Brief Answer:
All are normal, except weight gain

Detailed Answer:
Hi...
1. The weight gain is only 13.33gm per day where as it should have been 25-30gm per day.
2. Her breathing pattern and rate is normal. You need to worry only if the respiratory rate is more than 60 per minute or if she's grunting.
3. Pausing for 2-3 seconds is normal. You need to worry only if the pause is more than 20 seconds.
4. Put saline nasal drops only if there's nasal block.
5. Feeding every 3 hours is normal and mild fast breathing at the time of feeding is quite Normal.

I suggest you seek your pediatrician's consultation regarding not gaining appropriate weight.

Regards - Dr. Sumanth

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Brief Answer:
Suggestions on newborn baby

Detailed Answer:
Hi XXXXXXX I will tell you how to check the respiratory rate.
Coming to your queries one by one -

1. You are right - initial 7-10 days the babies normally lose 10% of body wright but they regain their birth weight by 10th day. So initial 10 days need not be taken into account. If that is taken off the weight gain seems to be appropriate. But the general calculation is that in the initial 3 months the gain should be 25-30 gm per day. You can wait till a total of 30 days is over and then recheck weight. We will take a call at that time.

2. Counting of respiratory rate is by chest movements and chest raise. Count for a full one minute to know the accurate respiratory rate.

3. What I suggested about assessing the pause of respiration for 20 seconds is called apnea in medical terms. This is the cut off point to say whether it is apnea or not. You start counting the seconds by just saying 1,2,3....likewise from the instance your baby pauses the respiration.... If you have counted more than 20 but still the baby is still in the pause phase of respiration, then its apnea. If this happens you need to take the baby to the nearest pediatrician or emergency room. Hope I am clear.

4. As I have suggested above, you need to check the chest raise and chest movements, not the movements at belly button.

Regards - Dr. Sumanth

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Brief Answer:
Suggestions on TV and feeding

Detailed Answer:
Hi...
1. It is safe to watch TV even immediately after delivery or during delivery also. Nothing will happen.
2. Please burp the baby before putting to sleep.... Its essential as while belching out swallowed air sometimes babies tend to aspirate milk into lungs.
3. Baby can be laid down after burping, no problem.
4. How much milk should be decided by the baby and not by us. If the baby refuses after certain amount of feed, do not force feed.

If you are happy with my suggestions, you can rate my answers. Next time if you want my suggestions, you can ask for my suggestions directly.

Regards - Dr. Sumanth

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Brief Answer:
Suggestions on noisy breathing

Detailed Answer:
Hi XXXXXXX ..

1. Those noises are normal if the baby is sleeping comfortably. They could be due to blocked nose or are due to immature airways which are pliant.... They will get better as the baby grows.... Don't worry.

2. For nose block you can use saline nasal drops 1 drop in each nostril every 4-6th hourly.

Regards - Dr. Sumanth

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Brief Answer:
Suggested 3 hourly feeds and burping

Detailed Answer:
Hi XXXXXXX ..thanks for your trust in me and my suggestions.

1. Newborn babies sleep almost 18 hours per day.... Its normal. But it should not be at a stretch. Sleeping at 10am till 6pm is at a stretch 6 hours, which may make babies at this sleep have low blood sugar levels - hypoglycemia. It again makes the baby more sleepy and a vicious cycle starts. So I suggest you wake up the baby atleast 3 hours once by flicking at the heel and feed her breast milk.
But you have just now said she's crying, a hypoglycemic baby cannot cry vigorously, so don't worry.
But if you still feel she's excessively sleepy and not waking up at all, please get her checked by a pediatrician.

2. Respiratory rate of 30/ minute is normal for a newborn baby.

3. Temperature of 98.3F is not fever. Only temperature of more than 100F has to be deemed as fever.

4. Sometimes babies swallow air while feeding rapidly and they tend to get it out as belching or flatus. When they tend to belch it out, sometimes they tend to regurgitate the milk already getting digested in the stomach.
I suggest you burp the baby every time you feed her and put her back to sleep. It is the same thing that I suggested in my last interaction with you. Always burp the baby after a feed and putting her to sleep. But while burping they may regurgitate sometimes, so don't worry.

Regards - Dr. Sumanth

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Brief Answer:
Normal breathing rate for newborn

Detailed Answer:
Hello...
Herewith I am depicting the normal breathing rates for children according to the ages XXXXXXX I observed that in your 1st question you have quoted that as 30-35 and now you are quoting it as 25-30 per minute. This is slightly lower than the normal rate as you can see it from the normal rates range which I am providing below.

Age      Breaths per minute
Newborn to 6 months. 30–60
6 to 12 months. 24–30
1 to 5 years. 20–30
6 to 12 years. 12–20

She is a term baby (fully mature), and born with a normal weight and also is gaining weight properly if the initial 10 days is not taken into account (for the loss and gain of 10% body weight physiologically). I feel she's a healthy kid. But as the breathing pattern is troubling you lot, I have 2 suggestions for you -

1. Kindly consult a pediatrician who is nearest to you and let him examine the baby for respiratory pattern and rate. If he feels it is normal, you can be rest assured.

2. Take a full one minute video of the baby and let it be seen by the pediatrician when you consult him as it will be helpful - if the baby cries at the clinic, he will not be able to assess the respiratory pattern and rate.

Please get back if you have any query or doubt.
Regards - Dr. Sumanth

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Brief Answer:
Startle response - Nothing to worry

Detailed Answer:
Hi...
1. What your quoting about - sudden shakes while touching during sleep is called startle response and is quite normal.

2. It is not dangerous.

3. Please don't worry. This is not shaken baby syndrome (SBS). SBS is a crime committed by adults on babies by abusive shaking to injure the baby. Self shaking of body parts by the baby is not shaken baby syndrome.

4. You carrying the baby is not all going to harm her and especially keeping a hand under the neck of the baby is good actually as it will support the baby's neck.

Regards - Dr. Sumanth

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Brief Answer:
Its natural - Don't worry

Detailed Answer:
Hi...its common for kids of this age to occasionally be awake till 5-6 hours.
If the feeding pattern is good and urination is normal.....don't worry.
Regards - Dr. Sumanth

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Brief Answer:
Nothing to worry

Detailed Answer:
Hi...nothing to worry. At this age, it is quite common for babies not to pass motion even for 4-5 days at a stretch. But as you said, you can continue breast feeding. This cannot be counted as constipation.

Unless the abdomen is distended or green colored bilious vomiting or the baby has stopped feeding - nothing to worry.

If the feeding pattern is good and urination is normal.....don't worry.

If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

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Brief Answer:
Please take snaps without flash

Detailed Answer:
Hi...the powerful camera flash is the same as daylight.
Actually infants have more protection from a flash than adults since they are usually not interested in being photographed and do not look right at the camera. Also, they typically have smaller pupils. This means less light reaches the retinas.

While it probably does not cause much harm, if any, there are ways of taking photographs which do not need flash, and these would be the safest way of taking photos.

I suggest you take the snaps but with good external lighting and without flash.

Regards - Dr. Sumanth

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Brief Answer:
Do gentle swaddling, don't press breast of baby

Detailed Answer:
Hi XXXXXXX

1. Now your baby is 35 days old. It is advisable to swaddle the baby till 2 months of age, but by proper technique and not too tight swaddling at the legs. Correctly done, swaddling will make the sleep cozy for the baby.
Too tight wrapping is not recommended. SIDS cases are not reported with normal gentle swaddling.

2. When the baby vomits during sleep, immediately turn her to onedside so that the vomiting comes out and is not aspirated. But as per science a neurologically normal baby should not aspirate as the protective mechanism of gag reflex sets in.

3. Please do not keep pressing the breast of the baby. It is harmful. The mild breast engorgement and discharge you are noticing is due to maternal hormonal effects and will become normal in due course. If you press it will cause even more engorgement and sometimes infection.

Regards - Dr. Sumanth

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Brief Answer:
Please wait till she burps

Detailed Answer:
Hi XXXXXXX ..sometimes babies can take prolonged times to burp even 30-60 minutes. Sometimes they fall asleep on the shoulder while you are patting them to burp.
Occasional vomiting after laying her does is OK. But if she is vomiting every time you put her to sleep, then you need to wait in the upright posture till she burps. The best way is to wait till she burps.

But if the wait gain is appropriate, then you need not worry at all. This means that only excess milk is coming out and the required amount is being retained.

Regards - Dr. Sumanth

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