Week 3 Flashcards
postpartum care
What are parent to infant bonding and attachment behaviors?
Calls the baby by name
Cuddles close to chest
En Face
Holds closely while feeding
Kisses baby
Sings/ talks to the baby
What are some bidirectional attachment behaviors?
Becoming “cue sensitive” to the entrance behavior
infants respond to comforting measures
parents respond to the infants cry
parents stimulate and entertain the infant while awake
what are some factors that can affect bonding and attachment?
Timing/time
Proximity of the parent and infant
Weather the pregnancy is wanted or planned
Ability of their parents to process
knowledge base of the couple
Past experience with children
Maturity and educational levels of the couple
Cultural expectations
Extended support system
Maternal and paternal expectations
which one is bidirectional, bonding or attachment?
Attachment
what is defined as the emotional feelings that begin during pregnancy or shortly after birth between the parent and the newborn?
Bonding
what is the emotional connection that forms between the infant and his or her parents?
Attachment
what are the three stages of maternal touch?
Initial: fingertips
2nd: hand to stroke newborn’s head or body
final: holding the newborn close to body
How long how long do postpartum blues last?
First few weeks lasting for a few days and affects the majority of women
what are some signs and symptoms of postpartum Blues?
Difficulty sleeping
Anger
Mood swings
Sadness
Weeping
Anxiety
Difficulty eating
. What is the difference between postpartum Blues and postpartum depression?
In postpartum blues many women are affected, but they are still able to take care of their infant
What are some possible causes of postpartum Blues?
Changes in hormone levels
Fatigue
Stress from new role
at what time of postpartum should the mother contact her health care provider after feeling postpartum Blues and why?
If symptoms persist beyond four weeks, because it might be postpartum depression
what are some factors that can affect transitioning through maternal phases?
Medications such as depressants
Pregnancy, labor, and birth complications
cesarean births
pain
Preterm infants
infants with complications
Mood disorders
Lack of support from partner or support system
Adolescent mothers
Lack of financial resources
Cultural beliefs
what are the three maternal phases?
Taking in (mother and her experience)
taking hold (mother to baby and independence)
letting go
What are the major differences between postpartum blues and depression 14-2
Blues: symptoms disappear without medical intervention, occurs within the first 2 wks postpartum, able to safely care for self and baby
Depression: requires psychiatric intervention, occurs within first 12 months postpartum
Unable to safely care for self and/or baby
What increases the risk of someone having postpartum psychosis or depression?
schizophrenia
What is the process that occurs during the first few weeks of the postpartum period regarding the psychological transition to become a mother?
Maternal phases
Which maternal phase might the woman have a decreased ability to make decisions?
Taking-in phase
Which maternal phase might a woman concentrate on personal physical healing?
Taking-in phase
what might be an indication that a woman is having trouble in becoming a mother?
Delay in transitioning through maternal phases
In which phase does the woman give up the pregnancy role and initiate taking on the maternal role of the mother?
Taking-hold phase
Which maternal phase might the woman relive and speak of the birth experience?
Taking-in phase
In which phase might a woman be dependent on others for her and her infants immediate needs?
Taking-in phase
In which phase might the mother have feelings of inadequacy and being overwhelmed?
Taking-hold phase
In which phase might the women begin to let more of the outside world in?
Taking-hold phase
In which phase might the woman be interested in the newborns cues and needs?
Taking-hold phase
In which phase will the women begin to be independent?
Taking-hold phase
In which maternal phase might it be the easiest to initiate postpartum teaching?
Taking-hold phase
In which phase might the woman show signs and symptoms of baby blue and fatigue?
Taking-hold phase
In which phase might the woman the eager to learn?
Taking-hold phase
In which phase might the woman need verbal reassurance that she is meeting her newborn needs?
Taking-hold phase
In which phase does the movement from independence to the new role of mother fluid and interchangeable with the taking-hold phase?
Letting-go phase
In which maternal phase might the mother have feelings of grief, guilt, or anxiety?
Letting-go phase
In which Maternal phase does grieving and letting go of old relationships behaviors in favor of new ones?
Letting-go phase
When is the best phase for patient teaching?
Taking-hold phase
In which maternal phase is reconnection or growth in relationship with a partner possible?
Letting-go phase
what are breastfeeding contraindications?
Elicit drug use radiation, or chemotherapy agents
Active and untreated TB
HIV positive
Herpes simplex lesions on a breast
Galactosemia
PKU
what is the composition of human milk?
Proteins, carbohydrates such as lactose, and cholesterol, vitamins and minerals, antibodies
what are the 3 stages of human milk as the body establishes the lactation process?
Colostrum
Transitional milk consisting of colostrum and milk
Mature milk consisting of foremilk and hind milk
What is the yellowish breast fluid that is present for two to three days after birth?
Colostrum
What are interventions to promote and support breastfeeding?
Formal breastfeeding education
Direct support of mothers during session
Training of primary care staff and breastfeeding techniques for support
Peer support
what is the difference between foremilk and hind milk?
Foremilk is produced and stored between feedings end hind milk is produced towards the end of a session and has higher fat content.
What type of milk is composed of 20% solids and 80% water?
Mature milk
which hormone is responsible for lactation?
Prolactin
______ _____ can lower the fatty acid content of breast milk
extreme malnutrition
in which maternal phase does incorporating the newborn into the mother’s life whereby the baby becomes a separate entity from her?
Letting-go phase
which type of breast milk has higher levels of protein and lower levels of fat, carbohydrates, and calories then other types of milk?
Colostrum
In which phase does the mother accept the newborn as he or she really is?
Letting-go phase
what stage human milk last from day 3 to 10?
Transitional milk
which has a higher water content foremilk or hind milk?
foremilk
to hydrate the baby
In which part of the breast is milk produced?
The areolar glands
high levels of ____ and ______ suppress lactation, so these levels ____ after childbirth
Estrogen, progesterone, decrease
In which phase does the mother give up the fantasy of what it would or could have been?
Letting-go phase
What can decrease milk volume?
Decreased caloric intake and fluids
what type of milk consists of colostrum and milk?
Transitional milk
what is the milk ejection reflex called?
Let down reflex
success in breastfeeding depends on what five factors?
Women’s desire to breastfeed
Proper positioning
Latching on
Supply
Transferring of milk
what are signs of successful breastfeeding?
When the woman a tugging sensation when the newborn suckles
latch on pain is no longer than 10 seconds otherwise pain is a sign of poor latch
newborn’s tongue is between the lower gum and breast
swallowing can be heard
how many feedings should a nurse or lactation consultant observed before being discharged?
Three complete feedings
______activity from the infant increases____ levels and ____ of milk production
Suckling, prolactin, volume
at how many weeks should a newborn recover his birth age?
Two weeks
crying is a ____ sign of hunger
Late
how does an infant crying affect breastfeeding?
May have difficulty latching
need to be calmed down
what are some ways to position the breasts to assist with latching on?
Mother placing one hand around the breast several inches behind areola
the newborn is brought to the breast
what are signs that a newborn’s hunger has been satisfied?
Spontaneously releases suction
does not respond with a rooting reflex when stimulated
Is relaxed and calm
what stimulates the let-down reflex?
Suckling/feeding
Crying babies
Sexual arousal
what is the position called when the newborn is held off to the side?
football or clutch
what is the newborns ability to grasp the breast and to effectively suckle called?
Latching-on
is limiting feeding time necessary? Why or why not?
No it’s not necessary and can be harmful in the establishment of milk supply
what breastfeeding possition facilitates good head control?
Cross cradle position when the baby’s and woman’s abdomen are touching and the newborns back is against the woman’s forearm
Why would you assess lochia?
Frequent assessment in the early postpartum period allows how much blood is being lost
newborns and infants usually nurse from how many breasts at each feeding
One
what are the steps to get a baby to latch?
Align nipple with baby’s nose
place the baby’s mouth one to two inches beyond the base of the nipple
to remove the baby insert a finger into the corner of the baby’s mouth to break the seal
what are some ways to decrease the risk of nipple tissue breakdown?
teach proper technique
Apply warm compresses to the breasts and nipple before feeding
express colostrum or milk and rub it on the areola and nipple at the end of the feeding session
Inspect for signs of irritation
Change holding positions
Wash with water only
What is the bloody discharge from the uterus containing sloughed off necrotic tissue
lochia
how many wet diapers should you expect per day once breastfeeding is established?
At least eight wet diapers and several stools per day
Nipple irritation can lead to tissue breakdown and what infection?
Mastitis
What might you recommend to the mother who has irritation of the nipples?
Apply warm compresses before feedings to enhance the let down reflex
What is a complication of infected endometrial tissue?
Metritis
What are some reasons why some women stop breastfeeding by or before the 8th week?
Decrease milk supply and irritation and pain of the nipples
after how much time is the amount of lochia determined
One hour