L4 (birth) Flashcards
3 stages of birth
- dilation (long period of contractions)
- transition/birth (pushing)
- afterbirth
Effect of the use of pain-relieving drugs during birth
- no harm to newborns
- can make labor longer, which increases the use of forceps
- doesn’t increase c-sections
Important functions of birth in a newborn
- squeezing of head stimulates hormones that help with breathing
- rids amniotic fluid from lungs
- washes baby in bacteria that promotes development of healthy microbiome
Pros and cons of c-sections
- convenient, fast, and less painful
- more allergies, asthma, and obesity in children born via c-section (due to lack of fetal washing)
What stage of sleep do babies engage in half of the time?
REM (rapid eye movement) sleep, wherein brain activity is similar to activity when awake
Autostimulation theory
brain activity during REM sleep facilitates visual development in fetuses and newborns
Myoclonic twitching
jerky movements enable the formation of sensorimotor maps
What method has the strongest evidence for improving sleep in babies?
extinction or letting them cry it out
no evidence of increased stress or changes in attachment
Shaken baby syndrome
correlated with crying (which increases over the first 2 months of life) and can lead to head trauma or even death
PURPLE program
- raises awareness on early intense crying periods
- effective at reducing head trauma and ER visits
What does PURPLE program stand for?
peak (~6 weeks), unexpected, resists soothing, pain-like face, long-lasting, evening
Colic
- inconsolable crying for more than 3 hours a day but usually goes away by 3-4 months
- probably related to gastrointestinal issues
When is a baby considered premature?
when born anytime before 34 weeks gestation (37 weeks after last period)
When are fetuses considered viable?
after 24 weeks (>50% chance of survival)
3 possible reasons why babies are placed in the NICU
- prematurity-related issues (e.g. underdeveloped lungs, jaundice)
- low birth weight (under 5lbs 8oz or 2.5kg)
- developmental defects corrected post-birth and recovery from surgery
What changes do infants undergo when placed in the NICU?
significant changes from the womb environment that infants are not developmentally prepared for
e.g. light, noise, pain from pin pricks and surgical cuts, drugs, separation from maternal interaction
Effect of NICU stress on infant development
disrupts normal patterns of neural activity and may lead to hard-wired brain abnormalities
Effect of early pain stimuli in NICU babies
permanent changes in the neuroendocrine system (HPA axis) that leads to chronically high cortisol and early onset of adult diseases
e.g. atherosclerosis, hypercholesterolaemia, diabetes, cognitive impairment
Effects of early repetitive pain vs early prolonged pain in later development
- hypersensitivity to pain and decreased pain threshold
- hyposensitivity to pain and increased pain threshold
Effect of early repetitive pain on adults
- increased anxiety and hypervigilance
- preference for alcohol
- defensive withdrawal behavior
Effects of early prolonged pain in infants vs adults
- less locomotor activity in infants
- stress/anxiety vulnerability and cognitive deficits in adults
Effects of the NICU experience on parents
- little to no preparation for the arrival of infant and NICU
- feelings of fear, grief, and loss of control
- life or death decisions
When are NICU infants more or less sensitive to pain?
premature infants are more sensitive to pain (even diaper changes) while extremely LBW but full-term infants are less sensitive
Changes in the NICU due to stressful effects
low lighting, quiet, parent physical contact, minimal number of procedures
