorie supply, protein, mineral substances, vitamin and microelements. He also needs a conventional examination, and the man at an advanced age need to receive a sperm viability test.

Q.9Will the normal labor be easier for the second child?

A

In terms of the labor pains, the second delivery will be easier than the first one and the pain duration will be shortened. In terms of the birth process, the second delivery will be faster than the first one, but if the interval between the two deliveries is very long and the woman is at an advanced age during the second delivery, there will be problems faced by elderly pregnant women, and the delivery may not be quick.

Q.10Is vaginal delivery possible this time if the first was normal labor and the woman received the hysteromyoma stripping after the delivery?

A

It depends on the type and size of the hysteromyoma, so the doctor should know about the intraoperative conditions at that time and then decide the delivery mode.

Q.11Is the second pregnancy an option if the first fetus has congenital diseases?

A

It depends on the type of the fetal abnormality, and the chance of the recurrence of the congenital diseases depends on the disease category. It is recommended that, the parents and their first child should receive relevant examinations, and the doctor then give suggestions based on the specific conditions.

Q.12What nutrients should be supplemented before the pregnancy if a woman plans to get pregnant again?

A

① Increase the protein intake: the couple preparing for pregnancy should have more protein intake.  The daily protein intake per kilogram of the weight is 1 to 1.5 g, which should be increased to 1.5 to 2 g before the pregnancy, and they should increase the intake of meat, fish, eggs, milk and bean products etc.
② Calcium supplement: the dose of calcium needed during the pregnancy is twice the usual dose.  In case of no sufficient calcium before the pregnancy, the fetus is prone to develop rachitis and convulsion. In case of excessive calcium loss from the pregnant woman, the fetus may develop osteomalacia and convulsion, the intake of calcium-rich foods such as fish, milk and green vegetables should be increased.
③ Iron supplement: the fetus has a rapid growth, so the daily intake of iron is about 5 mg, and the blood volume of a pregnant woman increases by 1500 ml compared with non-pregnant period; in case of iron deficiency, the pregnant woman will develop anemia during the second and third trimesters.  Iron can be stored in vivo for four months, so the iron should be supplemented three months prior to the pregnancy. The iron-rich foods include milk, pork, eggs, soy bean and seaweed, and another way is to cook food in an iron pan.
④ Vitamins supplement: vitamin deficiency can cause miscarriage, premature delivery or dead birth, or influences the uterine contraction and causes difficult labor. Vitamin deficiency will also result in fetal dysostosis, weak resistance, anemia, edema, skin disease, and dysostosis etc. Therefore, they should have a higher intake of meat, milk, eggs, liver, vegetables and fruits prior to the pregnancy.
⑤Folic acid supplement: the deficiency of folic acid in a pregnant woman will result in macrocytic anemia and increase the incidence rate of fetal deformity.  A pregnant woman should have folic acid supplement or eat more animal liver, green vegetables, grain, cauliflower and beans under the doctor’s guidance  six months prior to the pregnancy.
⑥ Zin supplement: zinc deficiency will cause menstrual disorder, aspermatism or oligospermia, which will influence the fetal growth and development.  They should eat more fish, rice, Chinese cabbages, lamb, chicken and oyster.
In addition, the pre-pregnancy nutrition of the man is also very important. For most men, the excessively low intake of vitamin-C-rich fruits and vegetables or the excessive drinking several weeks prior to the pregnancy will harm the genetic materials of sperms and can easily cause fetal congenital defects. Therefore, the men should have nutrient supplement such as zinc, protein and vitamin C six months prior to the pregnancy, that will benefit the sperm growth and development,.

Q.13What are differences between the first pregnancy and the second pregnancy?

A

During the second pregnancy, attention should be paid to the nutritional replenishment to prevent the excessive enlargement of the fetus. The pregnant women at an advanced age should increase the antenatal test frequency in a proper way to rule out the early pregnancy Down’s Syndrome or amniotic fluid puncture should be performed at the second trimester to rule out the fetal chromosome diseases. In terms of delivery mode, the birth process of a primipara is relatively long, the duration from the first stage to the third stage lasts over 12 hours, but the birth process of a pluripara is short, the development is rapid, so the woman should be taken to a hospital as early as possible.

Q.14When should the intrauterine device be removed after deciding to get pregnant for the second child? How soon to be ready for getting pregnant after the above birth control measures are stopped?

A

Generally, it is advised to remove the device after the menstruation has been clean for three days. A woman can get pregnant after the menstruation is recovered for two to three times following the device removal or the withdrawal of the birth control drugs.

Q.15Will the pregnant woman experience a high level in blood glucose if she had gestational mellitus diabetes during the pregnancy of the first child?

A

In case of high blood glucose during the first time, the chance of high blood glucose will be big during the second time; the pregnant woman is advised to have the blood glucose monitored prior to the pregnancy, and the blood glucose should be controlled to be within a normal range.. During the pregnancy, the blood glucose should be monitored, the diets should be controlled and moderate exercise should be kept.

Q.16If the anesthetic drugs did not take effect during the first C-section, will the drugs be still ineffective during the second one?

A

Not necessarily. Only a very minority of people are insensitive to anesthetic drugs. Whether anesthetic drugs take effect is associated with multiple factors, such as anesthesia mode, and the pregnant woman’s conditions (such as spondylopathy and body shape).

Q.1Can a woman keep the fetus in case of accidental pregnancy when the intrauterine device is still on?

A

For accidental pregnancy with intrauterine device, the incidence rate of complications such as miscarriage, fetal deformity, placental abruption, intrauterine infection and bleeding etc. is fairly high, which will cause adverse consequences to the fetus and the pregnant woman. In case of accidental pregnancy when the intrauterine device is still on, the artificial abortion should be performed immediately to terminate the pregnancy to guarantee the mother’s health. If the pregnant woman requires to keep the baby, examinations should be performed. The fetus can be kept only if it is confirmed to have a normal development.. In the meantime, the healthcare and antenatal examinations should be carefully performed.

Q.2Can a woman aged above 35 get pregnant?

A

Medically speaking, the pregnancy at an advanced age (usually above 35 Y) often increases the risk in fetal chromosome abnormality, and the risk of pregnancy complications will also increase. However, woman’s age is not an absolute restriction; some females aged above 40 Y can also have a try in case of good health and strong desire for reproduction. It is suggested that these women should go through systematic examination before conception, and they should have the fetal chromosome abnormality ruled out through antenatal diagnosis (early pregnancy Down’s Syndrome screening or amniotic fluid puncture at the second trimester) during the gestational period and receive gestation examination and monitoring.

Q.3Is it possible to get pregnant again after the ligation of fallopian tubes?

A

The fallopian tube can be recanalized through the fallopian tube anastomosis if the woman is in good health with a normal menstruation, in compliance with the family planning policy, and has no surgical contraindications. Generally speaking, the woman can prepare for the normal pregnancy after one menstruation. A period within 6 months after the fallopian tube recanalization is the golden time for pregnancy.

Q.4What should a woman do if an oophoritic cyst is found during the pregnancy?

A

(1) Oophoritic cyst can be found during the pelvic examination to confirm the pregnancy at the early stage, about 12% of what is found during the early pregnancy is corpus lutein cyst, which sometimes can have a length of 8 to 10 cm, with the manifestations of being cyst, mobility, occurrence at one side, and no pain. Usually, it will disappear within 3 months and the recheck three months thereafter shows that it is gone.
(2) In case of the detection of oophoritic cyst, a type-B ultrasonic check should be conducted to help confirm the nature of the lump for further diagnosis.
(3) In case the pathological tumor, such as chocolate cyst, teratoma, and serous cystadenoma is found during the early pregnancy, a recheck should be performed three months thereafter. In case of the detection of the lump with a size of over one centimeter three months thereafter, it can be surgically resected within 18 to 20 weeks of the pregnancy when the embryo enters the middle trimester and is very stable, thus it can bear the surgical intervention. After the operation, the woman should have a good rest and receive the fetus-protecting therapy.
(4) If the oophoritic cyst is not big and does not impede the uterine growth, it can be resected after the delivery. In case of torsion and rupture of pedicle, the surgery should be performed immediately. In case of malignant change, the surgery should also be performed immediately.
(5) At the third trimester, the oophoroma is at the lower segment of the uterus, which influences the engagement of head, and the C-section should be performed without any hesitation. The bilateral ovarian tissues should be carefully explored during the C-section, and the ovarian lump should be resected.

Q.5 How much the proper intake of calcium supplements is needed during the pregnancy?

A

The amount of reserved calcium is about 30g during the pregnancy, 25 g of which is preserved in the fetus, and the remaining in the mother’s bones for the future use of lactation.
Dairy and dairy products are rich in calcium with a high absorption rate, and they are the best source of dietary calcium. Shelled shrimps and kelp are also rich in calcium, but their absorption rate is not as high as the dairy products; bean products and green vegetables also contain some calcium; Calcium is low in grains, meat and fowls..
The proper intake of calcium during the second and third trimesters of pregnancy is 1000 mg and 1200 mg per day.
The maximum acceptable intake of calcium supplements for pregnant women is 2000 mg per day.

Q.6 What are the precautions for calcium supplementing during the pregnancy?

A

The calcium should not be taken at a fasting status; in case of a single qd dose, it should be taken before sleep to prevent the low calcium level in the next morning. The calcium products cannot be taken together with milk, otherwise, this would result in calcium waste, and the interval should be at least 1 to 2 hours. Sufficient vitamin D should be supplemented during the calcium supplementing, and the woman should be exposed to sun more frequently. More water should be drunk during the calcium supplementing. The patients with a gastric acid deficiency are not suitable to take calcium carbonate, and calcium citrate can be taken. More vegetables and fruits should be taken to supplement vitamin C, which will facilitate calcium absorption. Excessive calcium intake may result in constipation in pregnant women and influence the absorption of other nutrients.

Q.7References for daily healthy diets during the pregnancy

A

Breakfast: millet porridge: 1 bowl; cheese sandwich (2 pieces of bread; 2 pieces of degreased cheese; 2 pieces of tomatoes)
Breakfast: 1 egg; 1 middle-sized apple
Lunch: rice: 1 bowl; sweet and sour pork fillet: 3 pieces; celery, with peeled shrimp and tofu: 1 bowl (containing celery, peas, peeled shrimp and tofu); braised baby cabbage in broth: 1 bowl (containing baby cabbage, black fungus, shiitake and salty yolk)
Lunch: milk 200 ml; 1 corncob
Supper: mushroom chicken noodle soup: 1 bowl (containing noodle, mushroom and shredded chicken); beef seasoned with soy sauce: 3 pieces: boiled pea seedlings: 1 bowl.  Late-night snack: 1 kiwifruit

Q.8How to supplement vitamin A in a proper way during the pregnancy

A

The excessive intake of isotretinoin used for the treatment of severe cystic acne in the early stage of pregnancy can result in spontaneous abortion and neonate congenital defects, including central nervous system deformity, cranial and facial region and cardiovascular deformity. In addition, a high dose of 20000 -50000 IU vitamin A of can also result in the similar defects. According to 2013 Reference Intake Amount of Dietary Nutrients for Chinese Residents, the recommended intake of vitamin A during the second and third trimesters is 900 mg per day, equivalent to 3000 IU, and the maximum intake is 2400 mg per day.

Q.9What kinds of food should be avoided as much as possible during the pregnancy?

A

Smoked foods (roast beef and lamb, cured meat and ham etc.);
Pickled foods (pickles, preserved vegetables and salted meat), preserved plums (preserved fruits);
Fried foods and desserts (such as egg pie and walnut cake), cream foods (cream cake and ice cream), sugar-containing beverage, and fruit jam.
Processed meats (jerk, dried meat floss and sausage), canned food (including fish meat and fruits);
Raw fish, preserved egg, fermented bean curd, instant noodles, chips, deep-fried twisted dough sticks, MSG, popcorn, animal internal organs, jelly, vermicelli, milk tea, coffee, coke, hot spicy dips, duck neck and crawfish.

Q.1Can a pregnant woman have a natural labor in case of hysteromyoma?

A

It depends on the position where the hysteromyoma is located; if it is near the uterine fundus, most pregnant women accompanied by hysteromyoma can have a natural labor, and intervention may not be necessary. However, the presence of myoma influences the uterine contraction because it can induce the weakness in contraction, prolong birth process and cause postpartum hemorrhage etc. If it is close to the lower segment of the uterus, it depends on the size of the myoma. If everything is fine, natural labor is the best option; if the relatively large-sized myoma causes an abnormality in fetal position such as breech presentation and horizontal position, this will impede the fetal descent and a C-section should be given.

Q.2Will pregnancy make the hysteromyoma grow for a woman with hysteromyoma diagnosed before the pregnancy?

A

The estrogen level will increase during the pregnancy, the myoma may grow larger with the increase in gestational weeks, but most women with hysteromyoma before the pregnancy can go through the entire duration of pregnancy smoothly, only a minority of them will have red and degenerated hysteromyoma, and even experience miscarriage and premature labor. After the childbirth, over 90% of the myoma will return to the progestation status three to six months after the birth.

Q.3Should the surgical resection of hysteromyoma be performed before the pregnancy?

A

A comprehensive evaluation should be performed according to the patient’s age, andclinical symptoms, as well as the site, size, number and nature of myoma. Myomectomy should be performed if the myoma influences the shape of the uterine cavity or causes the infertility and repeated miscarriage. Moreover, age is a very important factor to be taken into consideration. The scars left by the myoma stripping on the uterus can be recovered after a period of time, and generally, it will be safer to get pregnant upon one-year birth control after the operation. The capacity to bear child of a woman aged above 35 Y decreases gradually; in case of the detection of myoma at this time, whether a surgery is necessary depending on pros and cons, so it is suggested to follow the doctor’s advice.

Q.1What nutrition is necessary for fetal brain development?

A

Folic acid, choline, zinc, iron, polyunsaturated fatty acids, etc..

Q.2Is DHA intake sufficient in accordance with the normal diet of the mother?

A

From pregnancy to lactation, DHA in the mother's body has been rapidly falling. The intake of DHA should be 200 mg/day.

Q.3What kinds of food are rich in DHA?

A

Milk, egg, salmon, etc..

Q.4Is iron supplement necessary during pregnancy?

A

Iron is the necessary trace element for human body, but is also most likely to be insufficient. Pregnant women in the middle and late phase are most vulnerable to anemia. Statistics show that 35-58% healthy women suffer from iron deficiency. In addition to the normal diet, the pregnant women should additionally take in 150 micrograms of iodine: Have seafood every 2-3 days.

Q.5What is the role of iodine for the baby?

A

Iodine supplement during pregnancy helps baby's cognitive development. The requirement for iodine in pregnant women is 250 micrograms per day.

Q.6In hot weather such as in spring and summer, can I have ice cream?

A

It is OK once in a while, 2/3 for the husband while 1/3 for the wife, but no more than 1-2 times a week, and should "eat slowly". Sugar Mother should be careful, and it is better not to eat it.

Q.7I want instant noodles for a long time. Can I have them?

A

If you really want to have a taste, then try it, but do dispense with the seasoning that has particularly high content of salt. It's better for the pregnant women with high blood pressure not to have seasoning of instant noodles. Hot food is not absolutely a no-no, but the pregnant mother should only have slightly spicy foods, not heavily spicy ones, which may cause constipation.

Q.8Can I have durian?

A

Durian is a kind of fat-containing fruit; as the saying goes: A Durian is equal to three old hens, but durian is rich in fat and sugar, so you'd better just have a bite or two.

Q.9Can I have sushi?

A

Raw food is not recommended for the pregnant, for the bacteria inside are uncontrollable, and above the limit in most cases, but cooked food is fine.

Q.10My wife has gestational diabetes; what kinds of fruit are recommendable for her?

A

For the pregnant woman with gestational diabetes mellitus, quantity of the fruit is our primary concern, with daily consumption being controlled within 150g-200g, and being taken by two portions. The quantity of 150g-200g is about a fist size; so that is to say the Sugar Mother can only have fruit with size no more than half a fist. Then time is also important; she can have fruit after breakfast and in the afternoon as the snack. In addition, fruits with low sugar content, like grapefruit and strawberry, are preferable, while durian and mango have high content of sugar. Sugar Mother may have melon, but no more than a small piece each time.
Some special fruit, such as pitaya, although not sweet, but may have relatively high content of sugar. Apples and cherries are fine, but not too much.nbsp;
Fruits and vegetables in season, such as cucumber, tomato, are advisable.
The pregnant woman with high blood sugar must be careful in choosing food, choosing coarse grains that feature slow digestion and low glycemic index, instead of rice or flour.

Q.11 My baby is 50-days old and has white on the coated tongue; is it normal?

A

It's normal to have white on the coated tongue. Check to make sure there is no white on the mucous membrane of mouth, and no need to intervene.

Q.12What should I do with the baby who wants to sleep facing down instead of sleeping on the back?

A

The intestine of the newborn is not fully developed, which may sometimes cause discomfort like flatulence, and sleeping on the back can relieve flatulence and colic, so adults only need to watch on the side to prevent aspiration.

Q.13 How can I relieve the baby's flatulence and colic?

A

Sleeping facing down can relieve discomfort, while the breast-feeding mother should pay attention to diet, taking in little gas-producing food, such as beans, radishes, milk and so on.

Q.14 Is it better to carry the baby horizontally or vertically?

A

For the baby less than three months old, horizontal posture is more preferable than the vertical posture, as its spine has not fully developed; vertical posture is fine after that age.

Q.15Experts suggest the baby should be breastfed. What if the first breast milk does not come?

A

Don't give up until the baby sucks into the breast milk. Sometimes it's just that we don't see it with the naked eye, and actually breast milk has come.

Q.16Which way is better in breast-feeding: use a milk bottle or feed in person?

A

It's better to feed in person, which can not only reduce the secondary pollution, but can also stimulate the mammary gland to secrete milk with the baby sucking the breast.

Q.17Can postpartum mastitis be prevented? How to prevent it?

A

Postpartum mastitis is often caused by blockage of the mammary gland. Early breast sucking and repeated feeding can be used to keep the mammary duct unobstructed and prevent mastitis.

Q.18Can I have a spicy diet during breast feeding?

A

Yes, but you should downsize appropriately; if the baby has the milk moss or diarrhea, try to eat less spicy food.

Q.19When should I feed water to the baby?

A

No additional water is necessary in the case of pure breastfeeding; for formula milk, add a small amount of water between feeding.

Q.20Should I continue breastfeeding in the lactation period if the menstrual cycle comes?

A

Yes, keep breastfeeding and drink plenty of water. Menstruation indicates that ovarian function has been restored. With the improvement of living standards, postpartum ovarian function recovers faster, so menstruation has also been restored earlier; you should adhere to breast-feeding, while doing a good job of contraception.

Q.21How should I do breastfeeding?

A

Each time when feeding starts, alternate the breasts; for example, start from the left breast first, then start with the right breast next time, so that both breasts can be fully evacuated. If the breast milk is insufficient, supplement with the formula milk, but the formula milk should only be taken after breast-feeding so as not to cause the newborn to refuse to suck the breast milk. About 10 days after birth, a lot of neonates show obvious increase in appetite, so if the breast milk is insufficient, more formula milk should be supplemented, but don't give up breastfeeding, as breast milk is better for gastrointestinal tolerance of the neonates, and reduces incidence of allergic diseases, thus being favorable for health in the long run.

Q.22Are there any restrictions on the number and frequency of neonatal feeding?

A

Each feeding interval should be about 3-4 hours, but do not have to strictly limit the time interval. For the first day, each feeding is about 15ml, and then gradually increase the amount of milk; 1 week later, each feeding is about 60ml, and 2 weeks later, 90ml or so each time; the night feeding interval may be extended.  According to the baby's weight, the total amount of milk per day is about 150ml per kilogram, which is enough for nutritional needs; too much feeding may cause proliferation of fat cells, which will lead to obesity. Reasonable feeding in the neonatal period is necessary to ensure that the newborn to get enough nutrition, and to achieve normal growth and development, while malnutrition or excessive nutrition will have an adverse impact on health of the neonate.

Q.23What is the physiological jaundice of the newborn?

A

Physiological jaundice is caused by bilirubin only 2-14 days after birth of the neonate. Physiological jaundice of the full-term infants often appears in 2-3 days, with individual differences in the degree of jaundice, and varying in severity. Most physiological jaundice occurs to a lesser extent, appearing on the face if less severe, and extending to torso or limbs if severe.  Serum bilirubin <12.9mg/dl, generally asymptomatic, and may also have mild sleepiness or anorexia. About 5 days after birth, here comes the peak of jaundice. A week after the arrival of the newborn, the liver's function to clear bilirubin gradually matures. As of the 7-10 day after birth, the bilirubin gradually decreases, and then the jaundice of the skin fades away. The physiological jaundice in premature infants is more frequent than in full-term infants. The jaundice is more serious, and the regression is slower. It can be extended to 2-4 weeks.

Q.24Does physiological jaundice require special treatment?

A

Physiological jaundice does not need special treatment, and it can subside by itself. The mother is encouraged to feed the baby in multiple times to promote intestinal peristalsis, which helps establish bilirubin excretion and normal intestinal flora, reduce absorption of the bilirubin in the intestine, and relieve physiological jaundice. Constant exposure of the baby's skin to the sun can reduce the jaundice of the skin, but his eyes should be protected from the glare. It is difficult to differentiate the physiological jaundice and pathological jaundice, so we should pay attention to the deepening of jaundice. It is necessary to find the cause of jaundice according to the gestational age, weight and pathological factors, and to monitor bilirubin, and if it exceeds the scope of the physiological jaundice, we need to give appropriate intervention and take treatment measures as soon as possible.

Q.25How to distinguish between physiology jaundice and pathological jaundice?

A

In terms of time, the general physiological jaundice will subside within 2 weeks, and if there still is a yellow staining, see a doctor immediately; in terms of the site of the jaundice, physiological jaundice is only limited to the trunk of the body, so if the yellow staining can be seen in the limbs of the baby under natural light, it is pathological jaundice in most cases.