Care of newborn by Ayurveda: Care of newborn by Ayurveda Presented by Dr Ravi Shankar Khatri JR III Department of Bal Roga F.O.A IMS BHU Supervisor Dr B. M. Singh(HOD) Department of Bal R oga F.O.A IMS BHU Introduction Care of Newborn deals with various aspects related to newborn like resuscitation, feeding, protective measures and general care. These are the original contributions of Ayurvedic Acharyas like Caraka, Susruta and Vagbhatta etc, though the concepts are also available in Buddhist and Jain literature. : Introduction Care of Newborn deals with various aspects related to newborn like resuscitation, feeding, protective measures and general care. These are the original contributions of Ayurvedic Acharyas like Caraka , Susruta and Vagbhatta etc, though the concepts are also available in Buddhist and Jain literature . Navjat Sishu Parichariya: Navjat Sishu Parichariya Charak Sushruta Vagbhtta pranapraytyagamna Mukh vishodhan Ulva parimarjan sanan Picchu dharan pranapraytyagamna Mukh visodhan Nal chedan Nal chedan Garbhidhak vaman Jat karma sanan Nal chedan sanan Picchu dharan Jat karma Suvarna parasan Rksha karma Garbhidhak vaman Jat karma Care of Newborn: Care of Newborn Divided into two types: 1. Immediate care 2. General care Immediate care of new born: Immediate care of new born Resuscitation of normal new born & unconscious or asphyxiated baby. B. Cutting of umbilical cord General Care : General Care Ulvaparimarjana and Bath Feeding Rakasha karma Kumaragar: Kumaragar Ayurveda has mentioned to give dhoopan ( anti infective method by giving the smoke of herbs in the room). Room should be warm , either fire was kept lighting in the room. Now a days room Radiant warmer are available. These are measures to protect from infective germs and harsh weather . Properties of Bala oil: Properties of Bala oil Once the baby is properly cleaned, the brahma-randhra (anterior fontanel) should be protected by putting a cotton pad soaked in Bala tail. The importance of Bala oil is to prevent hypothermia by conduction. Because it makes a layer between scalp & environment and large surface area of babies compared to their weight the head constitutes a significant portion of the newborn surface area can be a source of great heat loss. Oropharyngeal Cleaning (C.S.Sa.8/44-46, S.S.Sa.10/11-12) : Oropharyngeal Cleaning (C.S.Sa.8/44-46, S.S.Sa.10/11-12) Cleaning of oral cavity (including palate, lips & tongue) the attending pediatrician should properly clean finger, nails already trimmed and finger must be wrapped by cotton. For removal of swallowed grbhaodka , emesis should be induced by administering ghrta mixed with saindhva to new born. This process is similar to oropharyngeal cleaning in which the secretion present in nose & mouth of baby is removed by mucus sucker to prevent aspiration. Sign & Symptoms of Asphyxiated Baby (A.H.Utt.1/3-4 ) : Sign & Symptoms of Asphyxiated Baby (A.H.Utt.1/3-4 ) If the baby dose not respond by previous mention methods and showing these signs: Atiprabal moha (Deep unconsciousness): severely asphyxiated baby is either deeply stuporous or in coma and has marked hypotonia or flaccidity and exhibits little spontaneous limb movement. Klesanuroop rodhan asmarthata (No cry even after deep stimulation): due to absence of tone in vocal cord . Sign & Symptoms of Asphyxiated Baby cont.: Sign & Symptoms of Asphyxiated Baby cont. 4. Anavastitha deha dhatus (decreased or unstable dhatus ): It can be referred poor oxygenation of blood or poor cardiac out put due to cardio-respiratory failure. 5. Kar , vastra , shpars asaha : hypersensitivity of the pain is sign of moderate hypoxia. 6. Maranav anubhavato (dyeing like appearance) Management (C.S.Sa.8/42-46, ) : Management (C.S.Sa.8/42-46, ) Sound should be produced by striking or by rubbing two stone together near the base of newborn. Hot or cold water should be sprinkled over face of the child. Then fanning with winnowing basket made of krsnakapalia surp should be done till the baby completely revives. This provides artificial ventilation and optic stimulation to the baby. Vagbhatta add mantra uccharana in the right ear of the newborn along with this process. (A.S.Utt.1/4, A.H.Utt.1/3-4) PowerPoint Presentation: Area of brain Sound Stimulation Travel Pathway: organ of corti generate sound stimulus → → Cochlear nuclei cochlear nerve spiral ganglion ↓ ← ← lateral leminiscus Inferior colliculus Medial Fore brain bundle Area 41,42 of angular gyrus Medial Geniculate Body → → Kollikerfuse inspiratory nuclei Longitudinal reticular fibres of brain stem Initiate respiration ← ↓ ↓ Striking of stone Sound Stimulation Travel Pathway A conceptual analysis of ancient Indian resuscitative measures by P. S. Upadhyay , B. M. Singh, G. Singh, Sangyaharan shodh Feb. 2006 vol. 9 number 1 Sprinkling of hot / cold water over face in Initiate respiration in following pathway : Dorsal nuclear column Gracilus Cuneatus Facial nerve stimulated → → Ventro Postero Lateral Thalamus Medial leminscus ↓ ← ← Project 3,2,1 Area of cortex Medial Fore brain bundle → Kollikerfuse nucleus, pneumotaxic centre, Inspiratory nuclei in Longitudinal reticular fibres of brain stem Initiate respiration ↓ Hot/cold tactile sensory stimuli Sprinkling of hot / cold water over face in Initiate respiration in following pathway ← A conceptual analysis of ancient Indian resuscitative measures by P. S. Upadhyay , B. M. Singh, G. Singh, Sangyaharan shodh Feb. 2006 vol. 9 number 1 Optic Stimulation Pathway: Stimulate optic nerve Light reflex reaches retina → → Lateral Geniculate Body Optic tract Impulse passage optic chiasma ↓ ← ← Optic radiation Medial Fore brain bundle Optic parastriate area 18, 19 Optic striate area 17 → → Kollikerfuse inspiratory nuclei Longitudinal reticular fibres of brain stem Initiate respiration ← ↓ ↓ Winnowing of Black basket Optic Stimulation Pathway Frontal cortex → A conceptual analysis of ancient Indian resuscitative measures by P. S. Upadhyay , B. M. Singh, G. Singh, Sangyaharan shodh Feb. 2006 vol. 9 number 1 Nabhinal Kartan (Cutting of cord): Nabhinal Kartan (Cutting of cord) Umbilical cord is cut above 4 ( Vag .) or 8 (Cha. & Su.) angul from base of the cord. The cut end of the cord should be tied properly by the thread and hanged with the neck. Dalhan explains that hanging of cord in the neck prevent the oozing of blood from it. S.s.sa 10/11 dalhan comment This will prevent the chances of contamination from urine and stool and oozing due to antigravity position. Ulva Parimarjan: Ulva Parimarjan 1 st ulva parimarjan done with saindhav & ghrta Then massage with Bala oil. According to Ayurveda ‘ Bala ’ balances all the doshas – vata , pitta , kapha . It has more effect on vata dosha . “ Balatitikta madhura pittatisaranasani balaviryaprada pustikapharogavisodhani .” – Rajanighantu . Bala oil can be used orally, externally for massage and for giving enema ( basti ) also. bala is the best nervine tonic and rasayana for all kinds of vata disorders. It is also rejuvenative , nutritive and stimulant to the heart . Bath : Bath Bath should be given when baby is stable ( prtyaagatprana , prakritibhutsmiksha ) The baby should be given a bath with leukwarm water medicated with decoction of the barks of KsheeriVruksha ( Asvath , Udumbar , vat), The herbs help to prevent infection. Fragrant herbs like Sandalwood and also uses water warmed by dipping hot gold or silver rods in it. Bath should be given keeping in view the kala , vitiation & bala of the baby. Bath cont…. Dhalhana has mentioned specific condition for the use of different type of water. (S.S.Sa.10/12): Bath cont…. Dhalhana has mentioned specific condition for the use of different type of water. (S.S.Sa.10/12) Type of water Decoction of ksiri vrkash Sarvagandhodhaka Heated gold & silver rod water Decoction of kapitha Condition - dominance of Pitta - dominance of vata - less strength of the baby. - less strength of the Properties of Bathing drugs : Properties of Bathing drugs The aqueous extract of bark of ficus religiosa has an antibacterial activity against Staphylococcus aureus and Escherichia coli . www.indian-herbs-exporters.com/_ ficus _ religiosa .html The extracts of barks of Ficus religiosa L. and Ficus bengalensis L., were subjected for antibacterial activity against Enterotoxignic E.coli (ETEC) at 200mg/ml concentration by disc diffusion method. Uma , B.*, Prabhakar , K. and Rajendran , S. Division of Microbiology, Rajah Muthiah Medical College and Hospital, The stem bark of Flemingia paniculata showed significant activities against Staphylococcus aureus . M. Mukhlesur Rahman ab ; Alexander et.al. UK b Dept of Pharmacy, University of Rajshahi , Bangladesh c School of Biomedical Sciences, University of Ulster, Northern Ireland, UK 01 May 2008 Feeding : Feeding According to Charak on 1 st day of birth baby should be offered honey and ghrta as first feed and from next feed right breast should be offered for sucking. According to Charak breast feed should be start as soon as on first day of birth. (C.S.Sa.8/46) Sushruta (Su.S.Sa.10/14) and Vagbhatta (A.S.utt.1/12) says that On 1 st day honey and ghrta should mixed with ananata (gold/ ananta ) three times in a day On 2 nd & 3 rd day ghrta medicated by laksamana three times a day. On 4 th day mudhu and ghrta should be offer two in a day in baby’s palm full quantity and after that breast feeding should be started . Properties of honey: Properties of honey The removal of damaged connective tissue and cell debris resulting from infection or injury The killing and removal pathogens It contains an enzyme that produces hydrogen peroxide which is believed to be the main reason for the antimicrobial activity of honey. Formation of new blood vessels Stimulation of fibroblast proliferation that results in collagen biosynthesis that gives rise to the remodelling of connective tissue. Honey’s antioxidants help to eliminate free radicals in the body, they are also part of the nutrient supply for growth of new tissue. http://www.benefits-of-honey.com/honey-properties.html Carbohydrate Composition of Honey: Carbohydrate Composition of Honey Fructose (%) 38.38 Glucose (%) 30.31 Reducing Sugars (%) 76.65 Sucrose (%) 1.31 Fructose/Glucose Ratio 1.23 one tablespoon of honey contains 17 grams of carbohydrates and 64 calories (kcal). ( N a t i o n a l H o n e y B o a r d • ( 3 0 3 ) 7 7 6 - 2 3 3 7 • w w w . n h b . o r g • P a g e ¼) Properties of Ghrta: Properties of Ghrta Ghrta has appreciable amounts of butyric acid, used by the colon as an energy source. Lauric acid, a medium chain fatty acid, is a potent antimicrobial and antifungal substance. Ghrta also contains conjugated linoleic acid (CLA) which gives excellent protection against cancer. It also has small, but equal, amounts of omega 3 and 6 fatty acids, the so-called essential fatty acids. Ghrta is a rich source of easily absorbed vitamin A, Butter also contains all the other fat-soluble vitamins (E, K, and D). Calorie value of ghrta 900 kcal./100g by Stephen Byrnes, ND, RNCP Protective measures (Raksha karma) (A.S.Utt.1/16-19): Protective measures ( Raksha karma) (A.S.Utt.1/16-19) To protect the newborn from influence of various evil power(infections) Khadir karkandhu pilu prushka brak is hang in the kumaragar . Dhupan should be done by gugglu , agru , sarjrasa , gaura sarspa . Small pockets containing higu , vacha & turushak should be tied in the hand & neck of child. Tila , Atasi , sarsapa and kana should be scattered all around. Properties of Raksha karma drugs: Properties of Raksha karma drugs Antibacterial property of Acacia catechu against Pseudomonas, Staphylococcus aureus Jayshree D. Patel1, Vipin Kumar1, and Shreyas A. Bhatt2 Antimicrobial activity of mustard essential oil against Escherichia coli O157:H7 and Salmonella typhi Mélanie Turgis , Jaejoon Han , Stéphane Caillet and Monique Lacroix The ethanolic extract of Zizyphus sativa Gaertn (Syn. = Z. jujuba Mill.) fruit has been screened for anti-inflammatory, analgesic, antipyretic, bronchodilator and antimicrobial activities. Arif H. Shah, Abdullah M. Ai- Bekairi , Shoeb Qureshi , Abdulrehman M. Ageel The essential oil, chloroform extract and seven sesquiterpenoids compounds newly isolated from the oleo-gum-resin of Commiphora mukul showed a wide range of inhibiting activity against both Gram (+) and Gram (−) bacteria. M. Asif Saeed , and A. W. Sabir Department of Pharmacy, University of the Punjab ( Allama Iqbal Campus), Lahore-54000, Pakistan Properties of Raksha karma drugs cont……: Properties of Raksha karma drugs cont…… Acorus calamus Linn. rhizomes was investigated for its antimicrobial activities o various microorganisms including bacteria, yeasts and filamentous fungi. Phongpaichit , S., Pujenjob , N., Rukachaisirikul , V. and Ongsakul , M. Songklanakarin J. Sci . Technol ., 2005, 27(Suppl. 2) : 517-523 Phytochemical and antimicrobial screening of extractsof Aquilaria agallocha Roxb.aginst S. fleximenia B. Brevis P.aeroginosa B. Subtilis Manasi Dash1*, Jayanta Kumar Patra2, Prasanna Priyadarshini Panda2 Norditerpenoid alkaloids from the roots of Aconitum heterophyllum Wall with antibacterial activity Authors: Manzoor Ahmad a ; Waqar Ahmad b ; Mansoor Ahmad b ; Muhammad Zeeshan a ; Obaidullah c ; Farzana Shaheen a Care of child on Sasthi Ratri (A.S.Utt.1/26, A.S.Utt.1/21) : Care of child on Sasthi Ratri (A.S.Utt.1/26, A.S.Utt.1/21) Vagabhatta says that on 6 th night of birth of the newborn, all family members and friends remain awaken and rakasa -karma should be performed by offering sacrifices. Ancient scholars have observed very closely about the most crucial period of infancy and marked it up to six days. Care of 6 th night indicate that from birth to 6 th days period, babies are most susceptible to various infections and other complication. After one week, the incidence of infections and complication reduce, therefore the chance of survival increase.