NEW BORN BABIES CONSTITUTE THE

FOUNDATION OF A NATION AND NO

SENSIBLE GOVERNMENT CAN
AFFORD TO NEGLECT THEIR NEEDS
& RIGHTS. HEALTHY & STURDY
BABIES ARE LIKELY TO EVOLVE AS
PHYSICALLY & MENTALLY STRONG
ADULTS WITH ENHANCED QUALITY
OF HUMAN RESOURCE
DEVELOPMENT.
STATISTICAL OVERVIEW
W NEARLY 26 MILLION BABIES ARE BORN IN
INDIA EACH YEAR
W IT ACCOUNTS FOR 20 % OF GLOBAL BIRTH
W 1.2 MILLION DIES BEFORE COMPLETING
THEIR 1
ST
MONTH OF LIFE
W IT ACCOUNTS FOR 3.9 MILLION NEONATAL
DEATHS WORLD WIDE.
NNF TEACHING AIDS
GRADES OF THE
NORMAL BABY CARE
W LEVEL I CARE :-
NEW BORN >2000gm ,
37 WKS OR MORE
W LEVEL II CARE :-
1500 - 2000 gm , 32-
36 WKS
W LEVEL III CARE :-
< 1500 gm, < 32 WKS
MS USHA MALLICK
DY. NURSING SUPERINTENDENT
THE CALCUTTA MEDICAL RESEARCH INSTITUTE
IMMEDIATE ADJUSTMENT TO
EXTRAUTERINE LIFE
W RESPIRATORY CHANGES
- CHEMICAL FACTORS
- THERMAL STIMULUS
- TACTILE STIMULATION
- PULMONARY PERFUSION
W CIRCULATORY STSTEM
- FUNCTIONAL CLOSURE OF
FORAMEN OVALE , DUCTUS
ARTERIOSUS , DUCTUS
VENOSUS
PLEA OF A BABY AT BIRTH
W I HAVE COME FROM AN EXTREMLY
WARM, CLEAN, QUIET AND
COMFORTABLE ABODE
W PROTECT ME AT BIRTH FROM
MICROBES AND COLD
W I AM WET & NAKED, DRY ME,COVER
ME & PLACE ME UNDER A HEATER
W I DON'T KNOW HOW TO SMILE , LET
ME ANNOUNCE MY ARRIVAL BY A CRY
PLEA OF A BABY AT BIRTH
W DON'T HURT ME , BUT GENTLY
CLEAN MY WINDPIPE TO LET ME
CRY
W DON'T GIVE ME INJECTIONS ,
BUT GIVE ME A BREATH TO
SAVE MY LIFE
W I HAVE BEEN SWIMMING ALL
THROUGH IN THE WOMB, DON'T
BE IN A HURRY TO BATHE ME IN
THE LABOUR ROOM
MEHARBAN SINGH
DEFINITION OF
NORMAL NEW BORN BABY
THE HEALTHY NEW BORN INFANT
BORN AT TERM , BETWEEN 38
TO 42 WEEKS , CRIES
IMMEDIATELY AFTER BIRTH ,
ESTABLISHES INDEPENDENT
RHYTHMIC RESPIRATION ,
QUICKLY ADAPTS WITH THE
EXTRA - UTERINE
ENVIRONMENT , HAVING AN
AVERAGE BIRTH WEIGHT & NO
CONGENITAL ANOMALIES.
PHYSICAL
CHARACTERISTICS
W POSTURE:- FULL FLEXION
W SKIN : - RED , PUFFY ,
LANUGO PRESENT
W HEAD :- ANTERIOR &
POSTERIOR FONTANEL
PRESENT
W CHEST : - BOTH AP &
LATERAL DIAMETER ARE
SAME , SLIGHT STERNAL
RETRACTION MAY SEEN
W ABDOMEN :- CYLINDRICAL
PHYSICAL CHARACTERISTICS
OF HEALTHY NEONATES
W WEIGHT THE AVERAGE WEIGHTIS
2.9 KG ,WITH A VARIATION OF 2.5 TO
3.9 KG.
W LENGTH : - AVERAGE CROWN HEEL
LENGTH IS 50 cm WITH THE RANGE OF
48 - 53 cm.
W HEAD CIRCUMFERENCE : - HC
USUALLY VARIES FROM 33 TO 37 cm
WITH THE AVERAGE OF 35 cm.
W CHEST CIRCUMFERENCE : - IT IS
ABOUT 3 cm LESS THAN THE HC
PHYSIOLOGICAL
CHARACTERISTICS
W RESPIRATORY RATE : - 30 -
60 BREATHS / MINUTE
W HEART RATE : - IT VARIES
BETWEEN 120 - 160 BEATS /
MINUTE
W BLOOD PRESSURE : - IT
RANGES FROM 60 - 80 mm
of Hg SYSTOLIC &
DIASTOLIC 25 - 40 mm of Hg.
W BODY TEMPERATURE : -
36.5
0C
- 37.5
0C
HAEMATOLOGICAL STATUS
W BLOOD VOLUME : - 80
mI / kg of body weight
W RBC : - 6 - 8 miIIion /
cmm
W Hb% : - 18 gm
W WBC : - 10,000 - 17, 000
/cmm
ENERGY REQUIREMENT
:- 55 caI / kg /day
CHANGE IN STOOLING
PATTERNS OF NEW BORNS
W MECONIUM : - INFANT'S FIRST
STOOL , OCCUR WITHIN 24 - 48 HOUR
W TRANSITIONAL STOOL :- APPEAR
ON 3
RD
DAY , GREENISH IN COLOUR
W MILK STOOL :- APPEAR ON 4
TH
DAY ,
GOLDEN YELLOW FOR BREAST FED &
PALE YELLOW FOR FORMULA FED
SRS -2008
W ESTABLISHMENT OF
RESPIRATION
W PREVENTION OF
HYPOTHERMIA
W ESTABLISHMENT OF
BREAST FEEDING
W PREVENTION OF INFECTION
W IDENTIFICATION OF AT RISK
NEONATES
SECTION OF NEW BORN CARE
W PREPARATION BEFORE
DELIVERY
W IMMEDIATE CARE AT
BIRTH
W CARE AFTER BIRTH
W ESSENTIAL POST NATAL
CARE
PREPARATION FOR DELIVERY
W ARRANGEMENTS OF WARMING
DEVICES INCLUDING ROOM
THERMOMETER AND WALL
CLOCK
W CLEAN STERILE LILEN
W CORD CARING DEVICES
W RESUSCITATION ARTICLES ,
DRUGS INCLUDING OXYGEN
W MEASURING INSTUEMENTS
IMMEDIATE CARE AT BIRTH
W UMBILICAL CORD SHOULD
BE CLAMPED AS SOON AS
THE INFANT IS
COMPLETELY DELIVERED
W DETERMINE WHEATHER
THE BABY REQUIRES
RESUSCITATION
W ROUTINE CARE TO BE
PROVIDED
CARE AFTER BIRTH
W ESTABLISHED EFFECTIVE
BREATHING
W PREVENT HYPOTHERMIA
W ADMINISTRED VITMIN K 1.0
mg I/M
W QUICK CLINICAL
SCREENING
ESSENTIAL POSTNATAL CARE
W MAINTAINANCE OF BODY
TEMPERATURE
W CARE OF THE UMBILICAL
STUMP
W SKIN CARE
W CARE OF THE EYES
W HOME CARE
IDENTIFICATION OF NEW BORN
W IDENTIFYING BANDS ARE
SECURELY FASTEND
W
W VERIFY THE INFORMATION
OF NAME OF MOTHER ,
ADMISSION DATE , TIME OF
BIRTH OF BABY, SEX OF
BABY
W STORAGE OF BLOOD FOR
DNA TEST
W FOOT PRINTING & FINGER
PRINTING ARE NOT
RECOMMENDED
AAP-2002
ASSESSMENT OF
NEW BORN BABY
W INITIAL ASSESSMENT BY USING
APGAR SCORE SYSTEM
W TRANSITIONAL ASSESSMENT
DURING PERIOD OF REACTIVITY
W ASSESSMENT OF GESTATIONAL
AGE
W SYSTEMATIC PHYSICAL
EXAMINATION
ASSESSMENT OF
NEW BORN BABY
W AS SOON AS POSSIBLE AFTER
BIRTH
W SUBSEQUENT ASSESSMENT IN
THE POSTNATAL PERIOD
W ASSESSMENT INCLUDES
HISTORY OF PRENATAL ,
INTRANATAL PERIOD , GENETIC
HISTORY OF FAMILY ALONG
WITH HEAD TO FOOT
EXAMINATION AND REVIEW OF
MATERNAL INVESTIGATION
PURPOSES OF
INITIAL ASSESSMENT
W TO ASSESS THE NEED FOR
RESUSCITATION
W TO ASCERTAIN THE
GESTATIONAL AGE
W TO DETECT PRESENCE OF
ANY CONGENITAL
ANOMALIES
W ANY DISORDER WHICH MAY
AFFECT THE WELL BEING
OF THE BABY
APGAR SCORING
Criteria 0 1 2
Respiratio
n
absent Slow,
irregular
Good ,
crying
Heart rate absent Slow ,
below 100
More than
100
Muscle
tone
flacid Some
flexion of
extremities
Active
body
movements
Reflex
response
No
response
grimace cry
Skin
colour
Blue , pale Body pink,
extremities
blue
Completel
y pink
Total score -10
ONo depression : 7 - 10
OMild depression : 4-6
OSevere depression : 0-3
TRANSITIONAL ASSESSMENT
PERIOD OF REACTIVITY
W FIRST PERIOD OF REACTIVITY:- DURING FIRST 30
MINUTES THE INFANT IS VERY ALERT , CRIES
VIGOROUSLY , MAY SUCK THE FIRST GREEDILY.
W SECOND STAGE OF FIRST REACTIVE PERIOD:- IT
LASTS 2- 4 HOURS . HEART & RESPIRATORY RATE
DECREASE , TEMPERATURE CONTINUES TO FALL ,
URINE & STOOL NOT PASSED.
W SECOND PERIOD OF REACTIVITY :- BEGINS WHEN
THE INFANT AWAKES FROM THIS DEEP SLEEP . IT
LAST ABOUT 2 - 5 HOURS .
TESTS USED IN ASSESSING
GESTATIONAL AGE
W POSTURE
W SQUARE WINDOW
W ARM RECOIL
W POPLITEAL ANGLE
W SCARF SIGN
W HEEL TO EAR
NEUROLOGICAL ASSESSMENT
W JOINT
MOBILITY
W AUTOMATIC
REFLEX
WMUSCLE
TONE
DIFFFERENTIATION BETWEEN
TERM & PRETERM BABY
W SOLE CREASES : -
W GENITALS : -
W BREAST NODULE :-
W EAR CARTILAGE :-
W HAIR :-
REFLEXES OF THE
NORMAL NEW BORN
W ROOTING
W SUCKING
W SWALLOWING
W GAGGING
W BLINKING
W MORO
W DANCING
W PALMER GRASP
W DOLL'S EYE
CLUSTER OF NEONATAL
BEHAVIOUR
W DEEP SLEEP CLOSED
EYES , REGULAR BREATHING ,
NO EYE MOVEMENT , NO
BODY MOVEMENT
W LIGHT SLEEP : - CLOSED
EYE , IRREGULAR BREATHING
, SLIGHT MUSCULAR
TWITCHING , MAY SMILE
W DROWSY EYES MAY OPEN,
IRREGULAR BREATHING ,
ACTIVE BODY MOVEMENT ,
OCCASIONAL MILD STARTLES
CLUSTER OF NEONATAL
BEHAVIOUR
W QUIET ALERT : - EYES WIDE
, OPEN , BRIGHT , RESPOND
TO STIMULI , FOCUSES
ATTENTION ON STIMULI
W ACTIVE ALERT : - SLIGHT
BODY MOVEMENT , EYES
OPEN , IRREGULAR
BREATHING
W CRYING : - PROGRESSES TO
STRONG , GRIMACE , EYES
OPEN OR TIGHTLY CLOSED.
COMMON DEVELOPMENTAL
AND PHYSIOLOGICAL PROBLEMS IN
NEW BORN
W REGURGITATION OF
FEEDS & VOMITING
W BOWEL DISORDER
W DELAYED PASAGE OF
URINE
W PHYSIOLOGICAL
JAUNDICE
W JITTERINESS
W SUPERFICIAL
INFECTIONS
- PYODERMA
-UMBILICAL SEPSIS
- ORAL THRUSH
COMMON PROBLEMS CONT
W DEHYDRATION FEVER
W EXCESSIVE CRYING
W EXCESSIVE
SLEEPINESS
W CEPHALHEMATOMA
W UMBILICAL
GRANULOMA
W NAPKIN RASH
W SNEEZING & NOSE
BLOCK
W HIC CUPS
W PHYSIOLOGICAL
PHYMOSIS
DISORDER DUE TO TRANSPLACENTAL
PASSAGE OF HORMONES
W VAGINAL BLEEDING
W MUCOID VAGINAL SECRETIONS
MINOR DEVELOPMENTAL PECULARITIES:-
W TOXIC ERYTHEMA
W TONGUE TIE
W NON RETRACTABLE PREPUCE
W MONGOLIAN BLUE SPOTS
W CONGENITAL TEETH
W MILIA
W EXCESSSIVE SCALES & PEELING OF SKIN
W SUBCONJUNCTIVAL HAEMORRAGE
W PROMINENT XIPHISTERUM
ESTABLISHING & MAINTAINING
OF NEW BORN'S AIRWAY
W SUCTIONS TO BE DONE FOR
INFANT BEFORE IT IS
COMPLETELY BORN WITH A
BULB SYRINGE.
W THE MOUTH IS SUCTIONED
FIRST , AND THEN HIS NOSE
W AFTER DELIVERED INFANT'S
HEAD IS HELD SLIGHTLY
DOWNWARDS.
W THE INFANT'S FACE IS WIPED
THOROUGHLY CLEAN
PROVIDING WARMTH
W KEEP THE BABY DRY
W WRAP THE BABY WITH
ADEQUATE CLOTHINGS IN TWO
LAYERS
W MAKE SURE THAT BABY'S HEAD
& EXTREMITIES ARE WELL
COVERED
W BABY TO BE PLACED IN SKIN TO
SKIN CONTACT WITH MOTHER TO
MAINTAIN TEMPERATURE
W AMBIENT ATMOSPHERIC
TEMPERATURE TO BE KEPT
WARM ADEQUATELY ( 28 - 32
0C
)
BONDING PROCESS
W BONDING SHOULD BE
INITIATED IN THE DELIVERY
ROOM
W OTHERS CAN BE PARTICIPATE
IN THIS PROCESS
W PUTTIG THE BABY TO MOTHER
IS IMPORTANT FOR
- INTERACTION
- BREAST FEEDING
SKIN CARE & BABY BATH
W BABY MUST BE CLEANED OFF
BLOOD, MUCUS & MUCONIUM
BY GENTLE WIPING
W NO BATH , ESPECIALLY DIP
BATH TO BE AVOIDED TILL
THE UMBILICAL CORD
FALLEN OFF
W NO VIGOROUS ATTEMPTS TO
BE MADE TO REMOVE VERNIX
CASEOSA
SKIN CARE & BABY BATH
W BABY SHOULD BE BATHED
WITH WARM WATER IN A
CLOSED PLACE
W BABY SHOULD BE DRIED
SWIFTLY AND THOROUGHLY
W OIL CAN BE USED AFTER 3 - 4
WEEKS OF BABY'S LIFE
W EXPOSURE TO SUNRAYS IS
IMPORTANT SOURCE FOR
VITAMIN D
CARE OF UMBILICAL CORD
W THE UMBILICAL CORD IS
CUT ABOUT 2-3 INCHES
FROM THE NAVAL WITH
ASEPTIC TECHNIQUE
W THE CORD TO BE TIED
WITH STERILE COTTON
THREAD OR DISPOSABLE
PLASTIC CLIP
W THE CORD MUST BE
INSPECTED FOR ANY
BLEEDING / INFECTION
W AFTER CLEANING THE
CORD , THE CORD MUST
BE KEPT OPEN & DRY.
CARE OF THE EYES
W EYES SHOULD BE CLEANED AT
BIRTH AND ONCE EVERY DAY USING
STERILE COTTON SWABS SOAKED
IN STERILE WATER.
W EACH EYE SHOULD BE CLEANED
USING A SEPARATE SWAB.
W THE EYES SHOULD BE OBSERVED
FOR ANY SIGN OF INFECTION AND
APPLICATION OF DROPS AS PER
NEEDED
W ADVISED THE MOTHER TO
MASSAGE THE NASOLACRIMAL
DUCT AREA.
CLOTHING OF THE BABY
W THE BABY SHOULD BE DRESSED
WITH LOOSE , SOFT & COTTON
CLOTHES.
W THE FROCK SHOULD BE OPEN OR
BACK FOR EASY WEARING.
W LARGE BUTTONS , SYNTHETIC
FROCK, PLASTIC , NYLON TO BE
AVOIDED.
W BABY CLOTHING SHOULD ALWAYS
BE CLEANED WITH LIGHT
DETERGENT , WASHED PROPERLY &
SUN DRIED.
GENERAL CARE
W THE NEW BORN BABY SHOULD BE
KEPT IN BEDDING IN.
W BABY SHOULD BE HANDLE GENTLY
AFTER PROPER HAND WASHING
W BABY SHOULD BE ALLOW TO SLEEP IN
SUPINE POSITION TO PREVENT INFANT
DEATH SYNDROME
W TENDER CARE TO BE PROVIDED FOR
THE BABY.
ATRAUMATIC CARE
W AVOID PHYSICAL &
PSYCHOLOGICAL
DISTRESS OF THE BABY
W FIRST DO NO HARM
W MANAGING BABY'S PAIN
W AVOID SEPERATION
FROM THE PARENTS
IMMUNIZATION
W ZERO DOSE OF
ORAL POLIO
W ADMINISTER
BCG ,
HEPATITIS B
DEFENCE AGAINST INFECTION
W INFANT ITSELF CAAPABLES
W PASSIVE IMMUNITY FROM
MOTHER
W INITIATION OF BREAST
FEEDING
W MAINTAIN HAND HYGIENE
W USE SEPARATE ARTICLES
FOR EACH BABY
HOME CARE
ADVISED THE MOTHER & FAMILY
MEMBER REGARDING
FOLLOWING :-
W PROTECT THE BABY FROM
COLD / HEAT
W CARE FOR UMBILICAL CORD ,
SKIN, EYES , CLOTHINGS
W EXCLUSIVE BREAST FEEDING
W IMMUNIZATION ON TIME
THE NATURE HAS DESIGNED THE
PROVISION THAT INFANTS BE FED
UPON THEIR MOTHER'S MILK ,
THEY FIND THEIR FOOD &
MOTHER AT THE SAME TIME. IT IS
A COMPLETE NOURISHMENT FOR
THEM BOTH FOR THEIR BODY &
SOUL.
RABINDRANATH TAGORE
ADVANTAGES OF
BREAST FEEDING
W BENEFITS TO THE
BABY :-
NUTRIENT SUPERIORITY
W DIGESTION
W IMMUNOLOGICAL
SUPERIORITY
W OTHERS
W BENEFITS TO THE
MOTHER
BENEFITS TO FAMILY
AND SOCIETY
W IT IS MORE ECONOMICAL
W PROMOTES FAMILY
PLANNING
W DECREASES NEED FOR
HOSPITALIZATION
W CONTRIBUTES TO CHILD
SURVIVAL
ANATOMY OF BREAST
PHYSIOLOGY OF LACTATION
PHYSIOLOGY OF LACTATION
TYPES & COMPOSITION OF
BREAST MILK
W COLOSTRUM
W TRANSITIONAL MILK
W MATURE MILK
W PRETERM MILK
W FORE MILK
W HIND MILK
KEY MESSAGES TO PROMOTE
EXCLUSIVE BREAST FEEDING
W PUT BABY TO FEED AT BREAST
AS SOON AS POSSIBLE AFTER
BIRTH PREFERABLY IN THE
DELIVERY ROOM.
W DO NOT DISCARD COLOSTRUM
W KEEP BABY CLOSE TO MOTHER .
IT IS SAFE FOR BABY TO SLEEP
WITH MOTHER.
KEY MESSAGES TO PROMOTE
EXCLUSIVE BREAST FEEDING
W BREAST FEED DURING DAY & NIGHT
AT LEAST 8 TIMES , WHENEVER
BABY CRIES WITH HUNGER.
W THE MORE THE BABY SUCKS AT
BREAST,THE MORE MILK THE
BREAST WILL PRODUCE & THE
HEALTHIER THE BABY BECOMES.
W ALLOW BABY TO FEED AT ONE
BREAST UNTIL HE LEAVES THE
NIPPLE ON HIS OWN. THEN , FEED
HIM AT THE OTHER BREAST IF HE
CONTINUES TO BE HUNGRY.
KEY MESSAGES TO PROMOTE
EXCLUSIVE BREAST FEEDING
W GIVE BABY ONLY BREAST MILK
FOR THE FIRST 6 MONTHS , DON'T
GIVE BABY PRE-LACTEAL OR TOP
FEED DURING THIS TIME.
W NEVER USE BOTTLES
PACIFIER.THEY ARE HARMFUL &
ARE LIKELY TO MAKE BABY
FREQUENTLY ILL.
POSITION OF THE MOTHER
W THE MOTHER SHOULD BE
IN ANY COMFORTABLE
POSITION.
W SHE CAN FEED THE BABY
IN SITTING LYING OR SEMI
RECLINING POSTURE.
W HER BACK SHOULD BE
PROPERLY SUPPORTED
W SHE SHOULD NOT LEAN ON
THE BABY
POSITIONING OF THE BABY
W BABY IS WRAPPED PROPERLY WITH
A CLOTH
W BABY'S WHOLE BODY SHOULD BE
SUPPORTED
W BABY'S HEAD & BODY SHOULD BE IN
A STRAIGHT LINE
W BABY'S BODY SHOULD BE TURNED
TOWARDS THE MOTHER WITH THEIR
ABDOMENS TOUCHING EACH OTHER
W BABY'S NOSE SHOULD BE AT THE
LEVEL OF THE NIPPLE
ATTACHMENT ON
MOTHER'S BREAST
W PUT HER FINGERS BELOW HER
BREAST
W USE HER FIRST FINGER TO
SUPPORT THE BREAST
W PUT HER THUMB ABOVE THE
AREOLA HELPING TO SHAPE
THE BREAST
W NOT KEEP HER FINGERS NEAR
THE NIPPLE
W EXPRESS A LITTLE MILK ON TO
HER NIPPLE
W TOUCH THE BABY'S LIPS WITH
HER NIPPLE
ATTACHMENT CONT.
W WAIT UNTILL THE BABY'S MOUTH IS
OPENING WIDE , AND THE TONGUE IS
DOWN & FORWARD
W MOVE THE BABY QUICKLY ONTO HER
BREAST , AIMING THE NIPPLE
TOWARDS THE BABY'S PALATE AND
HIS LOWER LIP WELL BELOW THE
NIPPLE
REFLEXES FOR BREAST
FEEDING
W ROOTING REFLEX
W SUCKING REFLEX
W SWALLOWING
REFLEX
SIGN OF GOOD ATTACHMENT
W BABY'S MOUTH IS WIDE
OPEN
W LOWER LIP IS TURNED
OUTWARDS
W BABY'S CHIN TOUCHES
THE MOTHER'S BREAST
W MAJORITY OF AREOLA IS
INSIDE BABY'S MOUTH
CAUSES OF POOR
ATTACHMENT
W USE OF FEEDING
BOTTLES
W INEXPERIENENCED
MOTHER
W LACK OF SKILLED
SUPPORT
W INVERTED NIPPLE
POOR ATTACHMENT
RESULT IN
W PAIN OR DAMAGE TO NIPPLE OR
SORE NIPPLE
W BREAST MILK NOT REMOVED
EFFECTIVELY , THUS CAUSING
BREAST ENGORGEMENT
W POOR MILK SUPPLY , HENCE BABY IS
NOT SATISFIED AFTER FEEDING
POOR ATTACHMENT
W BREAST PRODUCES LESS
MILK RESULTING IN A
FRUSTRATED BABY AND
REFUSAL TO SUCK
W LEADS TO POOR WEIGHT
GAIN
CONTRAINDICATION
W HIV INFECTION
W MOTHER ON
ANTIMETABOLIC DRUG
W MOTHER ON
ANTICANCER
W MOTHER ON
RADIOACTIVE DRUG
INDICATORS OF ADEQUATE
BREAST FEEDING
W BABY PASSES URINE 6-8
TIMES IN 24 HRS
W GOES TO SLEEP FOR 2-3 HRS
AFTER THE FEEDS
W GAINS WEIGHT @ 20 - 40 gm /
day
W CROSSES BIRTH WEIGHT BY 2
WEEKS
REASONS WHY A BABY MAY
NOT GET ENOUGH MILK
BREAST FEEDING
FACTORS :-
W DELAYED START
W FEEDING AT FIXED TIMES
W INFREQUENT FEEDS
W NO NIGHT FEEDS
W POOR ATTACCHMENT
W USE OF BOTTLES, PACIFIERS
W OFFERING OTHER FLUIDS
MOTHER: PSYCHOLOGICAL
FACTORS:-
W LACK OF CONFIDENCE
W WORRIES , STRESS
W UNWILLING FOR
BREASTFEEDING
W TIREDNESS
REASONS WHY A BABY MAY
NOT GET ENOUGH MILK
MOTHER PHYSICAL
CONDITION:-
W ILLNESS
W PAIN
W SMOKING
BABY'S CONDITION
W ILLNESS
FACTORS NOT AFFECTING
BREAST MILK SUPPLY
W AGE OF MOTHER
W SEXUAL ACTIVITY
W MENSTRUATION
W AGE OF THE BABY
W CAESAREAN SECTION
W PRETERM DELIVERY
W SIMPLE, ORDINARY DIET
W MANY CHILDREN
W SIZE OF THE BREAST
PROBLEMS OF BREAST
FEEDING
W INVERTED NIPPLE
W SORE NIPPLE
W BREAST ENGORGEMENT
W BREAST ABSCESS
W NOT ENOUGH MILK
FREQUENCY OF BREAST
FEEDING
W BREASTFED ON DEMAND
W WHENEVER BABY CRIES FOR
FEEDS
W INTERVAL BETWEEN EACH
FED IS ABOUT 2 - 3 HRS
W BABY SHOULD TAKE 8 - 10
TIMES IN 24 HRS
W SHOULD NOT OMIT ANY
NIGHT FEEDS
EFFECTIVE SUCKLING
W BABY SUCKLES SLOWLY
W PAUSES IN BETWEEN TO SWALLOW
W MOVEMENT OF THE THROAT BONES
W GULPING SOUND CAN BE SEEN
W BABY'S CHEEKS ARE FULL
W CHEEKS ARE NOT RETRACTING
DURING SUCKLING
TEN STEPS TO SUCCESSFUL
BREAST FEEDING
W HAVE A WRITTEN BREAST
FEEDING POLICY THAT IS
ROUTINELY COMMUNICATED
TO ALL HEALTH CARE STAFF
W TRAIN ALL HEALTH CARE
STAFF IN SKILLS NECESSARY
TO IMPLEMENTED THIS
POLICY
W INFORM ALL PREGNANT
WOMEN ABOUT THE
BENEFITS & MANAGEMENT
OF BREAST FEEDING
TEN STEPS TO SUCCESSFUL
BREAST FEEDING
W HELP MOTHERS INITIATES
BREASTFEEDING WITHIN HALF
AN HOUR OF BIRTH
W SHOW MOTHERS HOW TO
BREASTFED , AND HOW TO
MAINTAIN LACTATION EVEN IF
THEY ARE SEPERATED FROM
THEIR INFANTS
W ENCOURAGE BREASTFEEDING
ON DEMAND
TEN STEPS TO SUCCESSFUL
BREAST FEEDING
W GIVE NEW BORN INFANTS NO FOOD OR
DRINK OTHER THAN BREAST MILK,UNLESS
MEDICALLY INDICATED.
W PRACTICE ROOMING-IN,ALLOW MOTHERS
& INFANTS TO REMAIN TOGETHER 24
HOURS A DAY
W GIVE NO ARTIFICIAL TEATS OR PACIFIERS
TO BREASTFEEDING INFANTS
TEN STEPS TO SUCCESSFUL
BREAST FEEDING
W FOSTER THE
ESTABLISHMENT
OF
BREASTFEEDING
SUPPORT GROUPS
AND REFER
MOTHERS TO THEM
ON DISCHARGE
FROM THE
HOSPITAL OR
CLINIC
EXPRESSED BREAST MILK
W MOTHER SHOULD EXPRESS HER
BREAST MILK IN A WIDE MOUTHED
CONTAINER.
W IT CAN BE STORED FOR 8 -10 HRS
IN ROOM TEMPERATURE
W IN REFRIGERATOR IT CAN BE
STORED FOR 24 HRS
W IN - 20
0C
IT CAN BE STORED FOR 3
MONTHS
MOTHER'S ROLE IN THE
CARE OF HER BABY
W MOTHER SHOULD BE AWARED ,
EDUCATED , SKILLED IN MOTHER
CRAFT
W SHE HAS TO INSTINCT , CONCERN
AND INTEREST TO LOOK AFTER HER
BABY
W SHE HAS LOOK AFTER HER BABY
WITH LOVE , AFFECTION & SENCE OF
SACRIFICE
W SHE HAS TO CONSTANTLY AND
CLOSELY WATCHING HER BABY
ROLE OF NEONATOLOGY
NURSE
W THERAPEUTIC
RELATIONSHIP
W FAMILY ADVOCACY
W DISEASE PREVENTION
W HEALTH TEACHING
W COUNSELLING
W RESTORATIVE ROLE
W COLLABORATION
W ETHICAL DECISION MAKING
W RESEARCH
W HEALTH CARE PLANNING
REFERENCES
W CARE OF NEW BORN - MEHARBAN SINGH
W THE SHORT TEXT BOOK OF PEDIATRICS -
DR SURAJ GUPTA
W WONG'S TEXT BOOK OF PEDIATRICS
W PEDIATRICS JOURNAL
W GOOLE . COM
W O.P. GHAI TEXT BOOK OF PEDIATRICS
W IAP TEXT BOOK OF PEDIATRICS