Brith Practices And Early Infant Feeding Flashcards
What happens immediately after a baby is born?
1) The baby is handled- usually by the midwife, student or parent (‘received’)
2) The baby is dried throughly and stimulated
3) The baby transitions to extra-uterine life by breathing and crying
4) The baby is placed on its mother’s abdomen
These four actions often occur
simultaneously
What is agar 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. This method is more deigned for white babies as it assesses the colour of the skin
which cannot be seen on darker skin tones
What is skin to skin contact?
Involves placing the dried, naked baby prone on the mother’s bare chest, often covered with a warm blanket
Positioning a baby safely for skin to skin contact?
-Is the mother alert and well enough?, if no start skin to skin
with partner
-Is the baby alert and well enough?, if no start as soon as baby is well
What are the steps for skin to skin contact if the above is a yes?
1) Ensure baby has been throughly dried
2) Place baby so their chest and abdomen is against mum’s chest and abdomen. Position will vary with corn length and preference.
3) Ensure baby’s head is turned to the ideal slightly so the nose and mouth are free and the head is supported so the airway is not obstructed
4) Cover with warm,dry towels or blankets to protect against heat loss
5) Check that the mother’s and baby’s body are both well supported, and using gravity for security.
6) Allow instinctual maternal behaviour to adjust the dyad’s positions
Benefits of skin to skin contact?
-Stimulates release of prolactin and oxytocin
-Calms and relaxes baby and mother
-Regulates the baby’s heart rate and breathing
-Regulates baby’s temperature
-Stimulates breathing-seeking behaviour and interest in feeding
-Stimulates endorphins release
-Protects baby from infection-colonises their microbiome
Physiology of skin to skin contact?
-Thermal regulation, avoiding hypothermia
-An early first feed and high blood glucose levels that counteract
physiological drop in blood glucose after birth
- The baby familiarises itself with its mother’s chest, and lean 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
Energy triangle for babies?
Hypothermia –>
Hypoglycaemia 9
low blood sugar)-
> Hypoxia (low 02 levels)
Observing the 9 stages of neonatal behaviour?
This needs to be done in the first hour of
birth and cannot be interrupted otherwise the next skin to skin it’ll be restarted.
1. Birth cry
2. Relaxation
3. Awakening
4. Activity
5. Rest
6. Crawling
7. Familiarisation
8. Suckling
9. Sleep
What can you expect from the first feed?
-Expect the baby to take its time working through the 7 steps prior to suckling, time amount is variable.
- Feed may last 5+ minutes, may start/stop/ start
- Expect the baby to fall into a pattern of rhythmic suckling once it’s latched.
- Baby may unlatch itself from breast, then relatch and feed again shortly afterwards.
Normal neonatal behaviour and not a sign of insufficient milk supply.
- May fall asleep on the breast, then awake and begin suckling again, normal neonatal behaviour
What are the post-birth hormones?
Oxytocin
Prolactin
Oxytocin?
-Peak during labour and birth
-Elicits feelings of love, attachment and contentment
- Plays a key roll in mother-infant bonding and feelings of protectiveness
- Stimulated by touch, feeing and skin to skin contact
-Positive feedback loop: mother are rewarded with this feel-good hormone when they ‘mother’ their baby
Prolactin?
-No longer suppressed by the progesterone being excreted by the placenta, so prolactin receptors are activated
- High circulating levels of prolactin can now lock into the receptor sites to stimulate milk production
- Ongoing prolactin production is stimulated by the baby suckling at the breast.
- When the baby suckles, prolactin is released from the anterior pituitary gland.
- Positive feedback loop: the more the baby feeds, the more prolactin is released, the more milk is made.
What is colostrum?
A concentrated version of breastmilk?
Why is colostrum important?
-Packed with protective factors
- Concentrated nutrition
-Small volumes-intensionally
Laxative effect- to clear meconium
