Normal Newborn

Question 1

Skin-to-skin

Answer 1

• Facilitates easiest transition for babies
• Mom has auto-regulatory mechanism which helps adjust newborn’s heart rate, temperature, and respirations
• Baby’s most well developed sense at birth is smell, babies learn very quickly who their mothers are by scent of their skin

Question 2

Newborn assessment - APGAR

Answer 2

• Assessment of how ell baby is adjusting to extrauterine life
• Infants with APGARs below 7 often need some assistance initially
• As long as umbilical cord is intact and pulsating, baby is receiving oxygen
• Current recommendation of ACOG and AAP is to not cut cord for a minimum of 2 minutes after birth so baby will receive it’s share of blood from placenta

Question 3

Newborn procedures

Answer 3

• Initial assessment by nursery staff which can be done any time within first 1-2 hours after birth
• Weight and measurements are done, they can be done at any time
• Vital signs can be done while baby is in mother’s arms
• Bathing should not be done until baby is at least one hour old and can be done at mom’s bedside

Question 4

Newborn medications - Prophylactic Erythromycin

Answer 4

• Eye ointment is sate law in every sate and is given to prevent serious damage from venereal disease but parents may refuse

Question 5

Newborn medications - Vitamin K

Answer 5

• injection is given to aid in blood clotting and is law in some sates but not all states and may be refused

Question 6

Newborn medications - Hepatitis B vaccine

Answer 6

• Is not required at birth in any state. It is intended to prevent hepatitis infection in babies who are in high risk living situations. Series of three injections must be given to assure immunity. Parents may refuse this at time of birth

Question 7

Newborn Jaundice

Answer 7

• Result of breakdown of red blood cells
• Biliruben is by-product of red cell breakdown and is eliminated by liver, kidneys and bowel
• Premature babies and babies with bruising from birth will have higher levels
• Babies who breastfeed in first hour have much lower incidence than babies that do not
• Moms who are Rh negative have infants with higher risk jaundice

Question 8

Newborn Jaundice - Symptoms

Answer 8

• Yellowish skin tone
• Poor appetite
• Dark colored urine
• Temperature instability
• Lethargy

Question 9

Newborn Jaundice - Treatment

Answer 9

• Frequent feedings
• Phototherapy with ultraviolet lights, IV therapy if servere
• Bili blanket which can be used at home

Question 10

Colic

Answer 10

• Most babies do not have reflux but are often treated for it
• Natural methods of treating upset include Gripe Water, or Minty Ginger
• Most “colic” is relieved by 3-4 weeks
• Use upright positions after feedings
• Baby Zantac is often prescribed

Question 11

Dr. Harvey Karp’s 5 S’s

Answer 11

• Swaddle
• Side-lying
• Shushing - white noise
• Swaying
• Sucking

Question 12

Breastfeeding - Advantages

Answer 12

• Antibodies for baby are provided in colostrum
• Perfect food for baby in both amount and nutrition
• Baby is less likely to develop allergies in life
• Breastfeeding is economical
• Breastfeeding aids in postpartum recovery
• Women who breastfeed for one year (total for all children) have reduced incidence of breast and ovarian cancer of 40%
• Breastfeeding is recommended as “Gold Standard” by AAP
• AAP recommends that infants breastfeed exclusively for at least 6 mo.

Question 13

Breastfeeding - Disadvantages

Answer 13

• Time consuming
• Pain and soreness if mother uses improper positioning
• Breastfeeding is natural process but it is learned skill mother’s babies
• Mom with previous breast surgery may have difficulties with milk supply (breast reductions have most difficulty)

Question 14

Getting started breastfeeding

Answer 14

• Attend breastfeeding class and LLL group meetings prenatally
• Assess breasts for flat or inverted nipples
• Know resources for support in your community
• Breastfeed in 1 hour after birth if at all possible
• Baby-led breastfeeding and feeding on demand is best and decreases engorgement
• If pain occurs with a feeding seek information and support from professional immediately
• Keep baby tummy to tummy and use variety of positions
• Observe baby’s cues for nursing and listen for audible swallowing

Question 15

Birth practices that may affect breastfeeding

Answer 15

• Significant fluid retention associated with use of Pitocin
• Excessive IV fluids during labor and birth
• Instrument delivery such as with forceps or vacuum may increase mom’s pain and impair breastfeeding
• Trauma to baby’s head and neck may make breastfeeding painful

Question 16

Formula Feeding Advantages

Answer 16

• Baby can be fed by anyone
• You always know how much formula baby has taken
• Some fathers/partners enjoy being able to feed baby
• Feeding can be done anywhere without embarrassment

Question 17

Formula Feeding Disadvantages

Answer 17

• Artificial milk is expensive and if baby requires special formula it is extremely expensive
• There is preparation time and supplies must be taken wherever you go
• Babies may react to differences in water in different locations
• Artificial milk is more likely to stain clothing
• There is more of an odor from soiled diapers or fit baby spits up
• Formula babies may experience more illnesses and allergies

Question 18

Developmental Concerns

Answer 18

• Baby must be held for all feedings
• DO NOT prop bottles
• Change positions when feeding baby, switch sides to stimulate both sides of baby’s brain
• Talk and engage baby during feedings