Medical Care and Testing of Newborns and Post-Partum Mom

1. Medical Care and Testing of Newborns and Post-Partum Mom Child Development

2. Neonate A Neonate is a baby from birth (when the baby is clear of the mother’s body) to one month old. The newborn is exposed to light, sound, breathing on their own, securing food on their own, and gravity too.

3. Pediatrician • A Pediatrician is the doctor who cares for infants and children. The delivery staff cares for the child and mom too. • Babies and parents are banded at the same time at birth for identification and security purposes.

4. N.I.C.U. • Good prenatal care gives the baby the best chance for a healthy start. All newborns need medical attention; sick newborns need extra medical care. • ICN is the Intensive Care Nursery. NICU, in the ICN, are the neonatal intensive care units. A NICU is a heated, completely enclosed bed, equipped with oxygen, monitors for breathing and heart rate.

5. Brazelton Scale The Brazelton Neonatal Behavioral Assessment Scale (NBAS) is an assessment test that determines the newborns responsiveness to its physical and social environment. It identifies problems in neurological functioning and predicts future development.

6. Scoring the Brazelton Scale Scoring takes about 30 minutes and occurs in the following four areas: • Interaction with the environment - alertness • Motor processes – general activity level and reflexes • Control of physical state – self-quieting behaviors • Responses to stress – startle reaction and trembling

7. The pediatrician will test for Anemia (low blood oxygen) • Phenylketonuria (PKU), a disease that can cause mental retardation unless treated by diet • Jaundice, an immature liver disorder, that can be treated by the use of special lights

8. Breast is Best!! • Breast Milk contains the right proportions of proteins, carbs, fats, vitamins, minerals and water. It also carries the necessary immunities the baby will need to stay healthy.

9. Breast feeding will reduce the child’s risk of developing chronic conditions like type I diabetes, celiac disease and Crohn’s disease. Breastfeeding also reduces the chance of a SIDS death.

10. It easy to digest, it is always sterile, ready to serve, the right serving size and rate of flow for the infant.

11. Breast is best for mom too! • it contracts her uterus • reduces her bleeding • delays the onset of ovulation and her monthly period • helps her bones • saves money

12. it is a “Green alternative!” • it is easy to prepare • it is easy to freeze for later use • it is a budget booster!! The cost of formula can range anywhere from $134.00 to $491.00 per month, that is $1608 to $5892 in one year savings!

13. A recent study projected the U.S. would save $13 billion per year in medical costs if 90% of the U.S. families breastfed their newborns for at least six months!

14. Formula feeding Formula feeding requires a little more effort. Use only commercially prepared formulas, sterilized bottles and nipples. Formula comes in ready to serve, condensed-just add water; and dry powder that must be reconstituted with water. Never save unfinished formula for later use. Most formulas are cow’s milk-based, some are soy based for infants with digestive problems.

15. Babies should be fed every 3-4 hours; they will usually let you know when they are hungry. • Babies must be burped because they swallow air during crying and feeding. Burp them twice, midway through and after feeding.

16. Bathing the Newborn • Sponge baths are recommended until the navel area heals. Always gather all supplies before bathing the baby, as you can’t leave the baby alone to retrieve a missing item.

17. SIDS Sudden Infant Death Syndrome (SIDS) is when an otherwise healthy baby dies without warning while sleeping. SIDS is more common in • African-American male children, • low birth weight babies, • children of smokers • children born to very young mothers.

18. Preventing SIDS When preparing the baby for bed: • do not overdress the baby before sleeping and • place the baby on his back to sleep • remove all toys, blankets, pillows and loose bedding in the crib.

19. The Newborn Baby 1st checks The Apgar Score assesses: • appearance - color of the child, • pulse - heart rate, • grimace – reflex irritability (coughing, sneezing, crying) • activity – muscle tone • respiration - breathing, crying

20. APGAR • The Apgar is done at one minute and five minutes after birth. • The rating is 0, 1, or 2 for each measure. The scores are then combined. This creates a top score of 10. • A score below 7 means the baby needs help establishing breathing. • A very low rating (below 4) will merit immediate medical intervention. • A score less than 10 is not necessarily reason for alarm because few babies achieve perfect score (10), even after 5 minutes.

21. Next, the baby is weighed, head circumference and length are measured and recorded.

22. Then a physical exam is given Facial features are checked for indicators of Fetal Alcohol Syndrome (FAS) or Down’s syndrome The mouth is checked for cleft palate and cleft lip.

23. The hips are checked for dislocation. • The feet are checked for Club Feet. ClubFeet are abnormally bent feet and ankles.

24. The anus is checked for an Imperforate Anus (closed anus). • The genitals are checked to make sure they are fully and correctly formed (CAH - middle sex or non-descended testicles).

25. The spine is checked for swelling or an ulcer (open wound). Spina bifida is when a bony part of the spine fails to develop exposing and leaving the spinal cord unprotected.

26. The navel is checked for swelling that could indicate a hernia, or failure of the abdominal wall to fully develop.

27. Reflexes Reflexes are instinctive to newborns and are checked in the delivery room. The strongest reflex is Rooting/Sucking. • Stimulus: cheeks or skin around the mouth is touched • Reflex: head turns in direction of touch and mouth searches for food.

28. Palmar Reflex • Stimulus: palm of hand is stroked • Reflex: baby grasps finger or object touching the palm • Plantar Reflex • Stimulus: ball of foot is stroked horizontally • Reflex: toes curl around or down around object

29. Babinski Reflex • Stimulus: outside sole of foot is stroked from heel to toe • Reflex: babies spread their toes-fan toes outward

30. Moro Reflex • Stimulus: loud noise bright light, change in body position, cough, or sneeze • Reflex: baby arches his back, flings legs and arms out; rapidly flexes (curls inward) limbs toward body

31. Tonic Reflex • Stimulus: head turned to one side • Reflex: extends arms and legs on that side, flexes (curls inward) opposite limbs

32. What does a newborn look like? • Baby’s head is large, often misshapen (depending upon the delivery method) and out of proportion to the rest of the body.

33. Fontanelles, soft spots, are present where the scalp bones have not yet joined together. It is normal to see them pulsing. Closure occurs by 18 months.

34. Skin is covered with a white, waterproof waxy-like coating known as the vernix. • The umbilical cord stump will be painted with iodine, which is purple/black in color. It will have a clip on the end of it. • Some hospitals have electronic monitors in the clip to prevent baby theft. • The cord will shrivel and fall off within 7 – 10 days. Do not get the cord wet nor pull the cord off.

35. The Meconiumplug is the first bowel movement. It will be black, sticky and somewhat tar-like. Then subsequent bowel movements should be greenish/yellow and somewhat runny.

36. It is normal for babies to lose some weight the first few days of life. The baby will usually regain the weight within 2 weeks. • Children that do continue to lose weight or lose a higher percentage of body weight are diagnosed with Failure to Thrive Syndrome. Medical attention is necessary.

37. Postpartum Care • Postpartum care extends 6 to 8 weeks after the delivery. The mom’s body is returning to its normal pre-pregnant state. She will lose about 18 pounds at delivery. The rest of the weight will come off with breastfeeding and exercise. During this time Mom needs lots of rest and emotional support.

38. ADJUSTMENTS to be made She will have a “period-type” of discharge as her uterus recovers. She may not use tampons during this time. • Mom will produce milk for breastfeeding. She may take medication to make milk production stop.

39. Her body must heal if she has had stitches vaginally or from the C-section. • Her time schedule is “up ended” because the infant sleeps 3 hours at a time. • If she has other children or a job outside of the home this, too, complicates her life.

40. Baby Blues 80% of new mothers experience a mild postpartum mood disorder that goes away after about 2 weeks. So many changes physically (like hormones) & emotionally cause this to occur.

41. Postpartum Depression 10 – 15% of new mothers experience serious depression that occurs after giving birth that may last up to a year. Mom needs medical care to help her. Symptoms may include: sleep deprivation, anxiety, withdrawal and hopelessness.

42. PPD Sleep deprivation caused by round-the-clock care of a newborn has been identified as one of the biggest contributing factors. Most cases can be treated with a combination of psychotherapy, lifestyle changes, family support, and anti-depressant medications.

43. Post-Partum Psychosis: rare and extreme disorder or severe mental illness. Mom experiences delusions and desires to kill herself and/or her children/infant. Mom needs medical care to recover.

44. https://www.youtube.com/watch?v=id8LTjE1wNc