MEDIATE PHYSIOLOGICAL CHANGES IN NEW BORN

Ring the process of birth, the baby has to face many physiological and environmental changes whic
oduce stress in newborn. The neonate needs to adjust to extrauterine life to maintain norm siological
activity.

Respiratory Changes

Soon after birth, changes occur in blood gases and blood pH. The level of carbon dioxide is in blood and
pH is decreased. These chemical changes excite the respiratory center Also, therma stimulus that is due
to sudden chilling of infant as he comes out of the warm womb, excites senson impulses in skin that are
sent to respiratory center. Along with these impulses, when the baby pa through the reproductive tract
during labor, the chest of fetus is compressed which removes flu accumulated in lungs. To replace the
fluid lost, air enters the lungs and respiration is facilitated.

Circulatory Changes

Soon after the baby’s birth, blood starts flowing through the lungs due to pressure changes in lung heart
and major vessels. The changes in heart after birth include functional closure of fetal shunts foramen
ovale, ductus arteriosus and ductus venosus.

Once lungs expand

Inspired oxygen dilates pulmonary vessels

This decreases pulmonary vascular resistance

Increase pulmonary blood flow

This, decreases pressure in right side of heart and pulmonary arteries

-Cord clamping leads to rise in systemic vascular resistance due to blood volume in placenta
Pressure in left side of heart increases 1

Blood flows from high pressure to low pressure 1 Blood circulation through fetal shunts is reversed

Fig. 1: Circulatory changes

Neurologic System

At birth, the nervous system is sufficiently developed to sustain extrauterine life. Most neurologic
functions are primitive reflexes. The role of autonomic nervous system is crucial during transition, as it
stimulates respiration, helps maintain acid base balance and regulates temperature partially.
Myelination of nerves occur following cephalocaudal and proximodistal pattern which leads to mastery
of fine and gross motor skilis. The neonate is born with rooting, sucking and swallowing reflexes which
help in taking feed.

4. Digestive System

Increased amount of saliva is secreted in first two months. Cardiac sphincter of stomach is immature
leading to regurgitation and frequent vomiting in new born. The neonate’s stomach capacity is about 90
ml and emptying time is short so they require small frequent feeds. The neonate’s liver is immature. It
stores less glycogen so neonate has higher risk of hypoglycemia. Bilirudin compgation is also affected
due to immature liver so physiologic jaundice is common in new born The neonate’s first stool is
meconium which is sticky and greenish black in color. It contains debris of intrauterine environment like
bile pigments, epithelial cells, fatty acids, mucus, blood and amniotic fluid. Passage of meconium should
be within 36 hours of birth. Three days after starting the

Feeds, color and consistency of stool changes.

5. Renal System The ability of the immature kidneys to concentrate urine is less and bladder capacity is
about 15 m

Only so the neonate may void about 15-20 times a day. The immature neonate kidneys may not be
Able to maintain fluid balance

Urine within 12 hours of birth.

6. Integumentary System

Case of fluid overload or fluid deficiency. Majority of babies pass

The neonate’s skin is very fine and delicate, so even slight friction can lead to injury or blisters. The fluid
lost by evaporation through the delicate skin is also comparatively more. The sebaceous glands are very
active in neonates and are mostly located on the face, scalp and genitalia and produce greasy cheesy
material called ‘vernix caseosa’ that covers the baby’s skin. Vernix caseosa rubs off on its own within few
days of birth. Plugging of sebaceous glands causes milia (pearly white cysts) on face of new born.

7. Endocrine System

The endocrine glands are almost formed but their functions are immature. The posterior pituitary gland
produces inadequate amount of antidiuretic hormone (ADH) due to which the neonates are prone to
develop dehydration, if fluid intake is not maintain The effect of maternal sex hormones is particularly
evident in new born. The labla are hypertrophied and the breasts may be engorged and secrete milk
(known as witch’s milk). Sudden drop in the level of estrogen and progesterone may cause
pseudomenstruation in female babies.

8. Musculoskeletal System.

The muscles increase in size and develop after birth. Bones of neonate are cartilaginous and undergo
ossification gradually. The skull bones are soft and not well fused. The fusion of skull bones makes soft
fontanelles that ossify gradually.