Newborn period (first month of life) is a very crucial period in one's life. If problems occur and they are not recognized and treated appropriately, there can be devastating outcome at times and the impact could be life long. For example, asphyxial injury to the brain at birth leading to cerebral palsy and mental retardation.

There are many conditions to the newborn period which appear abnormal to the mother, but may be totally normal from the medical point of view. For example, rashes over the body may be completely normal.

A new born baby may sleep for a long time if left undisturbed in the first few days of life and then becomes active. If a baby who has been active and crying for feeds, becomes sleepy or dull it is of major concern.

Superficial layers of skin may peel off or may appear dry in a post mature (baby born beyond the expected date of delivery). No treatment is required for this.

Bluish gray patches known as Mongolian spots are seen over the back. These are not of any significance and will generally fade within 10days.

Small white dots may be seen over the face especially over nose, secondary to sebaceous gland obstruction. These are known as Milia, which need no treatment.

In a female baby there may be white discharge or bleeding from the vagina which is normal and attributed to hormones. Bleeding from any other site is abnormal.

Excessive crying is commonly encountered in the newborn period, the most common cause being under feeding or hunger cry. Other causes include a wet nappy, crying before passing urine or motions. Another commonly encountered problems is a baby crying only at nights.

This disappears invariably by 2 months of age. Picking up the baby, consoling and adequate feeding and sleeping at nights without lights can bring relief. Exclusively breast-fed babies generally do not develop colic. All babies have to be burped after feeds.

All babies close their eyes during the first few days of life. It is a protective reflex.

Breast fed babies pass stools regularly without any difficulty. A baby may pass stools once a day on alternate days or every time the baby is fed. Blackish stools are seen during the first 48-72hrs followed by a watery diarrhea lasting for a day or two. This is known as transition diarrhea which does not require any treatment.

Later on, stools become yellow in color and pasty. If a baby does not pass stools with in first 24-hrs except in premature babies it is abnormal. Baby will have to be investigated to rule out a surgically correctable condition or thyroid deficiency.

Almost all babies pass urine in the first 24-hrs. If a baby does not pass urine within the first 24-hrs, it has to be investigated. Causes could be under feeding, kidney abnormalities or obstruction to the flow of urine.

Jaundice is commonly seen the newborn. There are innumerable causes for jaundice in the newborn period unlike in older children or adults. Over 70% of normal newborns develop jaundice on day 2 of life, which disappears by 10-14 days. This is known as physiological jaundice, which is most common cause for jaundice. This is due to increased red blood cell mass and immaturity of liver enzymes. If jaundice, appears within the first 24-hours of life, it is abnormal. Causes could be blood group incompatibility between the mother and the baby or infections. If jaundice, persists beyond 14-days, investigations to be done to find out the cause for jaundice. With the ever increasing population we are seeing more babies with jaundice.

Mild jaundice will settle down by itself. Exposure to sunshine might help. Jaundice can be effectively treated by phototherapy in 90 percent of the cases. Less than 10 percent require exchange blood transfusion.

Vomiting is common problem in the new born period. Many a times it is due to faulty feeding technique. In adequate burping can result in bile (greenish) it is definitely abnormal and medical attention is warranted. If a baby vomits completely and develops dehydration immediate medical attention has to be sought.

Having known the common problems or near normal situations, one should be aware of the danger signs in newborn babies which require immediate medical attention. There include convulsions, excessive vomiting especially blood or bile stained, pus collection anywhere in the body umbilicus, skin infection, conjunctivitis, bluish discoloration of the tongue, choking during feed, jaundice appearing with in first 24-hours of life delayed passage (beyond 24-hours of life) of urine or motions, breathing difficulty, fever and so on.

Almost 80-90% of newborn babies can be manages by the mothers with out much difficulty. Babies require warmth, breast-feeding, a clean hygienic atmosphere and immunizations at the appropriate time. If there is any change in the behavior, it is better to contact the medical professional at the earliest. Time is a very crucial factor in new borns with problems. Delay may cost the life or may have a long term adverse impact.