Doctor Kozlova answers young mothers’ questions

Interview by Vladimir Nesterov. Exclusively for Vestnik Kavkaza
Doctor Kozlova answers young mothers’ questions

Vestnik Kavkaza continues a series of programs ‘Ask doctor Kozlova.’ Lyudmila Kozlova, Honoured Doctor of the Russian Federation, Honored Worker of Science, Professor, MD, deputy chairman of the Federation Council on Social Policy, the senator from Smolensk Region answers questions of TV viewers, radio listeners and readers.

- Vestnik Kavkaza received a lot of questions from viewers, listeners and readers. We systematized them and decided to dedicate our continued cycle of problems that can happen with young mothers. I read the first question: newborn children are discharged from hospital at one abroad and only after three days in Russia at least. Why do we keep babies during extra days in hospital.

- I think it's right that children are discharged from hospital after three days at least. Imagine that a child is born, he was in a comfortable environment in the womb, and suddenly he is born. His life changes cardinally: another temperature, food. A child should eat himself. A child should adapt his for new conditions. It is good when a period of adaptation takes place under the supervision of doctors: both obstetrician, and neonatologist. If a woman and a child are well, it is one thing. If they had any birth difficulties, or any complications after birth, the observation must be only in the maternity hospital. When a baby is born the umbilical cord must be cut. Sometimes umbilical remnant bleeds, then it dries up and disappears. An umbilical wound remains and it requires care and observation. The most important thing is not to allow umbilical wound to infect.

And another important thing. It is necessary to prepare for discharging a child fromhospital. Firstly, it is necessary to carry out cleaning at home in order to make everything perfectly clear. It is necessary to limit and minimize all visits, especially during the first month of life. A person can come without even knowing that he is sick. The development of childish immune system is continuing, and it still cannot protect a child from contacts with microbes and viruses. So, unwanted are not favorable at this period of time.

Another question about bathing. I would not recommend to bathe a child after hospital. But you can do it the next day, and after this you should treat an umbilical wound with alcoholic solution of brilliant green (green disinfectant), or potassium permanganate (potassium permanganate). Being discharged from the hospital a nurse and a local pediatrician should examine a child during the first day and give his parents advice on care and feeding. 

- How often a child should be bathed? 

- Is it necessary to bathe a child every day, but only with boiled water if a child is healthy? 

- One more question. Children are actively swaddled in hospitals, but I know parents, who are against swaddling after bringing a child home. So do they need to swaddle a baby? One mother writes that a child always uncovers, as it does not like it.

- This is normal, that a baby uncovers and that it doesn't like it. Swaddling has its benefits and disadvantages. When swaddling a baby doesn’t become too cold, it sleeps quietly and it won’t wake himself up with the help of hands. What I would like to draw parents’ attention? If you don’t swaddle a child on the first day, so five days later a child will got used to it and it begin to sleep quietly. And one more detail: swaddling should not be tight, it should not constrain movements.

- One of our listeners fears that nappies are very harmful, especially for boys, but they are immediately put on in hospital. When I became a father for the second time, three years ago, I had to come to the hospital with nappies. If we don’t use nappies, what to do when it is cold outside?

- Certainly, nappies are in demand now, it is very convenient, both for parents and the child, especially when they walk during a cold season, or go to the doctor, for example. But they put it off after coming back home. In most cases, children continue to wear nappies at home. The material doesn’t let air pass through, so it can lead to maceration, inflammation and infection that can penetrate into the urinary tract and cause inflammation of the bladder, and then kidneys.

- How does one potty train a child?

- If you start to train at the age of 7-9 months, then a child will definitely begin to use a pot. But it requires patience and a lot of work. Many children are born with potentially good opportunities, but a lot depends on the environment in which they are brought up. In one family a child can surprise his parents with rapid development, but the situation can differ in other families, despite the same potential. A lot of things depend on the parents. The same situation applies to the development of skills of neatness. I believe that if a child appears in a family and you consciously wanted to have a baby, it's a big job. And we need to be tolerant, educate him and impart skills of neatness. Many people think that it is necessary to potty train during the period from 12 months to 18 months, or at the age of one and a half years. The majority of children receive their first skills of neatness during this period of time. But in some situations a child may urinate in bed until they are 3-4 years old. This may be a variant of the norm, or a result of using nappies. But if a child after four years urinates in a bed, you already have to think about him being examined for the presence of disease.

- One more question, all young parents are probably faced with it. A baby cries and doesn’t sleep when his stomach aches, but doctors recommend a colonic tube. How often should it be used?

- A colonic tube should be used when the cause of concern is increased flatulence. The less you use a colonic tube the better. It should be carefully placed into the anus. It should be done in this a way: A newborn should be held by the legs and the legs should be lifted a little bit. After that, no more than 2 cm of an oiled colonic tube should be placed into the anus. The stomach needs to be stroked lightly. The process can be repeated after two hours. But if a child has increased flatulence and he is breastfed, a mother should very carefully review her food and eliminate everything that can cause increased gas production, including cabbage, especially sauerkraut. If the baby is bottle-fed, you have to choose special infant food. Pay special attention to how your baby is fed. If he is breastfed he should be given the breast in the right way, so that the child could take not only the nipple, but also the halo. In this case it will swallow less gas. If it is bottle-fed, be sure that the ring is completely filled with liquid at the time of bottle-feeding in order to avoid swallowing air. You also can give a child dill seed water, or a camomile decoction. This all contributes to reduced flatulence.

- Another question: have you tried to suck out with the help of syringe if a suckling baby has a runny nose. What to do in this case? How to treat a baby with a runny nose?

- Speaking about runny noses, it is necessary to determine if there is liquid or not. Because it can happen due to difficult nasal breathing. The cause of complicated nasal breathing may be crusts. Then it is necessary to clean with the help of a cotton swab, not sticks. If there is liquid, it is possible to use children's vasoconstrictor nasal drops, including furatsilin-adrenalin. But you should definitely consult a doctor.

If there is mucus it can be sucked out with the help of special ‘pears.’ There are a lot of various suction things in drugstores: vacuum and others.

- Is it possible to smear a baby's dummy with sugar syrup or honey if a child categorically refuses to take a baby's dummy in his mouth?

- I want to tell the parents who asked this question that you are very lucky. You have a smart kid, and if it does not take a baby's dummy, so don’t make him do this. Firstly, a child gets used to it. Secondly, it can affect the bite. Thirdly, you can bring an infection inside. When I see a child who is being transported in a wheelchair, he has such clever eyes, but he sucks a baby's dummy, I feel sorry for him. It is very difficult for a child to break the habit later. If a baby's dummy falls into the dirt on the street it can lead to intestinal infections and helminthiasis. Therefore, it is better not to use a baby's dummy at all.

- Our little girl really wants to sit, but she is only four months old. What would you recommend?

- Do not sit her up under any circumstances. She will do it herself, i.e. in six or seven months. It is necessary to massage in order to strengthen muscles. In this case a child will be able to sit up herself in six months, more or less. It is allowed. For example, some children start standing at the beginning and only then start sitting. Although the majority of children start sitting at first and then standing.

To be continued.

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