Patient's question:
The baby is two days old, and there have been only two urinations. The meconium, however, is quite abundant, with a total of five occurrences, all black and viscous. How can these issues be resolved, and are they normal? The baby's milk intake is 90 ML. What is the normal amount? Additionally, are there any requirements for the nipple?Doctor's answer:
Hello: Newborn kidneys have the same number of nephrons as adults at birth, but the tissues are not yet mature. The glomeruli have more cuboidal epithelial cells and fewer blood vessels, resulting in insufficient filtration area, which is only 1/4 to 1/2 of that of adults when calculated based on body surface area. The renal tubules are short and poorly developed, with limited reabsorption and secretion functions, generally only capable of maintaining normal metabolism. Due to poor urine concentration function, newborns require 2 to 3 times more water to excrete the same amount of solutes compared to adults.Ninety-three percent of normal full-term newborns begin urinating within 24 hours after birth. In the first few days after birth, due to low fluid intake, they urinate only 4 to 5 times daily. After one week, as fluid intake increases while bladder capacity remains small, daily urination can reach as many as 20 times.
Currently, both domestically and internationally, early feeding is recommended to prevent hypoglycemia and hypothermia. Full-term newborns can be breastfed within 4 to 6 hours after birth. If milk supply is insufficient, do not overly emphasize fixed schedules; instead, allow the infant to suckle as needed to stimulate milk production. If breastfeeding is indeed inadequate, a small amount of cow's milk can be given after each feeding. After feeding, the infant should be placed on their right side to observe for any spitting up or vomiting and prevent aspiration.
Premature infants are generally started on sugar water 4 to 12 hours after birth. If they tolerate two trials without vomiting, they can be switched to milk. Infants with weak sucking ability can be fed expressed breast milk using a bottle. The nipple should be soft and the hole appropriately sized. Those unable to suck can be fed using a dropper or via nasogastric feeding.
The formula for calculating milk intake is: For the first 10 days, the total daily milk intake = (actual days since birth + 10) × weight (grams) / 100. After 10 days, the daily milk intake = 1/6.