Paralysis of the face (Bell’s paralysis) may follow the use of forceps. The prognosis is favorable. Paralysis of the nerve in the neck (musculospiral) is sometimes known as Erb’s paralysis. It happens in consequence of difficult breech deliveries or of vertex labors when much force is required to extract the shoulders.
The deltoid, biceps, and other muscles are affected so that the arm can not be raised. The failure to raise one arm will be the symptom that will attract the attention of the nurse. Some cases recover in a month or so, either spontaneously or by the aid of electricity. If not, the injured nerve must be cut down upon and its continuity restored.
Ophthalmia neonatorum is an infection of the eyes of the newborn by the gonococcus. The infection occurs as the child passes through the vagina or vulva, or when an unclean finger is put into the eye.
The reaction is violent. The discharge at first is thin, then thick, pus. If untreated, the eyesight may be lost by ulceration. In the asylums twenty-five per cent of the inmates are blind from this infection; and as late as 1896, seven per cent of the blindness in the state of New York could be traced to this avoidable disease.
The preventive treatment consists in the frequent douching of the vagina before labor with potassium permanganate solution 1:5000, or chinosol 1:1000. After labor, a drop or so, of 1 per cent solution of nitrate of silver is dropped into each eye and not neutralized.
After the infection has occurred, iced compresses are applied to the eye, night and day, and a solution of argyrol 15 to 20 per cent instilled into the outer corner, twice a day. In female infants with ophthalmia, the vagina must be watched for discharge which does not fail to appear in most cases. Argyrol (20 per cent) should be injected with a medicine dropper and left to drain out spontaneously. All dressings used about the child should be destroyed, and the nurse should use the most scrupulous cleanliness and care of her own person.
Separation of the cord may be delayed in puny babies and in cases where the cord is large and thick.
Some of these cases are doubtless due to a patency or fistulous condition of the urachus. Usually the separation may be hastened by touching the constrictured part with silver nitrate. Or, if the cord does not separate before the second week, it may be desirable to cut off the hanging fragment and touch the base with silver nitrate or dust with alum powder.
Granulations may protrude like a mulberry from the stump of the navel (“proud flesh”). These are touched with nitrate of silver stick.
Menstruation may appear occasionally from the vulva of the newborn. It is really a hæmorrhage, a menstrual flow, which is associated with uterine activity, but rarely significant. There is no treatment. It disappears spontaneously.