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Shishu Paricharya (Neonatal Care)

Shishu Paricharya

Concept of Shishu Paricharya 

The word ‘Shishu’ means ‘Neonate’ and ‘Paricharya’ means ‘Care’. ‘Shishu Paricharya’ focuses on each and every aspect of nursing and healthy upbringing of new-borns, infants and children by holistic approach for better progeny. The neonatal care describes in detail the methods of bringing up the children, purification of mother’s breast milk, diseases arising from taking the vitiated breast milk along with their treatment.

The ayurveda new-born care includes cleaning of the vernix caseosa (ulva parimarjana), cutting of umbilical cord (naal chhedan), resuscitative measures (prana pratyagatma), bathing (snana), external oleation (pichu dharan), (cleaning of stomach by emesis (garbhodaka vamana), ingestion of gold bhasma with medhya herbs (swarnaprashan), initiation of feeding of newborn (jata karma).

Just after birth in neonatal intensive care, the baby’s vernix should be removed by using ghee and saindhava (rock salt). This care during Shishu Paricharya dries the baby, and gives sufficient tactile stimulus for breathing besides preventing hypothermia.

Why is my baby in neonatal care?

Babies are conceded into neonatal consideration for the vast majority various reasons. The fundamental purposes behind a child to be conceded are:
1. they are conceived rashly
2. they have a low birth weight
3. they have a particular ailment which needs treatment.

Methods Used to Care the New-Born

There are various steps of ayurvedic measures in neonatal intensive care. Some of them which are used in this excellent centre of neonatal care in Bangalore for Shishu Paricharya are:

1.  Ulva Parimarjan

Ulva Parimarjan means the ulva (vernix caseosa and amniotic fluid) of a baby has to be cleared immediately after birth using rock salt and ghee. Vaghbhata has a similar view. Rubbing ghee and rocksalt on the baby’s body removes vernix and gives sufficient tactile stimulus for resuscitating a baby in primary asphyxia. 

The process of drying in Shishu Paricharya produces enough stimulation to initiate effective breathing in most new-borns. Cotton swabs soaked in ghee have to be placed on the head because it makes a layer between scalp and environment preventing heat loss from the large surface area of the neonate head besides protecting it from injury.

2. Pranapratyagaman 

General measures should be undertaken immediately after the birth of new-born in Shishu Paricharya by striking the stones near the child’s ear. This can create an intense sound to stimulate the vestibulocochlear nerve, a sensory nerve to carry sensation to its nuclei situated near the respiratory centre. When this gets stimulated, the respiration will begin. 

Also, sprinkling of cold and warm water on the baby’s face is done during the neonatal care. By this, the child regains the life breath which was afflicted by the birth process.  The oxygen availability to the baby should be increased by fanning the baby with a winnowing basket made of reeds (krishna kapalika surp) creating artificial ventilation to the baby until respiration is established.

3. Mukhavishodhana 

In the neonatal care in Bangalore, the oral cavity (palate, lips, pharynx, tongue) of the new-born will be cleaned first with nail trimmed forefinger wrapped with cotton. This method of Shishu Paricharya correlates with modern technique in cleaning the oropharyngeal cavity first and then the nasal cavity to avoid aspiration of amniotic fluid, vernix, blood, meconium into the respiratory tract when baby starts breathing.

4. Naalchedana

Naalchedana for Shishu Paricharya has to be undertaken after Pranapratyagaman where the cord should be marked at an eight angular distance (approximately 25.5cm) from its root. Both the sides of this mark should be carefully occluded in neonatal care by hand and cord should be cut at this mark by ardhadhara shastra, made of iron, silver or gold. 

The cut end of cord has to be tied properly by the thread and hanged loosely with the neck. This ayurveda newborn care prevents the chances of contamination from urine, stool and oozing due to antigravity position. If suppuration of umbilical cord occurs, oil medicated by paste of lodhra, priyangu, madhuka, suradaru, haridra should be applied. 

5. Snana (Bath)

In the neonatal care in Bangalore, the baby will be massaged with the bala oil (sida cordifolia) and thereafter a bath will be given to the baby. The oil massage given for Shishu Paricharya provides insulation against heat and insensible water loss. The bala oil has an anti-inflammatory effect to remove excess mucus from the body. 

During the ayurveda newborn care, the baby will be given bath with decoction of Kshirivriksha (Ashvatha, Udumbar, Vat, etc.), Eladi gana (water of aromatic drugs) or water heated with gold or silver or warm decoction of Kapittha leaves in accordance with bala, kala and dosha of the baby. The medications used in neonatal care or Shishu Paricharya to prepare the bathing water promotes healing of the umbilical stump besides having dosha pacifying properties.

6. Jatakarma 

Jatakarma in neonatal care involves the first feeding of a baby. On the 1st day of birth, the newborn should be offered honey and ghee as first feed and from next feed the right breast has to be offered for sucking. An earthen jar which is filled with water will be impregnated with mantras and kept near the head of the child during . Honey, ghrita and Ananta should be administered thrice a day for Shishu Paricharya. 

On 2nd and 3rd day, ghrita medicated by Lakshmana has to be administered thrice a day. On the 4th day honey and ghrita should be offered twice a day in an amount of swapanitalasamitta and after that breast feeding should begin. This licking of medicine preparations for ayurveda newborn care gives an opportunity during the neonatal intensive care to assess the rooting and sucking reflex of neonate. Swarnaprashan given to the baby by honey, ghee and gold bhasma, serves the purpose of both nutrition and immunisation during Shishu Paricharya and also it has a high caloric value, giving energy to the baby.

7. Raksha Karma

Raksha Karma involves antisepsis of bedding, clothing and aseptic measures to prevent infections from surroundings. Medicinal herbs will be placed during the neonatal care in the wardroom and tied to the neonate to reduce the chances of infection as it has Rakshoghna (antimicrobial) properties. Lighting fire inside the wardroom will provide a better visibility of neonatal care or Shishu Paricharya especially at night. 

Illnesses because of inappropriate cutting of the umbilical line

Because of ill-advised treatment of the umbilical string, strange states of rope stump are portrayed.

  • In an upward direction enlarged (ayama uttundita)
  • On a level plane enlarged (vyayama uttundita)
  • Mix of both (ayama vyayama Uttundita)
  • Development of round mass or ring around the umbilicus (pindalika)

Conclusion

The measures taken for new-born care at Rajeshwari Ayurdhama indicates the wisdom regarding resuscitation, prevention of hypothermia, aspiration and early initiation of breastfeeding. 

The modern protocol for resuscitating a new-born is very similar to the methods given in Ayurveda newborn care. There is an urgent need to strengthen the ayurvedic knowledge by accepting newer approaches for Shishu Paricharya as it will be highly beneficial to new-born babies.

Read also Garbhini Paricharya

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