Why do newborn babies have to cry?

Dr Shan Narayanan – Consultant General Paediatrician
Dr Shan Narayanan – Paediatrician

Child Health

Dr Shan looks at the care of term newborn babies in this article.

“Sometimes, the smallest things take up most room in your heart.” – Winnie the Pooh.

How true…both my boys filled my heart as soon as they “arrived”.

Arrival of a newborn brings along with it a barrage of activities and excitement. On the other hand there is a lot of stress and fatigue. Caring for a newborn is a full time job…no rest…thus support, both physical and emotional, is very important. Knowing what to expect helps to ease the anxiety and stress and gives you confidence to handle the small fragile ‘new thing’ in your life.

Babies born when the mother has completed 37 weeks of gestation are called “term babies”. Babies born earlier are “preterm babies”.

Immediate care of preterm babies varies from care of term babies. We will look at the immediate care of term newborn babies in this article.

Most newborn babies are vigorous (active + crying). About 10 per cent require some assistance and only 1 per cent need major resuscitation, that is, intubation (inserting a tube in the windpipe to ventilate), chest compression and medications to survive.

Most babies are delivered normally (vaginal delivery), while some may need instrumentation (vacuum/forceps) and others are delivered by Caesarean section. The newborn is covered with vernix caseosa.

Vernix caseosa, also known as vernix, is the waxy or cheese-like white substance found coating the skin of newborn human babies. Vernix starts developing on the baby in the womb around 18 weeks into pregnancy. It is composed of sebum, cells that have sloughed of the fetus’s skin and shed lanugo hair (first hair to be produced by fetal hair follicles).

Once the Obstetrician has delivered the baby (usually onto the mother’s abdomen) s/he, would clamp the umbilical cord and then cut it.

This is one time when everyone is “happy” when the baby cries. Without crying the mood is somber. Crying indicates a healthy newborn but WHY?

Why do newborn babies have to cryWhen the baby is in the womb the lungs are compressed and filled with fluid. Physiological changes occur as soon as the baby is born to adapt to the environment outside the womb (extrauterine environment).

In simple terms, when the baby cries, s/he takes a deep breath, called inspiratory “gasp”. This deep breath together with the contraction of the diaphragm and intercostal muscles brings about the following changes in the lungs:

  1. expansion
  2. reabsorption of fluid
  3. air rushing  in
  4. increased blood flow.

This sparks off the breathing process. HENCE EVERYONE WAITS FOR THE BABY TO CRY!!!

The baby is wrapped in a warm towel and shown to the mother. Then the weight, length and head circumference is taken. The baby is given an injection of Vitamin K (to prevent bleeding) and Hepatitis B vaccination.

The baby is then placed under a radiant warmer. When the baby is warm, s/he is bathed and fed. BCG vaccination is then given.

In the next part, I will discuss other aspects of the care of the newborn.

For more information, call Dr Shan’s clinic at Hospital Fatimah 05-546 1345 or email shaniea02@gmail.com.