Chapter 7 Section 2 The Developing Child The Postnatal Period Chapter 7 Section 2 The Developing Child

Introduction Imagine that you are a newborn. What do you think it would feel like to find yourself in the “outside world” after being accustomed to the dark, warm, confined space of the uterus? List 5 phrases expressing the newborn’s reactions to the “outside world.”

Examining the Newborn Shortly after the delivery, the baby’s physical condition is checked using the Apgar Scale. This gives the infant a rating from 0 to 2 in each of the following areas: Heart rate Breathing Muscle tone Reflect to simulation Skin color A total score of 6-10 is normal. Lower than 6 is a sign that baby may need special medical attention.

Apgar Scale Score 1 2 Heart Rate Absent Under 100 Over 100 Breathing 1 2 Heart Rate Absent Under 100 Over 100 Breathing Slow, Irregular Good, Crying Muscle Tone Limp Some movement of extremities Active motion Responsiveness (Baby's reaction when nose is irritated) No response Grimace Cough or sneeze Color Light-Skinned Child: blue or pale Dark-Skinned Child: grayish or pale Light-Skinned Child: body pink, limbs blue Dark-Skinned Child: strong body color, grayish limbs Light-Skinned Child: completely pink Dark-Skinned Child: strong color with pink lips, palms, and soles

Examining the Newborn The Apgar evaluation is done within 1-5 minutes after birth. The baby is also weighed, measured, and cleaned up. A copy of the baby’s footprint is made for public record. Two plastic bands giving the baby’s family name are clamped to baby and Momma’s wrist/ ankle- preventing confusion later.

Later Tests Within 60 minutes of delivery- drops of antiseptic are put into baby’s eyes to protect them from infection. Vitamin K is needed to help blood clot, the body can naturally reproduce Vitamin K once it has a dosage within the system. Baby’s are given a Vitamin K shot to stimulate this process. A blood sample is also taken from the baby to determine if certain diseases or defects are present. Example: PKU & Sickle Cell Anemia

Bonding and Attachment Bonding- forming strong emotional ties between parent and child. Some medical policies have changed over time to encourage bonding. Delayed cutting of the umbilical chord and cleaning infant. Baby is immediately placed in Mother’s arms to feel skin and hear the familiar heartbeat.

Bonding and Attachment If Mother is breast-feeding she may began nursing. Colostrum- the first breast milk given to baby. This milk is easy for newborn to digest and rich in antibodies to build up baby’s immunities. Some babies require immediate medical attention, preventing Mom and Dad from bonding right away.

The Hospital Stay Birth is a big moment for Mom and baby. The newborn is adjusting to a new world. Mom needs time to adjust , rest, and recuperate. The length of time mothers and babies stay in the hospital is unique to each pair. A healthy mother and baby may go home as soon as 12 hours after birth. An average stay ranges from 2-3 days.

The Hospital Stay In the past, it was common for women to stay 4 days after a normal delivery. Some say that insurance companies have forced hospitals to release women and babies too soon. Some states have passed laws requiring insurers to pay for a minimum of 2 days if requested by the doctor. Some conditions may delay release for a few days. Jaundice- baby has yellow colored skin and white of the eyes. Caused by having too much of a certain chemical that is not yet filtered by the liver.

Rooming-In Rooming-In: arrangement in which baby stays in mother’s room day and night rather than in the hospital nursery. This allows father to visit as he wishes. Benefits: Chance to care for baby before going home. Baby can be fed whenever hungry. Family visitors can also get to know baby.

Legal Documents Birth certificate is the most important piece of personal identification that anyone has. It is required for entering school. Social Security number is needed also. This number is used as a form if identification for government tasks such as filing for taxes or participating in government programs.

Caring for Premature Babies Between 5-6% of all babies are born Premature-born before 37 weeks of development . Many weigh less than 5 pounds. These babies require special care. Some may not be ready to live outside the mother’s body. Some are placed in an Incubator- a special enclosed crib where oxygen supply, temperature, and humidity is controlled. Heart and lungs are closely monitored. Good nutrition, healthy habits, prenatal care, and an understanding of warning signs can help prevent premature birth.

Postnatal Care of the Mother Postnatal- the period after birth. A lot of attention is focused on baby. Mother has special physical and emotional needs at this time as well. Physical Needs: Rest Exercise Nutrition Medical Checkups

Postnatal Care of the Mother: Rest During the first few days and weeks it is natural to feel tired. It is best to try and sleep whenever baby does. Asking friends and family to help with household chores or caring for the baby for a few hours allows for rest time.

Postnatal Care of the Mother: Exercise Wait for doctor approval. Once mother feels able and doctor approves, she can begin mild exercise. Exercise helps the woman return to her normal figure and correct posture.

Postnatal Care of the Mother: Nutrition Eating right is just as important now as it was during pregnancy. Breast-feeding supplies babies with essential nutrients. The food you eat determines the quality of breast milk given to baby.

Postnatal Care of the Mother: Medical Checkups After about 4-6 weeks after birth, mother should go in for a postnatal checkup. Doctor will make sure that the uterus is returning to normal. This is also an opportunity for the mother to discuss any questions or concerns she has.

Emotional Needs Having a baby is a joyful, but stressful event. Many new mothers experience a few days of mild depression after the birth- “baby blues.” New fathers may have these feelings too. Talking about feelings, taking care of yourself, seeking support, getting sleep, and avoiding isolation helps parents minimize the blues. More serious or longer-lasting depression requires medical attention.

Review What is the Apgar Scale? Why is it used? Why do hospitals now delay some of the tests on newborns? What is colostrum? What are the advantages rooming-in? What issues are involved in a mother’s postnatal care?