discharge teaching - week 1

Question 1

what are good resources for moms?

Answer 1

Baby’s best chance book
Public health nurse, Dr, MW, Nurse at 811
Best Beginnings web page on the Fraserhealth.ca website https://bestbeginnings.fraserhealth.ca/ for pregnant women to register
Healthyfamiliesbc.ca is now healthlinkbc.ca

Question 2

When is the best time to do ___

Answer 2

Infant Behaviours:
Watch your baby! See if there are patterns to the way they want attention.
Deep sleep: You have heard of “sleep like a baby”. They will not wake for a feeding
Quiet sleep: Eyes are closed, face relaxed
Put skin to skin and they will probably wake for a feeding
Drowsy: Put skin to skin and they will probably wake for feeding OR they are sleepy but not quite settled yet
Quiet Alert: Usually when they are full and content and calm, like after a bath. Best time to interact with your baby. Baby is nearsighted and sees best within 8-10 inches.
Active Alert: Great time to feed for a baby.
Crying: This is how baby communicates. You need to comfort and calm your baby before trying to feed them. You will get to know your baby’s cry. Every cry does not mean he is hungry.

Question 3

what you should know about breatfeeding

Answer 3

• Mom needs to be comfortable when she feeds, and it should not hurt.
• Breastmilk provides all the nutrition your baby needs. Feed often, 8 or more times a day. This will help increase your breastmilk supply as well.
• Hand Expression is important in increasing your milk supply as well. Good for top ups and extra feeds-you can freeze the milk.
• When babies go through a growth spurt, they may want to nurse more often for a couple of days to increase their milk intake.
• The small amount of colostrum (first milk) your baby gets in the first 2 to 3 days is perfect until your “milk comes in”
• In the early days, breastfeed from both breasts to help increase the milk supply. Later your baby may feed from 1 or both. Feed on the first breast until the baby falls away from your breast. Burp your baby and offer the second breast, as baby may not be done yet.

Question 4

How can you tell your baby is hungry

Answer 4

Early feeding cues:
Lip licking
Mouth Opening
Bringing hands to mouth
Rooting (moving head as if looking for nipple)
Sucking
Later feeding cues:
Fussing, squeaky noises, restless

Crying is a late cue:
If your baby is crying, you will need to calm your baby before you attempt to feed (S2S)
might need to spoon feed baby to smooth it if it is being too fussy

Question 5

how can you tell the baby has finished feeding?

Answer 5

• They stop sucking
• Baby sleeps
• Your baby may fall away from breast
• Hands unfold and relaxed

Question 6

how can you tell your baby is getting enough milk?

Answer 6

• You see your baby sucking and deep swallowing. Wet and dirty diapers are key to knowing if baby is getting enough.
• Your breasts are full before the feedings and softer after.
• Your baby is satisfied after most feedings.
• Your baby has returned to his birth weight by about 2 weeks
• After several weeks, it is normal to have soft breasts all the time and still have lots of milk.

Question 7

how do i know thier urine is normal?

Answer 7

• Day 1, 1 wet diaper. Day 2, 2 wet diapers and so on.
• By day 6, baby should have 6 or more wet diapers per day.
• The urine should be pale yellow
• Normal to have pink or brink orange stained mucous in the diaper in the first days, due to mom’s hormones still in baby.

Question 8

how do i know their bowel momevements are normal?

Answer 8

• Day 1 and 2, baby will have black meconium stool, then it will change to green/brown and end up a soft yellow colour with a mild smell. Bottle feeding babies will have browner coloured poop and it will smell
• Your baby has 2 or more poops a day. After the first 4 to 6 weeks it is normal for poop to be less. They may come once every few days. As long as the poop is loose and the baby has wet diapers, this is normal. If hard or blood stained, call your doctor.

Question 9

what is the Crying curve? (PURPLE crying)

Answer 9

All babies go through the crying curve. Some cry more than others, but all babies go through it. The curve usually starts at about two weeks, peaks at two to three months, and then declines until about five months of age.
Some of these babies can cry as long as five hours a day or more and still be normal. This early crying time is what we now call the Period of PURPLE Crying. This is normal and they have even found it in breastfed animal babies
Studies with parents who did everything possible to care for their babies showed that their babies still went through the crying curve. You are not alone.

website - purplecrying.info

Question 10

how do I sooth my baby?

Answer 10

If your baby crying is overtired or over stimulated try:S2S; check the diaper; warm bath; holding baby in your arms or a sling; feed and burp baby; let baby suck; speaking a steady soft voice; soft music or relaxing sounds; rocking or go for a walk.
It is important to respond to infant crying but your baby may still continue to cry
Healthy infants may look like they are in pain when they are crying-even when they are not.
If the crying is very frustrating for you or your baby won’t stop crying: Take a break.
Gently place your baby in a safe place and leave the room. Take a 10–15-minute break to give you the chance to calm down. Find someone to help you (family, friends, group)

Question 11

how should I care for the umbilical cord?

Answer 11

The umbilical cord stump will usually fall off in 7-15 days. Keeping the cord clean and dry is important to prevent infection
If there is any cord discharge, use water on an ear bud, cotton wool and clean gently around the base of the cord. When the cord falls off, continue this if needed
Fold the diaper below the cord to prevent irritation and to keep it dry and exposed to air.
Avoid buttons, coins or binders over the navel.
If the area around the cord becomes red, swollen or has pus coming from it, baby has a fever, poor feeding and/or sleepy, there may be infection.
Call your DR or the public health nurse if you are concerned.

Question 12

How often should I bath my baby?

Answer 12

It is your choice when to bath your baby. Make sure the room is warm and baby is immersed in the water. Check the temperature of the water with the inside of your wrist

Question 13

Is is safe to carry my baby in a sling?

Answer 13

Check out Health Canada, products information
Make sure it is in good condition and easy to understand the instructions
Make sure you can always see baby’s face, and baby’s chin is not pressed into his chest Remember to hold your baby when bending over

Question 14

What toys are safe for my baby?

Answer 14

Toys should be soft without removable parts, non-toxic and washable.
Keep small objects, such as pins (e.g., large diaper pins), coins, buttons, marbles and batteries, out of reach and in safe containers.

Question 15

what is tummy time? and how do i do it?

Answer 15

Lay your baby on their stomach when they are awake. You can put them on the floor, on a safe firm surface or on your chest for tummy time. Your baby needs to have supervised tummy time several times a day. It is good for development. Tummy time will prevent your baby from getting a flat area on the back of their head; will help make the muscles of your baby’s neck, back, and arms stronger; and your baby will learn to roll and crawl

Question 16

what nutirents are important to have for me and my baby?

Answer 16

Health Canada recommends that everybody takes vitamin D, to build strong bones and teeth. It is made even breastfed babies need it. From birth, give baby a daily vitamin D supplement of 400 IU, until they are eaching vitamin D enriched foods (normally 1 yr)
Not enough vitamin D increases the risk or your baby getting rickets – a disease that affects the way bones grow and develop.

Question 17

how should I care for my breasts while breastfeeding?

Answer 17

Wash your hands before handling your breasts. Ensure proper latch. Most important in preventing nipple problems. Express drop of colostrum after breastfeeding, rub into nipple, air dry
If you wear nursing pads, change then as soon as they are wet.
To know what size bra to buy, try it on before you feed-when your breasts are full.
Be sure your bra fits well. If your bra leaves a mark on your breast tissue, it is too tight
If the nipples are too sore to breastfeed, express or pump
Most mothers have tender nipples in the first week. Nurse on the non-painful side first.
If nipples are cracked or bleeding, still okay to breastfeed
If your nipples are: Damaged, Cracked, Bleeding, scabbed or blistered–talk with your PH nurse, MW, or LC. If breasts become full day 3-5, feed well and often. Breast must be soft at least once a day. Ibuprofen helps decrease swelling and cold compresses for comfort-frozen cabbage leaves work well.

Question 18

what will my flow look like in the next few weeks?

Answer 18

1-3 days after delivery: dark red with small clots-soak less than 1 pad per hour.
3-4 days after delivery: Bright red like a normal menstrual period.
4-10 days after delivery: Pink or brown discharge
2-6 weeks after delivery: Small amount of white or yellowish discharge
If your flow does not become less or smells bad, call your health care practitioner.
Use pads, not tampons, until any incision or vaginal tears are healed.
Change pads regularly-every 2-4 hours. Shower daily

Question 19

how should I care for my episosity

Answer 19

It is normal that the area between your vagina and anus be tender and swollen. If you had an episiotomy or tear, the stitches do not need to be removed. They will dissolve in 2-4 weeks. You may feel itching when this is happening. Don’t scratch.
Important to keep that area clean using the peri-bottle, until it is healed. When home, you can have a quick warm water sitz bath 2-3 times a day.
Use a pillow to sit on, if your bottom is sore. Lie on your side, when resting/sleeping.

Question 20

how will peeing be like after childbirth?

Answer 20

At first, it may be difficult to pee or tell when your bladder is full. It helps to pee at regular times to prevent the bladder from becoming too full. If it is hard to pee or it stings, pour warm water over your perineum or pee in the shower or bath.
You may have some leakage of urine for three months or more after your baby is born, this is called urinary incontinence. A cough, sneeze, laugh, or physical activity can make this happen. Doing Kegel exercises can help to control urine leakage. For most women, this gradually goes away DEMO…..Explain KEGEL EXERCISES

Question 21

what will my bowel movements look like after birth

Answer 21

Most mothers have a bowel movement within two to 3 days after birth.
Drink lots of water and fluids (about 2 litres)
Eat whole grains, bran, dried fruits (especially prunes and figs), fresh fruits, vegetables, and juices. If that does not work, get a stool softener.
If you have stitches, you may find that holding a clean, cool, wet pad over them, helps when you have your first bowel movement.

Question 22

how can I treat haemorrhoids

Answer 22

Haemorrhoids are swollen veins around the lower end of the rectum and anus. Haemorrhoids can occur during pregnancy and also from pushing during delivery. It feels itchy, uncomfortable.
For pain: Apply cold compresses or warm sitz bath
2. Elevate your bum on a pillow when resting 3. Try not stand for long periods
4. Haemorrhoids cream or suppository
5. Continue taking stool softeners if prescribed.
6. Drink water, eat foods rich in fibres such as vegetables, fruits, whole grains breads and cereals

Question 23

how should I care for my C- section insestion

Answer 23

• Keep your wound clean and dry.
• If you must come back for your staples to be removed, make sure you have an appointment before you leave. The sutures will dissolve. Never lift anything heavier than your newborn
• Use pain relief before the pain becomes bad.
• Driving is possible when you will be able to slam on breaks if needed. Normally 1-2 weeks.
• Call your DR if there is any redness, smell from the wound, you have a fever, your wound opens in an area, your pain does not get better-sometimes gets worse.

Question 24

When can I have sex again?

Answer 24

Ask your DR/MW when you can have intercourse.
The mom must feel ready
Flow is must not be red and if you have a tear/wound, it must have healed well and feel comfortable
Lubricants or different positions may be needed due to lower hormonal levels, thinning of the vaginal walls, decreased lubrication.

Question 25

how long after my c-sections should I start trying for baby again?

Answer 25

recommended two years