Uncomplicated

Our new baby boy is an uncomplicated little man.

Born full-term, but very small (3lb 14 oz), he arrived just hours after his birth. His blood sugar was low and he was hypothermic. Like many low birth-weight babies, Maudlin did not have enough body fat to generate heat.

A few hours later, Maudlin was in an incubator, and had taken a small milk feed. His temperature and blood sugar were both within the normal ranges. I had fully assessed him. I couldn't find a thing wrong with him.

As we warm hypothermic babies, we watch anxiously for breathing problems. Maudlin didn't have any. His lungs were clear and his heart beat was strong and regular. His muscle tone was normal, his abdomen was soft and there were no signs of infection or congenital abnormalities. I counted 10 fingers and 10 toes. He was sleepy, and he had a weak suck, but he was drinking.

So Maudlin doesn't need CPAP, or an IV, or antibiotics or even a feeding tube. You are very red, I thought, I hope you don't have polycythemia - a condition in which a high concentration of red blood cells can make newborns blood viscous. Occasionally, this can cause breathing problems and seizures. The bedside test I ran suggested that Maudlin did have a high concentration of red cells, but not high enough to cause symptoms. Maudlin was unlikely to need any special treatment, we would just have to make sure that he stayed well hydrated, so that his blood did not become too thick.

Two days after he arrived, Maudlin still has to be wakened for feeds every three hours, but he is drinking well from a bottle. Recently, we have admitted three infants with chromosomal abnormalities and we have cared for some extremely sick children. This has made me hyper vigilant. I can't help looking for problems. I am glad that in Maudlin's case I didn't find any serious or complex issues.