Chapter 6 preparing for birth Section 6-3 The postnatal period

What can new parents do to bond with their baby? Why is bonding important to a baby’s development?

Bonding In recent years, many researchers have devoted attention to the emotional needs of the newborn They have emphasized bonding- forming emotional ties between parents and child Most hospitals now delay some of the routine procedures after birth (if no complications) and let the parents hold the child and begin forming an attachment- Immediately following birth, nurses may place the baby on the mother’s abdomen to feel the warmth of her skin and to hear her voice and the heartbeat that became so familiar in the uterus

Bonding (continued…) Many fathers also examine their newborn’s tiny toes and fingers Parents usually begin touching and talking to the baby, looking into the baby’s eyes and stroking the baby’s cheeks The newborn instinctively focuses on the human face, which in turn helps the newborn bond

Bonding (continued…) Research has shown the newborns are even drawn toward rough sketches of the human face Bonding also helps a baby’s brain development- during first year, baby’s brain cells are making millions of connections in the brain Through simple bonding interactions (such as holding, rocking, or singing to baby) parents help strengthen development of baby’s brain

Bonding (continued…) If baby will be breast-fed, mother may begin nursing the baby right away Newborns are born with strong sucking reflex and are usually alert immediately after delivery Breast-feeding is important because each feeding session stimulates mother’s body to continue producing milk Early feeding also helps uterus contract after birth, stopping any bleeding High-calorie, high-protein early breast-milk (colostrum) satisfies baby’s appetite and provides protection from illnesses

How can mothers bond with baby? How can fathers bond with baby? Bonding (continued…) How can mothers bond with baby? How can fathers bond with baby? How can siblings bond with baby?

The hospital stay Neonatal period (first month after baby is born) involves major adjustments for mother and baby Labor and delivery are tiring, so mother and baby need time to rest and recover In some facilities (like alternative birth centers) a healthy mother and baby may go home as soon as 12 hours after birth In hospitals, average stay is about 2 1/2 days Average stay in hospital has actually risen slightly in recent years

The hospital stay (continued…) Jaundice, a condition that occurs in over 50% of newborns, causes baby’s skin and eyes to look slightly yellow- occurs when liver can’t remove bilirubin, a substance produced by breakdown of red blood cells. Baby’s body might be producing too much bilirubin, or baby’s liver (which is still developing) isn’t able to remover it quickly enough. If left untreated, jaundice can damage the central nervous system. In hospital, doctors may prescribe phototherapy- the use of ultraviolet light to help the liver do its job. Sometimes the treatment is continued at home.

Help with feeding All babies lose weight during first few days of life, but gain it back later. By third or fourth day, breast-feeding mothers begin producing more milk. Some mothers may have difficulty with breast- or bottle-feeding. Parents can get help with feedings while they are still in the hospital. Many hospitals offer lactation consultants (professional breast- feeding specialists) who show mothers how to encourage adequate milk and how to position babies properly so that they can nurse. Nurses can also help.

Help with feeding (continued…) During the first few days of life, some babies are too sleepy to eat. To wake them, mothers can try unwrapping their baby to expose them to the air in the room. A little stimulation, such as a light massage, can also wake the baby for a feeding.

Rooming-IN Many hospitals offer the option of full or partial rooming-in. Full= baby remains with mother in her room during entire hospital stay Partial= baby stays in nursery part of the time, such as during the night- but mother can ask that the baby be brought to their rooms for night feedings Hospitals that offer rooming-in generally allow father to visit whenever he wishes Rooming in has advantages for entire family- babies have one main caregiver (usually a nurse) so they seem to cry less, mother gets more rest and doesn’t worry about baby in nursery, parents start learning how to take care of babies right away

What legal documents are needed for babies? Why are they needed?

Legal documents Birth certificate Most important piece of personal identification anyone has- required for enrollment in school and other important things (driver’s license) Parents fill out a form in hospital or birthing center and temporary one is issued- Several weeks later parents receive copy of birth certificate, while another is sent to a government office to be filed. Social Security number Recommended to get within first year, but best to get ASAP Hospitals provide paperwork, parents must fill it out Once child has Social Security number parents can claim income tax exemption, obtain medical coverage, and take part in government programs

Caring for premature babies Premature babies- born before 37 weeks Many preemies spend time in hospital’s neonatal intensive care unit (NICU), which has special equipment and highly trained nurses- but not all hospitals have (in many areas, babies are transferred to a large hospital that has a NICU

Caring for premature babies (continued…) Premature babies stay in hospital until their internal organs develop enough to function independently- may take anywhere from a few days to a month or more Preemies usually fed through a tube in stomach because they lack the ability to coordinate sucking and swallowing milk Breathing machines used to help immature lungs NICU also cares for newborns with other serious medical conditions

Caring for premature babies (continued…) Outlook for premature babies has improved significantly over the years, but there is still an increased risk of medical and developmental problems (long-term difficulties such as cerebral palsy and developmental delays) How well a premature baby thrives often depends on how close baby was born to actual due date- more premature=more risks (babies born between 23 and 26 weeks have highest risk, decrease in risk for babies born between 28 and 30 weeks)

Caring for premature babies (continued…) As premature babies grow, doctors determine when they can leave incubator and move to open crib When preemies can breathe without a machine, drink, maintain a steady body temperature, and maintain a weight of 5 pounds or more, they can leave hospital unless other problems require a longer stay Preemies need constant monitoring, which can disrupt parent-child bonding If baby is extremely premature, parents may touch them through openings in incubator As babies grow, parents can hold, sing, talk to, and bathe them Contact with babies helps them develop more quickly

What kind of postnatal care do mothers need? What are some things they should do?

Postnatal care for the mother Mother has special needs during postnatal period Mother might be physically exhausted after birth, but is now responsible for well-being of newborn- Nurses will explain how mother can care for herself and new baby Mothers who give birth by cesarean section have a longer recovery time since they have had major surgery

Postnatal care for the mother (continued...) Physical Needs Recovery from pregnancy and birth takes time New mother’s hormone levels change and sleep may be interrupted by feedings- Breast- feeding mothers experience additional changes related to producing milk

Postnatal care for the mother (continued...) Physical Needs (continued…) Women who have had a c-section require additional care (generally required to stay in hospital longer and will be more fatigued) Rest- During first few weeks new mother may be tired- She should try to sleep when baby is sleeping- Relatives and friends can help by preparing meals, offering to do household chores, and helping care for baby Exercise- With physicians approval new mother can begin to exercise gently- Stretching and walking short distances can help her lose weight and feel more energetic

Postnatal care for the mother (continued...) Physical Needs (continued…) Good Nutrition- eating right is important- Should follow guidelines for healthy eating- Breast-feeding mothers are naturally hungrier and require more nutrients because they’re taking in nutrients for their own bodies and baby’s (Need about 300 more calories than before birth)- Breast-feeding mothers also need plenty of fluids Medical Checkups- Woman should have postnatal checkup four to six weeks after birth- Doctor makes sure uterus is returning to normal and there are no other problems

Postnatal care for the mother (continued...) Emotional Needs Many women feel confused a few days after birth Some women have mood swings- These “baby blues” are very common- Mother may cry for no reason, feel anxious, feel irritable, feel lonely, feel anxious, feel sad Joining a support group for new mothers or talking with other new mothers often helps

Postnatal care for the mother (continued...) Emotional Needs (continued…) A small percentage of new mothers experience these symptoms to a greater degree- these “blues” don’t go away, but worsen Symptoms of postpartum depression may include feeling sad or crying a lot, having no energy, being overly anxious about baby, having little interest in baby, or thinking of causing harm to themselves or baby Treatment is available for postpartum depression- Very important for women who have symptoms to talk to doctor about treatment (don’t be embarrassed) Talking to therapist can help, as well as medication