Neonatal Care Guide: The Newborn Chapter

1. The Newborn Chapter 6

2. When the cord is cut the newborn’s life begins • Official time of birth happens when the baby is clear of the mother’s body • Neonate – medical term for the baby from birth to one month of age

3. Great changes happen in the neonatal period • Time of adjustment for newborn and for parents

4. Plan Ahead • Plan carefully • Accept the responsibility of parenthood • Love and communicate with each other • Live one day at a time • Realize that, in time, frustrations such as sleepless nights will decrease and the joys of parenthood will increase

5. Medical Care and Testing • All newborns also need medical care for healthy development • In the hospital doctors and nurses take care of mom and the baby

6. Care for Premature Babies • Born too small or too soon • Some congenital problems • Need immediate, intensive care • Intensive care nursery (ICN) – special nursery that can provide immediate intensive care just after birth for babies who need it • Neonatal Intensive Care Units (NICU) – heated, completely enclosed beds for newborns who need intensive care

7. Neonatology – branch of medicine concerned with the care, development, and diseases of newborns

8. Apgar Test • Test that checks the baby’s chance of survival • Predicts chances of child’s survival • Baby scores 0,1,2 in 5 areas • Total score possible is a 10 • Checks baby’s pulse, breathing, muscle tone, responsiveness, skin color

9. Skin color is a sign of circulation ( least important) • Heart rate and breathing (most important) • Test is given at one minute and then 5 minutes after delivery • 5 minute score should be higher • See page 175 figure 6-3

10. Most healthy babies score 6 or 7 at 1 minute, then 8 to 10 at 5 minutes • A low score means the baby needs special medical care • Drops of silver nitrate are put into the eyes to prevent infection • Footprints are made • Namebands are placed on wrists and ankles

11. Neonatal Assessment • Brazelton Scale – used to determine whether a baby has problems interacting with the environment, handling motor processes, controlling his or her physical state, or responding to stress • Detects problems early • Early intervention

12. Brazelton Scale • Four areas: • Interaction with the environment • Motor processes • Control of physical state • Response to stress

13. Other Hospital Care • Pediatrician – doctor who cares for infants and children • Anemia – low level of oxygen-carrying substances in the blood • Phenylketornuria (PKU) – disease that can cause mental retardation if left untreated

14. Jaundice – liver condition that can make the skin, tissues, and body fluids look yellow • Place babies under bright lights • See figure 6-5 page 177

15. Well Baby Check up • Routine medical visit in which the doctor examines a baby for signs of good health and proper growth • Occurs within the first few weeks • Tests are performed

16. Physical Traits of a Newborn • Traits are on page 179 figure 6-7 • Not as cute as on television • Things that make parents nervous: • Cough/sneeze to clean out mucus • Breathe unevenly

17. Reflexes • Automatic, unlearned behaviors • Some triggered by an outside stimuli • Built in responses

18. Reflexes are Important • Clue to the health and maturity of the nervous system • Withdrawal reflex – draw their legs up when soles of feet pricked • Its absence can be sign of brain damage

19. Babies need some reflexes for survival • Touch around newborn’s cheek, mouth the baby searches for foot (rooting reflex)

20. Some reflexes lead to voluntary, learned behaviors • Sucking reflex leads to learned sucking

21. Using reflexes may give the newborn the practice needed to develop voluntary behaviors such as sitting, walking, and climbing • See more about reflexes on page 182 figure 6-8

22. Meeting the Newborn’s Physical Needs • Newborns are completely helpless • Depend on adults to meet their needs • Dependent and fragile

23. Feeding • Need nutrients to grow and stay healthy • Grow quickly • Breast-feeding • Formula feeding

24. Breast Feeding • Best first food for babies • American Academy or Pediatrics recommends breast feeding for at least the first 12 months

25. Breast Feeding Tips • Eat a balanced diet • Drink at least 8 (8oz) glasses of fluid • (milk, water, fruit or vegetable) • Check with pediatrician about giving baby supplement (iron, fluoride, vitamin D) • Realize that certain foods may upset baby • Coffee, tea, chocolate, cola, cocoa, herbal teas, artificial sweeteners

26. Tell doctors and dentists when nursing • Over the counter drugs may harm child • Rest and avoid stress • Milk supply decreases when mom is tired or stressed • Consult with a doctor, nurse or breast feeding expert for help • Use breast feeding time to bond with baby

27. Formula Feeding • Consult with doctor about the type to use • Some are cow or soy based • Report any digestive upset or rash • Formulas are available in powdered, liquid or ready to eat • Be sure water you add is boiled for 1 to 2 minutes and then cooled

28. Do not make your own formula • Feed newborns the right amount of milk as recommended • Keep utensil, bottles, nipples completely clean • Keep mixed and ready to use in fridge • Check nipples for clogs, holes • Babies don’t always finish bottles, throw it out

29. Hold and cuddle baby during feeding • Do not prop bottles • Babies can choke

30. Burping the Baby • Babies must be burped • Swallow are while sucking or crying: • Place the baby in a sitting position with a hand on collarbone under chin • Laying baby face down across your lap • Lightly pat baby’s back for 3 minutes or so • Burp baby before, midway and or after feeding

31. Clothing & Dressing • Comfortable & easy washed • Easy to put on and off • Clothes without too many ties, etc • Flame retardant • Don’t overdress babies • Quickly outgrow clothes • Borrow from friends, store first child’s clothes

32. Newborn Dressing • Put out the baby’s clothes before you begin • Support the baby’s head as you life him or her • Pull the baby’s arms and legs through the openings • Cuddle fretful babes before continuing to dress them

33. Diapering • Disposable or cloth diapers • Different brands and sizes of disposable diapers • Consider cost and convenience • Disposable required at day care centers • Some areas have diaper services (costly)

34. Prevent diaper rashes by changing baby’s diapers regularly • Bacteria grow rapidly on warm, moist, air free skin • Wash area with soap and water, expose to air and use petroleum jelly or rash ointment

35. Bathing • Faces, necks and diaper areas need cleaning • Sponge baths are recommended until navel has completely healed (3 weeks) • Leave cord alone until it is dry and loose • Wipe with cotton swab dipped in 70% rubbing alcohol 4 to 5 times a day

36. Sleeping • Average 17 hours a day • Take 7 to 8 naps a day • Firm mattress • No pillows or stuffed toys • Placed on back for sleeping to reduce SIDS—sudden infant death syndrome – in which a baby dies without warning in his or her sleep

37. SIDS • Lying face down increase SIDS risk • Side positions aren’t good either (roll onto stomach) • Becoming too hot has also been linked to SIDS • Bedding equipment on page 190 figure 6-16

38. Exercising • Important for muscle development, coordination and even relaxation • See page 191 figure 6-17

39. Scheduling • Most doctors feel newborns should feed on demand • Mom should watch for clues of hunger • Patterns develop but are likely to change • Meeting babies needs help them learn to trust the world

40. Meeting Newborn’s Intellectual Needs • More people study children’s learning, more they realize that learning begins right after birth • Parents are first teachers

41. Brain Research says about Newborns • Newborns need to be touched and cuddled, talked to and offered sensory experiences • Don’t overwhelm them • Receive food for the brain when they are alert

42. What Can Newborns Do? • Tell difference between human speech and other sounds • Will recognize parents voices over strangers • Imitation – coping actions of another person • Now we know infants do this at an earlier age

43. How Can Parents Help Their Babies Learn? • Stimulation comes from being near parents and other caregivers • Fascinated at seeing faces, hearing sounds, feeling warm and love when cuddled • Newborns enjoy looking at objects • Can’t see clearly for 3 to 4 weeks • Mobiles are useless for infant

44. Objects should be changed frequently • Grasping objects are a reflex action • Safe toys • Use colorful bed bumper pads • Wind chimes • Music

45. Meeting the Newborn’s Social-Emotional Needs • Each baby is an individual • Some like to be cuddled • Some cry a lot • Learn what your baby needs

46. Alertness of Newborns • Learn best when they are alert, inactive state • Develop warm relationships with others • With each passing week, newborns spend more tim in the alert-inactive stage • Parents can work to establish good relationship early in the newborn’s life

47. Soothing a Fussy Baby • Colic – condition which a baby has intense abdominal pain and cries inconsolably • All babies cry even when nothing is wrong • Some cry more • Some have colic • Caused by:allergies, tension, swallowing air

48. How To Sooth Baby • Rock baby in vertical position over your shoulder • Carry baby around house • Sing and play music • Take baby for a car ride

49. Meeting Parents Needs • Parenting skills don’t come automatically • They are learned • First few weeks may be difficult • Take care of yourself • Get enough sleep

50. The Need for Rest • Good rest lessens irritability and depression • Put off unnecessary chores • Sleep when baby sleeps • Take turns getting up with baby