Normal newborn Flashcards
Criteria for discharge
9
- uncomplicated course
- SVD, singleton, 37 weeks, AGA
- stable VS past 12 hrs
- normal PE
- at least 1 UO and BM
- established proper latch and milk transfer
- no jaundice in first 24 hrs
- educability and ability of parents to care for bb
- able to follow-up in next 48 hrs
Breast milk storage
Room temp < 25C - 4 hrs
Room temp > 25C - 1 hr
Ref (4C) - 8 days
Freezer 1 door - 2 weeks
Freezer 2 door - 3 mos
Deep freezer -20C - 6 mos
in sterile polypropylene containers labeled with date and time of collection
satisfaction in BF
5
- seems satisfied postfeed
- sleeps 2-4 hrs after
- wt gain 25g/d x first 3 mos
- 6 diaper/d, pale yellow UO
- 2-3 stools/day, yellow pasty
BCG, Hep B, Vit K doses
BCG 0.05 ml ID
Hep B 0.5ml IM
Vit K 1 mg IM; 0.5mg for < 1500g
Pathologic jaundice
- within 24 -36 hrs
- rate of rise > 0.2mg/dl/hr or 5mg/dl/day
- DB > 2 mg/dl
- peak total bili > 12 mg/dl term; 10-14 mg/dl preterm
Indications for DVET
4
- ongoing hemolysis and TB fails to decline despite 4-6h of intensive phototx
- rate of increase of TB indicates that the level will reach 25mg/dL within 48h
- signs of bilirubin encephalopathy
- severe hemolysis causing anemia and hydrops fetalis
Indications for ROP screening
- 32 wks or below; 1500g or less
- 32-36 wks if with STOP (sepsis, transfusion, O2, preterm with stormy course)
Cranial UTZ indication
- 32 wks below, 1500g or less
1st on D 3-7
repeat on D28-30 or PTD
EINC
- immediate and thorough drying
- skin to skin contact
- properly timed cord clamping
- non-separation of mother and baby
Components of surfactant; synthesis and maturity
- dipalmytoil phosphatidylcholine (lecithin), sphingomyelin, phosphatidylglycerol
- synthesis at 24-28 wks
- maturity by 35 wks
MOA of phototherapy
converts bilirubin into nontoxic, easily excreted form via photoisomerization
proper breastfeeding technique
7
- face-to-face, chest-tochest, and tummy-to-tummy with mother
- Stimulate infant to open mouth wide by stroking corner of baby’s lips
- chin touches breast and lower lips outward
- baby grasps entire nipple plus 1 inch of surrounding areola
- allow baby to suck 15 to 30 minutes per breast
- empty breast 8 to 10 times or more a day to ensure adequate milk supply
- C hold: support breast with hand of opposite arm with thumb above and 4 fingers under breast
BF positions
Cradle hold: ipsilateral arm supports baby’s back, contralateral hand supports the breast with thumb above and 4 fingers under breast Cross-cradle hold: same as cradle hold but with the roles of the arms switched. Allows more control over how baby latches.
Side-lying: lower arm cradles the baby, other arm supports the breast
Football hold: ipsilateral hand supports baby’s neck and nestles baby closely to the side with feet and legs tucked under arm
10 steps to successful breastfeeding
- written breastfeeding policy
- train all healthcare staff
- inform all pregnant moms about benefits of bf
- help moms initiate bf within 30 mins
- show moms how to bf and maintain lactation
- no food or drink for nb
- rooming in 24/7
- encourage bf per demand
- no artificial teats or pacifiers
- foster establishment of bf support groups
benefits of breast milk
- always available
- comlete nutrients for growth and dev
- easily digested and absorbed
- contains antibodies to protect bb
- contains DHA for brain dev
