I Noticed My Baby Was Flat, Unresponsive and Refused to Feed. We Had to Rush Back to the Hospital Where He Was Placed in the Neonatal Intensive Care Unit…

I was discharged from the hospital 48 hours after having my first baby; delivery was vaginal and uncomplicated. However, few hours at home, I noticed my baby was flat, unresponsive and refused to feed. We had to rush back to the hospital where

he was placed in the neonatal intensive care unit. Please, what could have been the cause? Do you think my baby was not properly checked before discharge?

The vast majority of normal babies remain perfectly well and start feeds while their mothers quickly take on full responsibility for their care. The challenge for health-care professionals is to spot the baby who is developing a serious illness in order to try to avert a collapse. This can be difficult: the baby who is passed as fit for discharge in the morning can deteriorate so rapidly that he requires ventilation and inotropic support by noon. Conditions that can cause such a dramatic deterioration include congenital heart disease (coarctation or hypoplastic left heart syndrome), sepsis, inborn error of metabolism, necrotizing enterocolitis or a gut volvulus, and intracranial haemorrhage.

Danger signs include fluctuating temperature; a change in activity including refusal of feed or having to be wakened for feeds; unusual skin colour, mottling, extreme pallor and jaundice on the 1st day. Others are abnormal heart rate or respiratory rate including grunting or fast breathing; apnoea; excessive jitteriness or abnormal stereotyped, repetitive movement patterns; delayed stooling (beyond 48hours) or completely dry nappies; abdominal distension, green vomit (bilious until proved otherwise); abnormal lumps or swellings; lethargy, floppiness; paucity of movement and excessive sleep.
Any of these should prompt a thorough re-examination of the baby, and if a deviation from normality is confirmed, the safest course of action is to admit the baby to the neonatal unit and initiate investigation and treatment, including a screen for infection and antibiotics treatment, without delay.

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