contribute to the reduction umbilical wound and her scarring; prevention of infection of the umbilical wound.

II. INDICATIONS:

falling off of the umbilical residue, the formation of an umbilical wound in its place.

III. NURSING PROCESS CONTRA-INDICATIONS: none.

SAFETY PRECAUTIONS: do not leave the child unattended on the changing table.

POSSIBLE PROBLEMS: anxiety of the child, bleeding of the wound, serous or purulent discharge, redness of the skin around the wound.

IV. EQUIPMENT:

a set of sterile sticks with a cotton swab in a kraft bag or bix, 3% hydrogen peroxide solution. 95% (70%) alcohol, 5% potassium permanganate solution, trays for equipment and used material, gloves, disinfectant, diaper.

V Algorithm for performing a simple medical service.

Preparation for the procedure:

1. Introduce yourself to your mother, explain the purpose and course of the upcoming procedure, and obtain informed consent to carry it out.
2. Treat your hands in a hygienic way, dry them, put on gloves
3. Process the changing table dez. solution, put a diaper on it.

Execution of the procedure:

1. Place your baby on the changing table.
2. Unwrap the baby, unfold the inner diaper without touching the baby's skin with your hands.
3. Examine the umbilical cord. In the presence of hyperemia of the skin, bleeding of the wound, swelling, discharge, inform the doctor without treating the wound. With a dry umbilical wound, treat it.
4. Treat the bottom of the umbilical wound with a sterile stick moistened with 3% hydrogen peroxide, carefully stretching the edges of the wound with your index and thumb.
5. Dry the bottom of the wound with a dry sterile stick, also stretching its edges.
6. Clean the wound with 95% (70%) alcohol with a sterile swab.
7. Treat the wound - stew with a stick with a 5% solution of potassium permanganate, without touching the skin around the wound (so as not to cause skin burns). Throw each of your used sticks into the waste tray.
8. Swaddle the baby, put it in the crib.

End of procedure:

1. Remove the diaper from the changing table, treat the changing table with dez. solution, remove gloves.
2. Used materials must be disinfected.
3. Treat your hands in a hygienic way, dry them.
4. Make a record of the manipulation in the medical records.

NOTE: treat the wound daily until it is epithelized.

This tube was his thread of life. Not without reason in the cultures of many peoples, so much attention was paid to the placenta - the placenta with the umbilical cord attached to it. There is an opinion that there is also an energy umbilical cord that connects mother and child until about three years old. So, during childbirth, the umbilical cord is cut, and this connection is interrupted. All! The child begins to exist independently. Let him be near and dependent on his mother, but the beginning of a new life has been laid!

There are several blood vessels in the umbilical cord.

When they are cut, the blood coagulates and clotted black blood crusts form, which protect the umbilical wound from infection. When they dry up and fall off, this will mean that the healing process in the wound is over.

How and how to treat an umbilical wound at home?

First stage. Pour three to five drops of 3% hydrogen peroxide into the umbilical wound. It is usually recommended to do this after bathing the baby, when the crusts on the wound are slightly soaked in water. The beauty of peroxide is that it is not only a high-quality antiseptic, but also perfectly foams, and its bubbles help to mechanically wash off those dark crusts from the umbilical wound that have already dried up and are ready to fall off. Please, when treating with peroxide, do not clean the navel with a cotton swab and do not pick off the crusts that are not yet ready to fall off from the wound! If you forcibly remove a couple of such crusts, then the umbilical wound will again become fresh and wet. This means that the child's body will again have to put up a barrier to infection, form protective crusts, and the process of "crust - wound - crust - wound" will go in cycles.

From practice

I remember a case when one young mother carefully and actively “cleaned her baby’s navel to the very bottom, like a well, and he didn’t heal for a whole month until it turned out and I stopped her.

Second phase. Pour two to four drops of alcohol tincture into the umbilical wound. I usually recommend a 1% alcohol tincture of chlorophyllipt (eucalyptus leaf tincture) to the parents of my young patients.

What are the benefits of eucalyptus? Many microbes coexist with us. Staphylococcus aureus is especially widely, but infamously known. It is he who most often causes inflammation in the umbilical wound in newborns. In one quantity or another, Staphylococcus aureus is also at home, but it is especially abundant in hospitals. Over the past decades, this staphylococcus has been poisoned with a variety of chemicals. As a result, he became insensitive to the vast majority of them, but natural remedy- an extract from eucalyptus leaves - so far it is easily defeated.

• it is convenient to use conventional pipettes for accurate entry of drugs into the navel;
• if there is a choice, then you can buy peroxide in a bottle with a narrow nose, and then a pipette is not required for it;
• when processing, try not to touch the umbilical wound itself with your hands, cotton pads or sticks, so as not to infect it;
• try to drip all preparations exactly into the core of the umbilical wound, and immediately wipe the spilled and spilled liquid, for example, with a cotton pad, so as not to irritate the skin of the baby's tummy;
• if the umbilical cord residue is high enough and somehow bent-curled, then it can be slightly lifted from the sides with clean hands, so that it is more convenient to drip into the middle of the navel, like into a rosebud;
• in the case of using a staple on the umbilical cord, the treatment should be carried out in the same way.

How often to treat the navel?

Usually once a day after a bath. If the doctor thinks that the child's navel is getting wet and there is a tendency to inflammation, then he will probably recommend that parents treat the umbilical wound more often or change drugs.

The umbilical wound is the entrance gate of infection in abdominal cavity baby, so you need to watch her very carefully and examine her a couple of times a day. If you suddenly see signs of inflammation on the wound, such as redness, swelling or weeping, especially with colored discharge (yellow or greenish), then you need to urgently show the newborn to the doctor!

Often mothers ask whether it is necessary to close the umbilical wound with a sterile gauze and turn off the edge of the diaper. This is not necessary, except in those cases when a sufficiently large plastic clip was placed on the umbilical cord in the hospital. In this case, you will have to turn off the edge of the diaper yourself or slide it just below the navel.

From practice

Very often I hear from mothers: “In the maternity hospital, my baby’s navel was tied badly and now it sticks out ugly!” This is the most common misconception! Remember: you can not cut the umbilical cord beautifully or ugly! The doctor always cuts a little higher than the end of the skin passing from the abdomen to the umbilical cord. It’s just that in one child, the skin practically does not go over it, while in the other, on the contrary, it has risen high along the umbilical cord, and therefore a large “stump” has formed, which parents just don’t like. Doctors call it the "skin" navel. Yes, it will seem sloppy and large compared to the usual one, but don’t worry, over time, the navel will seem to flatten, curl up, besides, fat will appear on the tummy, and in the end the navel will be beautiful and wonderful!

Most parents are terrified of treating their child's navel. Yes, this is a serious and responsible, but, you see, an easy procedure. Do not be afraid to handle the navel, carefully monitor its condition.

Before and after the examination, it is necessary to wash and treat hands with an antiseptic solution.

Equipment

Devices, tools, medical products

Sterile pipette - 1 pc.

Sterile tweezers - 1 pc.

Tray for processed material - 1 pc.

Medicines

Antiseptic solution - 2 single doses.

3% hydrogen peroxide solution - 50 ml.

70% ethyl alcohol - 10 ml.

1% solution of brilliant green - 5 ml.

Other Consumable

Soap - for processing hands. Sterile cotton swab - 5 pcs

Algorithm for caring for the umbilical wound of a newborn

1. Preparation for the procedure:

introduce yourself to the mother (or other relatives of the newborn), explain the purpose and course of the upcoming procedure;

prepare the necessary equipment;

wash, dry and treat hands with an antiseptic solution;

swaddle the baby in the crib (or on a “non-sterile” changing table). Unfold the inner diaper without touching the baby's skin with your hands.

2. Performing the procedure:

It is good to stretch the edges of the umbilical wound with the index and thumb of the left hand.

Using a pipette or a cotton swab taken with tweezers, generously cover the umbilical wound with a 3% hydrogen peroxide solution.

After 20-30 seconds, dry the wound, quenching it with a dry sterile cotton swab using tweezers.

Treat the wound and the skin around with tweezers with a cotton swab moistened with 70% ethyl alcohol (moving from the inside out).

With another cotton swab dipped in 1% brilliant green solution, treat only the wound, without touching the skin around the wound.

3. End of procedure:

Dispose of waste material into a disinfection container or disposal bag according to the waste class.

Wash, dry and treat hands with an antiseptic solution.

Swaddle the baby or dress.

Make an appropriate record of the procedure performed in the medical records.

Achieved results and their evaluation:

The absence of visible changes (irritations) from the umbilical wound of the newborn.

Hygienic bath:

bathing in the first 6 months daily (in the second half of the year - every other day).

the start date of the hygienic bath is determined by the doctor (before or only after the healing of the umbilical wound).

if bathing is prescribed, but the wound has not yet completely healed, then a solution of potassium permanganate is added to the water until a faint pink color is obtained (the crystals are first dissolved in a separate container).

water is boiled only if it is taken from open reservoirs.

use a special baby bath designed only for bathing a child, store it in a clean place, wash it with soap before use, and then rinse with hot water.

bathing water temperature - 37°С, air temperature in the room - not lower than 22°С.

bathe better evening(in the interval of 19-20 hours).

soap is used no more than 1-2 times a week (prevention of dry skin), soaping is done on a “mitten”, a lump of cotton wool or soft tissue, on a hand (washcloths, sponges are still rough for the baby’s delicate skin).

bath duration 5-7 min.

at the last stage, dousing with water is carried out, the temperature of which is 1 ° C lower than the temperature of the water in the bath - a hardening element;

drying is carried out with blotting movements, then the natural folds are processed, the child is swaddled and fed.

walks

in summer time a newborn can be taken for a walk almost immediately after being discharged from the hospital (for 2-3 days), first for 20-40 minutes, then quickly increasing the time spent in the open air up to 6-8 hours a day;

in winter, in central Russia, children are first taken outside at the age of 2-3 weeks at an air temperature not lower than -5 ° C, starting from 15-20 minutes and gradually bringing this time up to 1.5-2 hours 2 times a day ( the approach is carried out individually, taking into account the weather).

Evaluation and registration of the chair.

In newborns original feces (meconium), which is a thick viscous mass of dark color, departs by the end of the first day of life. On the second or third day appears transition chair, having a mushy consistency, darkish in color, then set normal stool yellow color with a sour smell (chest stool). The frequency of stool in newborns is 2-6 times a day, in older children - 2-4 times a day.

The nature and frequency of stools depend on the type of feeding. When breastfeeding the chair is 3-4 times a day, yellow, mushy, with a sour smell. With artificial feeding the stool is observed less frequently, 1-2 times a day, more dense, formed, light green, sometimes grayish-clay, reminiscent of putty in consistency, with a pungent odor.

Loose stools can be with digestive disorders; the color of the feces changes, pathological impurities appear in the form of mucus, greenery, blood, etc.

Elements of parenting newborns

NPR - education

The first toys are hung above the child's chest at least 50 cm and they are periodically changed. A bright, one-color toy for hanging. For the development of visual, concentration. To look at while lying on your stomach

Physical development - tactile massage

Non-special hardening methods used immediately after the birth of the child. After birth, the child goes through a period of adaptation to the extrauterine environment, which takes from 1 week to 1.5-2 months. Non-special methods include matching the child's clothing to the ambient temperature and creating a pulsating thermal regime in the room.

Proper dressing of the child, starting from the neonatal period, is essential. At an air temperature of + 21-22 ° C, the child of the first months of life during wakefulness must be dressed in a light undershirt and a flannelette blouse. A cotton or flannelette hat is worn only up to 2 weeks of age. During wakefulness, the baby performs a large number of movements. Already at the age of 1 month, when the period of wakefulness lengthens, children can wear sliders in which movements are freely carried out.

Type of child's clothing at different room temperatures

(according to G.V. Terentyeva)

Non-special hardening is also possible during hygiene procedures, for example, when washing or bathing a child. In the first months of life, the child's face is washed with warm water, the temperature of which is 32-33 ° C. Then gradually reduce the temperature of the water.

Special hardening methods

air hardening

air bath- This is the first special hardening procedure in a child's life.

Carrying out air baths, as well as other tempering special procedures, is advisable to carry out in the morning or in the evening (at 17-18 hours). Air baths should be carried out no earlier than 1.5 hours after a meal and no later than 30 minutes before a meal. At this time, the child has high initial energy expenditure, a high level of metabolism and the ability to mobilize energy and plastic resources to implement adaptive reactions. During this period of the day, recovery processes are also most pronounced after the implementation of motor activity and other hardening effects.

Changing diapers, changing clothes, undressing a newborn before bathing - these are the first air baths, the first tempering procedures. For an infant, the air temperature, both in the room and outside during the air bath, should not be lower than 22 0 C. After appropriate training, the temperature during the air bath can be 20 and 18 0 C.

Air baths must be carried out carefully; their duration at first should not exceed 2 - 3 minutes. gradually increase time

Exemplary complexes of hardening measures

One of the primary tasks facing mom and dad after returning from the hospital is the treatment of the newborn's navel. It is the umbilical wound that is the direct route for infection to enter the baby’s still fragile body, and improper care can cause long-term healing of the umbilical tissues, which contributes to the appearance of fungi and the reproduction of pathogenic bacteria.

About the umbilical cord

During the period when the child is still in the womb, the umbilical cord connects him to her. After birth, the organs of the newborn are ready for independent functioning and there is no need for such a connection. As soon as the baby is born, almost the entire umbilical cord is cut off, and a small, about 2 cm, process is clamped with a special clothespin for the navel. For some time, the remainder of the umbilical cord with the clothespin still sticks out, but after a few days, having hardened and dried, it falls off painlessly. In order for the navel to fall off imperceptibly and without much difficulty, it is important for parents to know how to care for the umbilical wound and what special solutions to use.

After the baby is born, the midwife cuts the umbilical cord, leaving only a small part of it. Time will pass and the umbilical process will dry out, leaving behind a small cavity

Means for the treatment of the navel

The first question that new parents ask themselves is: what is the best way to handle the navel of a newborn? Among the huge number of both traditional and modern pharmaceutical developments, the most popular and in demand are: hydrogen peroxide, potassium permanganate, alcohol solution and, of the latest innovations, chlorophyllipt.

However, no matter what you prefer, you must use the tool strictly for its intended purpose. Careless handling or too much use of any ointment can cause burns and additional wounds on the skin of the newborn.

Baneocin

The use of baneocin in the care of the umbilical wound promotes its healing and helps prevent possible inflammation of the skin around the navel of the newborn. It is recommended by many modern pediatricians.

Before using this powder, the place of application should be treat with 3% hydrogen peroxide and lightly blot with a cotton pad or swab. At natural process If the umbilicus falls off, the procedure should be repeated twice a day, but if an ichor is released from the wound and it continues to be wet, the number of procedures should be increased up to 4-5 times. It should be noted that during a short course of treatment (about 5-7 days) baneocin is absolutely harmless to the baby.

Chlorophyllipt

One of the latest newfangled methods is chlorophyllipt treatment. Its wide distribution is associated with a number of its advantages:

Procedures with chlorophyllipt are always carried out after bathing the baby. First, a few drops of a 1% alcohol solution of this medicine are dripped from a pipette directly into the navel. Next, using a cotton swab, you need to gently smear the skin around the umbilical wound with chlorophyllipt.

Potassium permanganate solution

There are a number of nuances that you need to know when using potassium permanganate.

• Firstly, a 2-5% solution is more suitable for treating the navel.
• Secondly, before treating the umbilical wound, dilute a dark pink solution of potassium permanganate and strain well through gauze folded in several layers. Such a procedure will ensure that crumbs of undissolved potassium permanganate crystals do not enter sensitive areas of the skin.
• Thirdly, you can store a ready-made solution for no longer than ten days.

Hydrogen peroxide

When caring for the navel during the healing process, many mothers prefer a 3% hydrogen peroxide solution. With the help of a pipette, it is dripped into the very umbilical fossa of the baby, and then a cotton swab dipped in hydrogen peroxide is carefully treated with the entire wound. So far, brilliant green has often been used along with hydrogen peroxide, but at present, the use of brilliant green has become undesirable. Modern doctors claim that the thin film on the skin that brilliant green forms prevents rapid and effective healing.

Basic rules and sequence for processing the navel

Initially, the navel is processed in the hospital. You should continue to do the appropriate procedures at home until the baby's umbilical wound is completely healed. In order for such manipulations to be of high quality and safe, you will need:

• cotton swabs, discs or swabs;
• pipette;
• warm boiled water;
• hydrogen peroxide;
• the selected treatment agent (potassium permanganate, chlorphyllipt or other).

Step-by-step algorithm of actions when processing the navel to an infant:

1. Wash your hands with soap immediately before the procedure. Dirty hands are a source of germs and bacteria.
2. Apply a cotton pad soaked in hydrogen peroxide to the umbilical wound or drop a little solution onto the navel with a regular pipette.
3. With a cotton swab, remove the remnants of peroxide and fallen crusts, after wetting it with boiled water.
4. Using cotton swabs, treat the wound with an appropriate agent.

A few more important points about the technique of the procedures:

• Do all manipulations with the navel carefully and carefully. In no case do not press or rub the damaged areas of the skin.
• Apply all solutions exclusively to the wound so as not to cause additional irritation around the navel.
• There is no need to remove all dried crusts at once. In due time, they will painlessly fall off by themselves, otherwise it is possible to damage already especially sensitive tissues.
• Make sure that the wound site is always open, and there is constant air access to the navel - this will speed up the healing process. Wear a diaper in such a way that it does not cover the wound, and do not seal it.

Duration and frequency of treatment of the umbilical wound

In addition to questions about how and how to treat an umbilical wound, parents are interested in questions about how often and how much such procedures should be carried out. In the initial period, the navel should be treated twice a day, preferably in the morning and evening before going to bed. If the healing process is going well, then the number of procedures can be reduced to one per day. If the navel remains wet and continues to bleed, the number of treatments should be increased to 3-4 per day.

It is necessary to process the navel until the final restoration of damaged tissues. Usually, when proper care, the navel heals completely within 3 weeks. Otherwise, you should show the newborn to the doctor.

Also, you should consult a doctor if the child behaves restlessly against the background of swelling or redness of the skin in the navel. Sometimes the healing process can be accompanied by heavy bleeding. You should not panic, its cause may be the detachment of a large crust.

During the newborn period of a baby, too restless behavior of mothers and fathers is quite natural. Moreover, excessive vigilance in the issue related to the processing of the navel of a newborn will not hurt. For parents, and especially those who are not yet experienced, it will be useful to watch a video lesson with Dr. Komarovsky just on this topic. It is important to closely monitor its condition and ensure proper care. It is necessary to constantly check the discharge from the umbilical wound: if it is an ichor, everything is in order, but if pus appears, the skin is inflamed, do not postpone a visit to the doctor. Suppuration may be the result of an umbilical fistula.

With such a procedure as the treatment of the umbilical wound of a newborn, all young mothers face. Of course, if a doctor did it, then everything would be very good. But, alas! Treatment of the umbilical wound of a newborn will lie on your shoulders. When the umbilical residue disappears from the crumbs, a small wound surface is formed, which becomes the "entrance" for most infections. That is why the baby's navel must be carefully cared for. Let's figure out what needs to be done and how the umbilical wound of a newborn is treated. First, let's find out what is required for such a process:

1. Cotton swabs (sterile).

2. Zelenka (one percent).

3. Sterile gauze pads.

4. Hydrogen peroxide solution.

Treatment of the umbilical wound of a newborn, an algorithm for conducting

Such actions are recommended to be carried out once or twice a day, preferably before feeding in the morning and after evening bathing. After about two weeks, the wound should dry out and heal. during this period, it is recommended only in boiled water and exclusively with the addition (add only before the procedure). So:

1. Wash your hands well.

2. Stretch the edges of the navel with a large and index finger left hand.

3. Lubricate the edges of the umbilical wound with a cotton swab (soaked in hydrogen peroxide solution).

4. Take a dry cotton swab and dry the baby's wound (you can take a cotton swab instead of a wand).

5. Treat the place with green paint.

6. Apply a sterile napkin to the umbilical wound.

Most mothers do not even suspect where they take the baby immediately after birth. The answer is quite simple: processing and inspection. It is important that the first one is the most important point. After all, your baby has just appeared and, like all adults, needs elementary rules hygiene. Let's take a step-by-step look at how newborns are processed. It is divided into four stages:

The first stage is the most important and responsible

Aspiration of the contents of the oral cavity and nasopharynx. This is done in order to free the above places from accumulations of mucus, which can interfere with the normal breathing of the baby.

Second phase

Baby. At this stage, the eyelids of the crumbs are wiped with a dry and sterile cotton swab.

Third stage

Prevention of bleeding from the umbilical cord, umbilical sepsis. Doctors apply two clamps to a certain area of ​​​​the navel and cut it with sterile scissors. The remaining wounds are treated with 96% alcohol.

Fourth stage

Prevention of pyoderma. The child's skin is treated with a cotton swab dipped in vaseline and vegetable oil to remove dirt and cheese-like grease.

Summing up

Processing an umbilical wound is a simple matter, but it requires attention from parents. After the obstetrician solemnly gave you your baby for the first time, he also gave you all the "authority" to care for the child. Do not forget about the simplest and most important steps in caring for your child. The main thing is not to be afraid! And then you will succeed!