Hi XXXXXXX

Thanks for writing to health care magic.

I request you to not to be worried and depressed of having a preterm delivery.
In fact large number of popular personalities of the world are born preterm. Sir XXXXXXX Newton who discovered the laws of gravity, XXXXXXX Churchil who became prime minister of UK etc are only few examples. So do not worry regarding your baby.

Did your baby have any problems during NICU stay? Were there any complications like seizures, birth asphyxia, respiratory problems etc?

The rupture of membranes you had is described as preterm premature rupture of membranes. This can occur because of several causes and some times the cause cannot be identified. Decrease of collagen content of the membranes is basically responsible for this. The various causes are infection or inflammation of membranes, infection of the cervix or vagina, polyhydramnios (increased amniotic fluid causing stretching of the membranes and their rupture) or increased stretch because of multiple pregnancy, trauma, poor antenatal care in lower (because of lower socio economic status), smoking, prior preterm delivery, sexually transmitted diseases, vaginal bleeding, procedures like cerviacal cerclage and amniocentesis etc. In most of the cases causes is unknown.

• Whether Diaper use has any side effects on my baby?

If diapers are used and not changed regularly diaper rash can occur. Only thing you should ensure is that they should be changed regularly to prevent diaper rash. (The ammonia of the excreta may irritate the babies skin).

• Should I use diapers or any other method?

Diapers can be used for your baby. (I personally suggest my parents to keep the baby open when they are at home and use diapers when they travel.) Only thing that should be ensured is baby should be dry and not soiled. You may prefer to use any method of your choice.

• Can I make him sleep with me in bed?

Yes definitely. Please make him sleep along with you. This will provide warmth to the baby and also reassures the baby. Breast feeding is more successful if you make him sleep along with you.

Also you should try and follow kangaroo mother care. ( keep the baby on your naked chest and wrap him up along with you. This will increase the stimulation to the baby and provide warmth)

• Can I massage him? If yes then how?

Massage can be done to the baby. It stimulates the baby. But do a gentle massage which the baby enjoys. Gentle application of coconut oil is good enough. Do not squeeze the muscles. Be gentle. See that the baby enjoys the massage. See that baby is not exposed to cold room temperature when you undress him for a massage.

• Which cream or lotion I can use on my Baby skin to make it smooth on a regular basis?

No specific creams or lotions are required for normal babies skin. Simple coconut oil with out color or perfume applied before bath is good enough. If there is excessive dryness of the skin then aloe vera containing creams (like Venusia cream) are prescribed.

• He is passing motion every 3-4 days, is it ok or need to consult doctor?sometimes he is having constipation also, please advice

If your baby is otherwise normal then you need not worry about this part. (I already explained regarding foremilk increasing the frequency of stool)

• Should I clean his mouth every morning?If yes then how?

If a baby is top fed then gentle wiping of the oral cavity may be done. I personally feel if the baby is breast fed it is better to leave it alone.

• Can I give him water to drink? If yes then how much?

No I strongly advice you to not to give any water to your baby. Please do not do that even during hot summer.

If you have any further queries I request you to please continue asking follow up queries. (You are provided with three more follow up queries free). If you have any doubts regarding the above or any thing else please feel free to ask further queries. I will be happy to answer you.

Dr Y V Siva Sanakara Murty, M.D.(Pediatrics)
Associate Professor
Pediatrics

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Hi XXXXXXX

Thanks for your reply.

You are facing this issue mostly because of nipple confusion. A baby who is fed by a bottle is unlikely to feed on breast because of the nipple confusion. He will have to work hard while he is fed on breast and if he is fed on bottle he need not put in much effort. So feed him by spoon and glass or a palade if you will have to feed him expressed breast milk.

Do you have any problem with the nipple (like a inverted nipple or retracted nipple)? In such cases you will have to use a syringe to pull out the nipple. Every time you feed him using Expressed breast milk first try to put him on the breast and let him feed on it and then try breast feeding.

No do not go for formula.

Monitor the number of times he passes urine. If a baby is passing urine around 6 times a day he should be having sufficient milk. Other thing is baby should be sleeping around 2 to 3 hrs after feed which indicates baby is having sufficient feed. Adequate weight gain is also a good indicator of sufficient feeding but over a long term.

You should use the corrected age for checking developmental mile stones. Since your baby is born at 31 weeks you should reduce one and half months (six weeks) from his current age.

Hope I answered your query.
Please feel free to ask any further questions.

Take care.

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