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The care of a newborn is termed as “Navajata shishu paricharya” in [[Ayurveda]]. ‘Navajata shishu’ is a newborn baby, and ‘paricharya’ indicates the care and necessary management protocols. The atmosphere and surroundings change from intrauterine dependent life to independent external life after birth. The child has to adapt to the new changes quickly. It is essential to take care of newborns until the body systems are well adopted and developed to survive in the new world. [[Ayurveda]] classical texts include the methods and practices followed for newborn care in ancient times. The ancient practices include use of available natural resources. Hence, they can be practiced with cost effectiveness and the least medical equipments. Though the principles of care are same, the contemporary practices have changed significantly with advances in medical technology. This article deals with the analysis of these practices along with their contemporary views.  

The care of a newborn is termed as “Navajata shishu paricharya” in [[Ayurveda]]. ‘Navajata shishu’ is a newborn baby, and ‘paricharya’ indicates the care and necessary management protocols. The atmosphere and surroundings change from intrauterine dependent life to independent external life after birth. The child has to adapt to the new changes quickly. It is essential to take care of newborns until the body systems are well adopted and developed to survive in the new world. [[Ayurveda]] classical texts include the methods and practices followed for newborn care in ancient times. The ancient practices include use of available natural resources. Hence, they can be practiced with cost effectiveness and the least medical equipments. Though the principles of care are same, the contemporary practices have changed significantly with advances in medical technology. This article deals with the analysis of these practices along with their contemporary views.  

 

{{Infobox

{{Infobox

|label1 = Section/Chapter/topic

|label1 = Section/Chapter/topic

|data1 = [[Sharira]] / [[Artava]] / Menstrual disorders  

|data1 = [[Sharira]] / [[Garbha]] /Neonatal care (Navajata shishu paricharya)  

|label2 = Authors

|label2 = Authors

|data2 = Karthik K.P.¹, Anagha S.², Deole Y.S.²

|data2 = Karthik K.P.¹, Anagha S.²  

|label3 = Reviewers  

|label3 = Reviewers  

|data3 = Bhinde S.³ Basisht G.²,  

|data3 = Bhinde S.³ Basisht G.²,  

|label4 = Editor

|label4 = Editors

|data4 = Basisht G.²

|data4 = Deole Y.S.² Basisht G.²

|label5 = Affiliations

|label5 = Affiliations

|data5 = ¹ Department of Kaumarabhritya, AIIA , New Delhi,

|data5 = ¹ Department of Kaumarabhritya, A.I.I.A. , New Delhi, India

²[[Charak Samhita Research, Training and Development Centre]], I.P.G.T.& R.A., Jamnagar,

²[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar,India

³ Department of Kaumarabhritya, ITRA, Jamnagar.

³ Department of Kaumarabhritya, I.T.R.A., Jamnagar,India

|label6 = Correspondence email

|label6 = Correspondence email

|label7 = Date of first publication:

|label7 = Date of first publication:

|data7 = August 10, 2021

|data7 = August 10, 2021

|label8 = DOI

|label8 = DOI

|data8 = under process

|data8 = under process

4. A club or pestle is placed along the lower wooden beam of the door frame.

4. A club or pestle is placed along the lower wooden beam of the door frame.

5. Medicines like Acorus calamus (vacha), Saussurea lappa (kushta), Ferula asafetida (hingu), Brassica juncea (sarshapa), Linum usitatissimum  (atasi), and Allium sativum (lashuna) and other drugs that are capable of eliminating the surrounding morbidity factors (rakshoghna) are to be tied inside a cloth packet and suspended down from the upper beam of the door frame.

5. Medicines like Acorus calamus (vacha), Saussurea lappa (kushtha), Ferula asafetida (hingu), Brassica juncea (sarshapa), Linum usitatissimum  (atasi), and Allium sativum (lashuna) and other drugs that are capable of eliminating the surrounding morbidity factors (rakshoghna) are to be tied inside a cloth packet and suspended down from the upper beam of the door frame.

6. These packets are worn by the mother and child on their necks.

6. These packets are worn by the mother and child on their necks.

- Site of origin and manifestation of the disease. [Cha. Sa. Sharira Sthana 8/64]

- Site of origin and manifestation of the disease. [Cha. Sa. Sharira Sthana 8/64]

===Evaluating a sick newborn===

===Evaluating a sick newborn===

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===Fetal aspiration syndrome (ulbaka)===

===Fetal aspiration syndrome (ulbaka)===

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Due to insufficient clearing of amniotic fluid or the mucus in the throat, the nutrient fluid derived from the consumed food gets vitiation due to interaction with them. This leads to the fainting of the child with clenched fists. The child also gets afflicted by various other diseases like heart diseases, convulsions, dyspnea, cough, vomiting and fever. It is called ulbaka or ambupurna. [A.S.Uttara Sthana 2/52]

Due to insufficient clearing of amniotic fluid or the mucus in the throat, the nutrient fluid derived from the consumed food gets vitiation due to interaction with them. This leads to the fainting of the child with clenched fists. The child also gets afflicted by various other diseases like heart diseases, convulsions, dyspnea, cough, vomiting and fever. It is called ulbaka or ambupurna. [A.S. Uttara Sthana 2/52]

'''Management:''' After immediate neonatal resuscitation, the disease should be treated with principles of purification of channels (srotoshodhana) followed by palliative therapy (shamana chikitsa)

'''Management:''' After immediate neonatal resuscitation, the disease should be treated with principles of purification of channels (srotoshodhana) followed by palliative therapy (shamana chikitsa)

Daily administration of goat’s urine is recommended in this condition. It is not practiced currently. Oil massage and bathing are strictly contraindicated. A medicated ghee preparation namely “Billvadi gritam” is indicated in this condition. [A.S.Uttara Sthana 2/52]

Daily administration of goat’s urine is recommended in this condition. It is not practiced currently. Oil massage and bathing are strictly contraindicated. A medicated ghee preparation namely “Bilvadi gritam” is indicated in this condition. [A.S.Uttara Sthana 2/52]

'''Meconium aspiration syndrome'''

'''Meconium aspiration syndrome'''

The fetus passes meconium (greenish to brownish black thick secretion containing gastric contents), which may be aspirated in utero, during birth, or after birth known as “Meconium aspiration syndrome”. The meconium that has been breathed in, due to its mechanical properties, result in trapping of air inside the alveoli, and with irritant nature and toxicity, causes the inflammation of lung parenchyma, deactivation or wash-out of the surfactant and pulmonary hypertension leading to further complications. The clinical features of the condition include apnea leading to respiratory distress, suprasternal, substernal and intercostal retractions, grunting, emphysema, atelectasis, and consolidation. The management of MAS includes stomach wash, oxygen supply, thermoneutral environment, and symptomatic management. Continuous positive airway pressure, specific antibiotics, inhaled nitric oxide, and surfactant therapy constitute other therapeutic considerations.  

The fetus passes meconium (greenish to brownish black thick secretion containing gastric contents), which may be aspirated in utero, during birth, or after birth known as “Meconium aspiration syndrome”. The meconium that has been breathed in, due to its mechanical properties, result in trapping of air inside the alveoli, and with irritant nature and toxicity, causes the inflammation of lung parenchyma, deactivation or wash-out of the surfactant and pulmonary hypertension leading to further complications. The clinical features of the condition include apnea leading to respiratory distress, suprasternal, substernal and intercostal retractions, grunting, emphysema, atelectasis, and consolidation. The management of MAS includes stomach wash, oxygen supply, thermoneutral environment, and symptomatic management. Continuous positive airway pressure, specific antibiotics, inhaled nitric oxide, and surfactant therapy constitute other therapeutic considerations.<ref>Meharban Singh, Respiratory Disorders, Care of Newborn, Revised Eighth edition (2017), CBS Publishers and Distributors Pvt. Ltd., Chapter 19, Page No: 353.</ref>

</div>

</div>

===Swelling on head ( upashirshaka)===

===Swelling on head ( upashirshaka)===

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<div style="text-align:justify;">

|Extent of resolution ||Spontaneous and complete || Spontaneous, very rarely leaves elevated margins and calcifications.

|Extent of resolution ||Spontaneous and complete || Spontaneous, very rarely leaves elevated margins and calcifications.

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|Intervention || Not needed || Incision or aspiration in case of infection or hyperbilirubinemia.  

|Intervention || Not needed || Incision or aspiration in case of infection or hyperbilirubinemia.<ref>Meharban Singh, Care of the Normal Newborn, Care of Newborn, Revised Eighth edition (2017), CBS Publishers and Distributors Pvt. Ltd., Chapter 8, Page No: 163. </ref>

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===Diaper rash (gudakuttaka) ===

===Diaper rash (gudakuttaka) ===

Due to increased sweating or adhesion of feces to the anal region, coppery-colored lesion associated with itching occurs. Gudakutta in Ayurveda is also popular by other names Matrkadosha, Ahiputana, Anamika (Diaper rash or diaper dermatitis). [A. Hr. Uttara Sthana 2/69-70]

Due to increased sweating or adhesion of feces to the anal region, coppery-colored lesion associated with itching occurs. Gudakutta in Ayurveda is also popular by other names Matrkadosha, Ahiputana, Anamika (Diaper rash or diaper dermatitis). [A. Hr. Uttara Sthana 2/69-70]

• Leech therapy (raktamoshana using jaloka) in cases of redness and itching. [ A.Hr. Uttara Sthana 2/71-75]

• Leech therapy (raktamoshana using jaloka) in cases of redness and itching. [ A.Hr. Uttara Sthana 2/71-75]

Diaper dermatitis is contact eczema that results from the cumulative effect of hyperhydration of the stratum corneum due to the stagnation of urine and feces within the diaper. The friction of the diaper on the skin leads to inflammation, skin barrier dysfunction and increased vulnerability to infections. Maceration of skin, fungal infection, etc. are also seen contributive to diaper rash. It is managed by educating the parents about diaper related hygiene and topical medications like Zinc Oxide, petrolatum, Aquaphor or rarely topical steroids.

Diaper dermatitis is contact eczema that results from the cumulative effect of hyperhydration of the stratum corneum due to the stagnation of urine and feces within the diaper. The friction of the diaper on the skin leads to inflammation, skin barrier dysfunction and increased vulnerability to infections. Maceration of skin, fungal infection, etc. are also seen contributive to diaper rash. It is managed by educating the parents about diaper related hygiene and topical medications like Zinc Oxide, petrolatum, Aquaphor or rarely topical steroids.<ref>Fölster-Holst R. Differential diagnoses of diaper dermatitis. Pediatr Dermatol. 2018 Mar;35 Suppl 1:s10-s18. doi: 10.1111/pde.13484. PMID: 29596730.</ref>

   

   

Some other diseases and symptoms mentioned in Ayurveda classics, prevalent in neonates and infants are:

Some other diseases and symptoms mentioned in Ayurveda classics, prevalent in neonates and infants are:

Diseases arising due to consumption of vitiated breast milk (Ksheeralasaka, Kumarashosha)

Diseases arising due to consumption of vitiated breast milk (Ksheeralasaka, Kumarashosha)

Affliction by evil forces named Grahas is described. These conditions are similar to the present-day infections and developmental disorders due to birth trauma and other perinatal factors.

Affliction by evil forces named 'Graha' is described. These conditions are similar to the present-day infections and developmental disorders due to birth trauma and other perinatal factors.

 

==General principles of management of diseases in newborns and children==

==General principles of management of diseases in newborns and children==

The pathophysiological factors of diseases in the infant are the same as that in an adult. The difference is that body components in the infant are very immature.[ A.Hr.Uttara Sthana 1/30-31] Hence, there are restrictions in administering medicines and therapeutic procedures in children.  

 

The pathophysiological factors of diseases in the infant are the same as that in an adult. The difference is that body components in the infant are very immature.[A.Hr.Uttara Sthana 1/30-31] Hence, there are restrictions in administering medicines and therapeutic procedures in children.  

The nature of medicines used in children must be decided after considering the following factors:

The nature of medicines used in children must be decided after considering the following factors:

==Related Chapters==

==Related Chapters==

[[Jatisutriya Sharira]]

[[Jatisutriya Sharira]]

==Abbreviations==

==Abbreviations==

•  A. = Ashtanga

• Sa. = Samhita,  • Cha. = Charak, • Su. = Sushruta, •  A. = Ashtanga, • Hr. = Hridaya, • S. = Sangraha,

• Hr. = Hridaya

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• S. = Sangraha

==References==

==References:==

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