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Predictable Newborn Patterns

Predictable Newborn Patterns. Birth & Beyond California: Breastfeeding Training & QI Project With funding from the federal Title V Block Grant. Objectives. Identify three infant states of consciousness Identify nursing responses and interventions Infant is sleepy, difficult to awaken

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Predictable Newborn Patterns

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  1. Predictable Newborn Patterns Birth & Beyond California: Breastfeeding Training & QI Project With funding from the federal Title V Block Grant

  2. Objectives • Identify three infant states of consciousness • Identify nursing responses and interventions • Infant is sleepy, difficult to awaken • Infant is crying, difficult to soothe • Describe the normal infant feeding pattern • Identify three infant feeding cues • Describe practices that maximize infant behaviors in the first hours and days of an infant’s life 2

  3. Infant States Two Sleep States Transition State Three Awake States Thoman, Early development of sleeping behavior in infants, 1975

  4. Latch 1,2,3Troubleshooting Breastfeeding in the Early Weeks The Healthy Children Project 4

  5. The Interactive Baby State Infants breastfeed and families bond during the Quiet Alert State De Chateau, Develop Med Child Neurol, 1977 5

  6. Predictable Infant Responses To wake a sleeping baby To calm a crying baby 6

  7. Predictable Infant Responses Variety to awaken Repetition to soothe 7

  8. Predictable Infant Responses • Variety to awaken • Skin to skin • Rubbing • Patting • Humming • Singing • Talking • Diaper off • Cool cloth • Eye to eye • Visitors removed • Others? • Repetition to soothe • Skin to skin • Humming • Singing • Swaddling • Rocking • Walking • Visitors removed • Others? 8

  9. Why Do Some Moms Not Know How to Quiet or Wake Their Baby? “The Lost Art” 9

  10. Societal Shift: From Villages to Nuclear Families Compartmentalized System Vertical System 10

  11. Activity:Newborn Infant Feeding Pattern Sleep/Wake Cycling Effect on Infant Feeding Pattern 11

  12. 12

  13. Baby A Q4H 2 X X Q2H 2 X X Q1/2H 8 X X X X X X X X 13

  14. The Normal Infant Feeding Pattern is Cluster Feeding • Feeding pattern characterized by closely bunched feedings • May be followed by extended periods of sleep • Normal newborn feeding behavior • Usually starts on second night • Often interpreted as sign of insufficient milk 14

  15. Baby’s Second Night Baby misses the habitat of the womb Mother’s chest is the new “habitat” Baby’s second night pattern: Feed – Snuggle – Sleep Newborn sleep cycle: Drowsy – Active Sleep – Quiet Sleep 15

  16. Feeding Cues Soft sounds: grunts Wiggling Hand to mouth Lip smacking Sucking motions Rooting 16

  17. Feeding Cues CRYING is a LATE feeding cue! 17

  18. How Often Should I Feed My Baby? If she opens her mouth, bring her to the breast to latch on She needs all the colostrum she can get Your breasts need as much stimulation as possible to establish a good milk supply Take every opportunity – no matter how short 18

  19. Recommended NewbornFeeding Frequency “During the early weeks of breastfeeding, mothers should be encouraged to have (at least) 8 to 12 feedings at the breast every 24 hours, offering the breast whenever the infant shows early signs of hunger…” AAP Breastfeeding Policy Statement, Pediatrics, 2005 19

  20. Definition of a Feeding Baby actively initiates suckle Baby has a wide gaping mouth Baby’s jaw glides Baby’s swallow is audible Baby ends the feeding Baby is satisfied 20

  21. When Left Skin-to-Skin in the First Hours After Birth Lifts head and lunges to breast Searching behaviors Ability to self attach Klaus, Your Amazing Newborn, 1998 21

  22. Breastfeeding: Baby’s Choice 22

  23. Maximizing Infant Behaviors: Immediately Following Birth AAP Breastfeeding Policy Statement, Pediatrics, 2005 Skin-to-skin Allow familiarization time Do not rush breastfeeding Delay bath and procedures 23

  24. Maximizing Infant Behaviors: The First Few Days Skin-to-skin Allow babies to “re-boot” if needed Encourage and explain cluster feeding Refer babies who “refuse” the breast to the lactation consultant 24

  25. Amazing Talents of the Newborn: A Video Guide for Health Care Professionals and Parents Video provided by Marshall Klaus, MD 25

  26. Babies Need Their Hands Hands help to initiate feeding and to soothe Take off the blanket Take off the mittens 26

  27. Let the Baby Do It The breast is home 27

  28. Summary • Newborns have predictable sleep-wake cycles and feeding patterns • Parents may need to be taught: • What feeding cues are and when to feed the baby • The normal pattern of cluster feeding • Interventions to wake a sleepy baby • Interventions to calm a crying baby 28

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