Chapter 6 Section 2 The Postnatal Period

Objectives Describe common hospital procedures following birth Give recommendations for the postnatal care of the mother Explain the special needs of a premature baby

Examining the Newborn Apgar Scale: a method of evaluating a newborn’s physical condition Rate scale of 0-2 in each of the 5 areas Pulse Breathing Muscle tone Reflex to stimulation Skin color

APGAR Rating 6-10 is considered normal Lower score= needs medical attention Usually given 1 minute after birth & 5 minutes after

APGAR Test A look at the APGAR test

After Birth Within 60 minutes: Drops of silver nitrate or antiseptic are given as eye drops Weighed, measured, cleaned Permanent copy of footprint is made Two bands: family name on wrist or ankles Given to baby & mother

What happens immediately after birth?

Bonding and Attachment Bonding: the process of forming lifelong emotional ties Important to begin forming soon after birth How? Focus on kangaroo care Nurse within minutes of delivery Initial supply of breast milk= colostrum Thick, clear-yellowish Rich in antibodies & nutrients

Hospital Stay Mother needs rest: has undergone huge physical change Constantly monitored Length of stay? Minimum- chance to rest, eat, and bathe As soon as 12 hours after birth Average: 2-3 days

Rooming-In Arrangement in which baby stays in the mother’s room Father may visit whenever Advantages: Homelike atmosphere Family may visit Couple may practice before going home Fed whenever

Not rooming-in? In the nursery

Birth Certificate Issued soon after baby is born Process Parents fill out form Temp certificate is issued Most important form of ID Required for entrance into school

Postnatal Care of Mother Attention is focused on baby; however mother needs just as much care to meet physical & emotional needs

Physical Needs Rest: try to sleep whenever baby does May need another relative staying with couple for several days Exercise: as soon as doctor approves Simple stretches, mild exercise Helps mother return to normal figure & correct posture

Continued… Nutrition: especially important if breast-feeding If not- still need to eat healthy to regain energy Medical checkups: 4-6 weeks after birth Postnatal checkup Make sure uterus is returning back to original size Mother can discuss any questions

Emotional Needs Joyous but stressful time Possible post-partum depression Some fathers experience these feelings as well Communication with each other, family members, or friends Arrange time together as a couple

Caring for Premature Babies Requires special care Less than 5 ½ lbs or born before 36 weeks Not ready to live outside mother’s body Reflexes, systems, breathing, sucking are not mature Placed in an incubator Special enclosed crib in which oxygen, temp, and humidity are controlled

Incubator Baby’s heart and lungs are monitored Special procedures or meds may be needed Advanced technology has improved survival rates Babies weighing as little as 1lb can survive and grow to be healthy Once healthy, they are moved to a bassinet Must be able to achieve ability to control temp and gain weight

Chapter 6 Section 3 A New Family Member

The Amazing Newborn Able to: Focus their eyes Hear Smell Vocalize Less than a day old can focus on a pattern Prefer human faces Hearing is present at birth but days a few days for fluid to clear

Sounds Respond particularly well to female voice Differentiate between pitches Cochlear Implant

Reflexes Must be able to respond involuntarily until they learn Reflexes: instinctive, automatic responses Ex: sneezing, yawning Help the baby function i.e. sneezing helps clear nose, swallowing prevents choking

Temporary Reflexes Most continue throughout lifetime Some are only temporary Rooting reflex Grasp reflex Startle reflex

Rooting Reflex Automatic response When touched on the lips or cheek, newborn will turn towards the touch and begin to suck Helps baby find food Around 4 months the reflex stops Baby is able to turn head and see bottle or breast

Rooting reflex

Grasp Reflex Automatic response of hand to close over anything that is comes in contact with the palm Often so strong that the newborn can be lifted off the bed Lets go without warning 3 months begins to reach= reflex weakens Gone by 1 year

Grasp Reflex grasp reflex

Startle Reflex Automatic physical response Legs thrown up, fingers spread, arms extended, and then brought back to the midline with the fingers close in a grasping Response to loud noise or touch on the stomach Disappears around 5 months

Startle Reflex startle to touch startle to sound

Tie it together… Neonatal Reflexes

Learning to Care for the Newborn Parents quickly gain confidence Routines Recognize baby’s needs Adapt responses to individual

What Do Babies Need?? Food: whole body communication Squirms, mouth open Crying Important to feed right away Builds trust

Babies Need: Sleep Most take short naps around the clock Wake at night 1-3 times for feeding Sleeps avg 15 hrs 6-8 sleep intervals Every baby is different

Babies Need: Kept safe, clean, and warm Medical care Diapers Bathing Baby-proofed home Medical care Periodic baby checkups throughout 1st year

Babies Need: Things to look at, touch, listen to, and play with Stimulating surroundings help babies learn Favorite thing: human face & gentle voice

Babies Need: 6. Exercise: moving arms and legs develop the baby’s nervous system 7. LOVE Babies feel secure One of the strongest forces

What Do Parents Need? Knowledge Resources Time for many roles Emotional support Financial planning Reassurance & confidence Agreement on parenting Health, rest, nutrition Privacy and time alone

Ask the Experts… Sudden Infant Death Syndrome SIDS Crib death Usually affect healthy infants between ages of 2 weeks and 6 months No warning, no cry, and no evidence of pain No cause has been discovered Extremely difficult time for parents

Adjusting to New Routines Baby needs several weeks before settling in to a pattern Parents must adjust schedule to baby’s needs Cannot “spoil” a newborn, parents are meeting their needs After a month, a fairly predictable pattern occurs

Understanding the Baby’s Language CRYING Hunger is most common Hot or cold Uncomfortable Fatigue Loneliness Parents learn to distinguish between cries

Early Temperament Style of reacting to the world and relating to others All babies are different Some are calm Some are loud Research shows Babies as early as 2 weeks adjust to parents reactions Gentle= soft cooing & motions Playful= grunts & active

Understanding Your Baby's Cues