Birth practices Flashcards
What happens immediately after a baby is born?
The baby is handled - usually by the midwife, student or parent (‘received’)
The baby is dried thoroughly and stimulated
The baby transitions to extra-uterine life by breathing and crying
The baby is placed on its mother’s abdomen
(often occur simultaneously)
What is Apgar scoring?
A rapid method of assessing the clinical status of the newborn infant at 1 minute of age and the need for prompt intervention to establish breathing. The baby is scored out of 10.
When are babies scored using Apgar scoring?
At 1 and 5 minutes of age, and again at 10 minutes if previously low.
What is skin to skin contact?
Skin to skin contact involves placing the dried, naked baby prone on the mother’s bare chest, often covered with a warm blanket
What are the requirements for skin to skin contact to go ahead?
Mother must be alert and well enough
Baby must be alert and well enough
What happens if mother is not alert and well enough?
Start skin to skin contact with birth partner
What happens if baby is not alert and well enough?
Start mother-infant skin to skin contact as soon as baby is stable.
How is a baby positioned safely for skin to skin contact?
- Ensure baby has been thoroughly dried, with the exception of palms of their hands
- Place baby so their chest and abdomen is against mum’s chest and abdomen - position will vary with cord length and preference
- Ensure baby’s head is turned to the side slightly, so the nose and mouth are free
- Cover with warm, dry towels or blankets to protect against heat loss
- Check that the mother’s and baby’s bodies are both well supported, and using gravity for security
- Allow instinctual maternal behaviour to adjust positions
What are the benefits of skin to skin contact?
Stimulates release of prolactin and oxytocin
Calms and relaxes baby and mother
Regulates baby’s heart rate and breathing
Regulates baby’s temperature
Stimulates breast-seeking behaviour and interest in feeding
Stimulates endorphin release
Protects baby from infection - colonises their microbiome
What does skin to skin contact in the first hour encourage?
Thermal regulation, avoiding hypothermia
An early first feed and higher blood glucose levels, counteract physiological drop in blood glucose after birth
The baby to familiarise itself with its mother’s chest, and learn how to locate and self-attach to the breast
Normal transition to extra utero life - more stable heart rate, respiratory rate and oxygen saturation
Reduction in mean time for placental expulsion
What are the 3 components in the energy triangle for babies and what does it mean?
Hypothermia, Hypoglycaemia, Hypoxia
One affects the other
What are the 9 stages of neonatal behaviour?
Birth Cry
Relaxation
Awakening
Activity
Rest
Crawling
Familiarisation
Suckling
Sleep
Why is the timing of neonatal behaviour important?
These behaviours only occur in the habitat of the maternal chest - if the baby is removed, it mist start these steps again from the beginning when next put in skin to skin contact
The first hour after birth is a ‘sensitive period’ for programming the baby’s brain for survival behaviours, such as suckling
What should be expected of the first feed?
The baby will take its time working through the 7 steps prior to suckling - amount of time is variable
The feed may last 5+ minutes, may be start/stop/start
The baby should fall into a pattern of rhythmic suckling once it has latched
The baby may unlatch itself from the breast, then re-latch and feed again shortly afterwards - this is normal neonatal behaviour, not a sign of insufficient milk supply
The baby may fall asleep whilst on the breast, then awake and begin suckling again
Even after the feed, the baby may not want to be put down
What happens to the mother’s placental hormones post birth?
Immediate drop in levels of placental hormones:
human placental lactogen (hPL)
human chorionic gonadotropin (hCG)
oestrogen (7 days)
progesterone (24-48 hours)
