NEED OF NEW BORN AND PARENTING PROCESS

NEED OF NEW BORN

Care of a normal baby at birth

OBJECTIVES

❖ To describe evidence-based routine care of a newborn baby at and soon after birth
❖ to describe evidence based routine care of new-born baby at and soon after birther

Basic needs of a baby at birth

FOUR basic needs at birth:

❖ Thermal protection
❖ Normal breathing
❖ Mother’s milk
❖ Protection from infection

CARE AT BIRTH
➢ Call out time of birth
➢ Receive the baby onto a warm clean towel and place on mother’s chest
➢ Clamp and cut the umbilical cord
➢ Dry the baby with a warm, clean towel or piece of cloth
➢ Assess baby’s breathing while drying

Dry baby immediate after birth

 ❖ Wipe both eyes (separately) with sterile gauze pieces
❖ Put the baby between mother’s breasts for skin-to-skin contact
❖ Place an identity label on the baby
❖ Cover mother and baby with warm cloth; put a cap on the baby’s head
❖ Initiate breastfeeding

Immediate skin-to-skin contact & breastfeeding

Ensuring warmth at the time of delivery: ‘Warm chain’

‘Warm chain’: At delivery

1. Ensure the delivery room is warm (25° C), with no draughts.

2. Dry the baby immediately; remove wet cloth
3. Wrap the baby with clean dry cloth
4. Keep the baby skin-to-skin with mother

Helping the baby breathe

1. crying breathing adequately,
2. no intervention is needed
3. not breathing or gasping, then skilled care in the form of RESUSCITATION) would be required

‘Warm chain’: After delivery

❖ Keep the baby clothed and wrapped; cover the head
❖ Postpone bathing particularly for small babies
❖ Keep baby close to the mother
❖ Use kangaroo care for stable LBW babies
❖ Show mother how to avoid hypothermia and to recognize
❖ Initiate breastfeeding
 Initiating breastfeeding
❖ Keep the baby in skin-to-skin contact between mother’s breasts immediately after
drying
❖ Help the mother in her first few attempts to breastfeed
❖ Make her and the baby comfortable
❖ Explain and show her proper positioning and attachment

Ensure skin to skin contact after birth

Baby shows feeding cues…

..and is ready for breastfeeding

Prevention of infections: ‘Clean chain’

At delivery: WHO five cleans

Clean

1. Hands of attendants (washed with soap)

2. Surface for delivery
3. Cutting instrument for cord(i.e. razor, blade)
4. String to tie cord
5. Cloth to wrap baby and mother

Prevention of infections: ‘Clean chain’

After delivery

1. Hand washing before handling the baby

2. Exclusive breastfeeding
3. Keep the cord clean and dry; do not apply anything
4. Use a clean cloth as a diaper/napkin
5. Hand wash after changing diaper/napkin

CORD CARE

• Apply a sterile tie tightly around cord at 2 cm and 5 cm from the abdomen
• Cut between the ties with a sterile instrument
• Observe for oozing blood every 15 minutes; if blood oozes, place a second tie
• Do not apply any substance to the stump
• DO NOT bind or bandage stump
• Leave stump uncovered

EYE CARE

• Clean eyes immediately after birth with swab soaked in sterile water
• Use separate swabs for each eye; clean from medial to lateral side
• Give prophylactic eye drops within 1 hour of birth (as per hospital policy)
• Do not put anything else in baby’s eyes

MONITATING BABY

• Do not leave the mother and baby alone in the three p every 15 minutes:
• Breathing: Grunting, chest in-drawing, fast breathing (>60/min)
• Warmth: Check if the baby’s feet are cold (by using your hands)
• Colour: Evaluate the colour of trunk and extremities

SPECIAL SITUATION

Mother has HIV/AIDS

1. Follow universal precautions as with any other delivery

2. Baby can have immediate skin-to-skin contact as any other mother and baby
3. Breastfeeding can begin when the baby is ready*
4. If mother chooses replacement feeding, prepare formula for the first few feeds
5. All other care (including cord care and eye care) remain the same

KEY POINTS

❖ Four basic needs at birth: warmth, normal breathing, breastfeeding, prevention of infections
❖ Ensure warmth by skin to skin contact with mother’s chest/abdomen
❖ Help the mother to initiate early breastfeeding
 ❖ Follow ‘WHO five cleans’ to prevent infections

PARENTING PROCESS

➢ INTRODUCTION

Attachment is the strong, long lasting bond which develops between a baby and his or her caregiver.
This enables a baby to feel safe and free to learn and explore, and helps with forming relationships
throughout their lives.

Providing consistent responsive and sensitive love and care during the first few months can help your baby
develop. Responding to babies' cues not only helps them to develop secure attachment but also is the
beginning of two-way communication.

Unresponsive care can lead to attachment problems that can have an ongoing negative effect on your baby’s
development.

Human beings are designed to connect together - we all need a safe and secure base. People who have had
strong attachments as babies develop an inner sense of security, enjoy trusting long-term relationships, seek
out support and have an ability to share feeling with others.

DEFINITION

Parenting or child rearing is the process of promoting and supporting the physical, emotional, social, and
intellectual development of a child from infancy to adulthood. Parenting refers to the intricacies of raising a
child and not exclusively to the biological relationship.[1]

The most common caretaker in parenting is the biological parent(s) of the child in question, although others
may be an older sibling, a grandparent, a legal guardian, aunt, uncle or other family member, or a family
friend.
[2]
Governments and society may also have a role in child-rearing. In many cases, orphaned or abandoned
children receive parental care from non-parent blood relations. Others may be adopted, raised in foster care,
or placed in an orphanage. Parenting skills vary, and a parent with good parenting skills may be referred to
as a good parent.
[3]
Parenting styles vary by historical time period, race/ethnicity, social class, and other social features.[4]
Additionally, research has supported that parental history both in terms of attachments of varying quality as
well as parental psychopathology, particularly in the wake of adverse experiences, can strongly influence
parental sensitivity and child outcome

Factor affecting on parenting process

➢ Style
➢ Practice
➢ Across the life span
➢ Assistance
➢ Childbearing and happiness
 Types/style

❖ Authoritarian disciplinarian
❖ Permissive or indulgent
❖ Uninvolved
❖ Authoritative

Most common parenting style

✓ Instinctive parenting
✓ Attachment parenting
✓ Helicopter parenting
✓ Authoritative parenting
✓ Permissive parenting

Family types

➢ Nuclear family
➢ Extended family
➢ Single parent family
➢ Reconstituted family
➢ Childless family

babies attach to?

Baby attachment behaviours?

Attachment behaviours are when babies and toddlers try to get comfort and protection from the people they
feel attached to.

➢ This can be by making eye contact, smiling and cooing, crawling and following, holding out their
arms, crying and many other signals that parents and carers learn to know.
➢ When the child gets an appropriate response, such as eye contact, a smile, a touch or a quick cuddle,
and feels safe, the child is free to relax, play, explore and learn again.
➢ If the response is not sensitive to the baby's needs, for example if the baby feels ignored or punished,
the baby continues to feel anxious or afraid and continues the attachment behaviour. So, for example,
if the parent thinks a toddler should be brave and urges her to leave the safety of being close before
she is ready, the child is likely to respond by feeling more afraid and clinging more. Some babies or
toddlers who are very afraid eventually give up trying.
➢ Helping children to feel safe first is the best way to encourage them to be brave.

Responding to babies' cues

Responding to babies' cues not only helps to develop secure attachment but also is the beginning of two-way
communication.

Approaching our babies calmly and gently requires most of us to slow down. This may mean that we have
to make changes to our own lifestyles in order to be with our babies at their pace that allows us to notice
their signals to us.

Even young babies can give signals for attention, and also signals for when the care is not quite right.
To show they need attention young babies may:

• make eye contact

• make little noises
• smile
• copy the parent's gestures
• look relaxed and interested

To show when they need a break or perhaps a different, gentler approach young babies may:

• look away
• shut their eyes
• try to struggle or pull away
• yawn
• look tense and unsettled
• cry.

It is important to respond to these signals in ways that meet your baby’s needs because this says to the baby
that they have been heard and responded to. Your baby is then beginning to develop a sense of an
independent self. When your baby lets you know she needs a break it is important to understand that she is
not rejecting you, but is simply indicating her own needs.

Small babies cannot yet think about someone else's needs.

Babies will develop their own special ways of showing what they need and special patterns of interaction
with their parents.

Attachment and separation

By the time your baby is about 6 months old she will have become attached to the people who care for her
most. These people will be her safe base to explore the world for the next few years until she is old enough
to really feel secure when you are not there. This can also bring with it being afraid of people she does not
know so well, sometimes even the other parent or a loving grandparent.

This is a normal part of learning to feel safe in the world and she will soon learn to feel safe again with
other people in her life when you reassure her that all is well and if she is not pushed to separate too quickly.

During the next few years until they are about three or four, babies and toddlers gradually get to manage
longer separations from their special people. At first they continually check - even follow you into the toilet
once they can crawl. Then they will move away and play for a while but check back by looking for you or
coming to you from time to time. This is how they gradually develop confidence. By three or four they can
usually manage a half day or day with other people without being upset, but some children take longer. It
depends on their temperament and their early experiences. This is sometimes known as the 'Circle of
security'.

There is more in the topic 'Separation anxiety'

Helping babies have secure attachments

Much research has gone into looking at the best ways to give babies secure foundations.

➢ Have realistic expectations of what babies can do . Knowing how babies develop means
you don't expect them to be able to do things that they can't.
 • For example some parents think that young babies are trying to manipulate them when they cry at
night. But young babies don't remember that you are there when you are out of sight.
• They cry because they need something and if parents come when they cry, and comfort them, they
eventually learn to know that the world is safe and they cry less.

➢ Be willing to take time to be with your baby and learn to "read" her messages.

• Young babies often give very small signals for what they need. The carer needs to learn to know
their baby’s signals to respond to them.

➢ Be able to respect and think about the baby as a separate person with his or her own
needs and wants and feelings.

• Think about how it feels for a baby to be suddenly picked up without warning and put down
somewhere else, or have a nappy change or be handed to a stranger.

➢ Have support for yourself - have someone to talk things over with, to encourage you when you
are doing well and to give you a break when you need it.

• It is often much harder than you would think to learn, understand and respond to little babies, and
parents need support too.

➢ Have some understanding of your own parenting, what your parenting meant to you and
how it affects the way you feel about and care for children (because it always does).
➢ What mother can do

• Think about, treat, and talk to your baby as an individual with his own needs, likes and dislikes.
• Learn to know your baby's signals, what his messages mean, and then respond to them.
• Think about timing. Introduce changes such as picking up, nappy change gently and gradually - tell
your baby what you are going to do so the baby learns that the world is predictable and is not
startled.
• Be flexible.

❖ Learn to know what works for your baby.

❖ Develop a routine that suits your baby and you.
❖ Remember that babies grow and change quickly, and need more time awake with you, so you
need to respond to their changes.

• Find out about how babies grow and learn so you know what babies are like and don't have
unreasonable expectations. Your baby’s health record ('Blue book' in South Australia) has key
points about development.
• Copy your baby's little noises and gestures - this is the beginning of conversation.
o Wait for your baby's response before going on.
o If your baby looks away or yawns, stop and try again later.
• Make eye contact. Babies like to look into your eyes.
• Notice when your baby is trying to get your attention with looks, smiles or cries. Crying always
signals a need. Take time to watch and learn what your baby might be telling you.
• Provide comfort when your baby is upset.
• Try to relax and concentrate on the baby's world, what he is looking at, trying to do, feeling etc.
• Find out what your baby really likes.
• Give your baby opportunities to succeed and make things happen, eg put a rattle where he can hit it
and make a noise, or crawl to reach it.

Remember mother are the most important part of your baby's life.
If mother are worried about their relationship with her baby ask for help. It is such an important part of
baby's life that getting help when he or she is young can make a big difference to mother and to mother
baby.

Pre-pregnancy
Main articles: Family planning and Prenatal care

Family planning is the decision regarding whether and when to become parents, including planning,
preparing, and gathering resources. Prospective parents may assess (among other matters) whether they have
access to sufficient financial resources, whether their family situation is stable, and whether they want to
undertake the responsibility of raising a child. Worldwide, about 40% of all pregnancies are not planned,
and more than 30 million babies are born each year as a result of unplanned pregnancies.[53]

Reproductive health and preconception care affect pregnancy, reproductive success, and the physical and
mental health of both mother and child. A woman who is underweight, whether due to poverty, eating
disorders, or illness, is less likely to have a healthy pregnancy and give birth to a healthy baby than a woman
who is healthy. Similarly, a woman who is obese has higher risks of difficulties, including gestational
diabetes.[54] Other health problems, such as infections and iron-deficiency anemia, can be detected and
corrected before conception.

Pregnancy and prenatal parenting

Pregnant women and their unborn children benefit from moderate exercise, sufficient sleep, and high-quality
nutrition.

During pregnancy, the unborn child is affected by many decisions made by the parents, particularly choices
linked to their lifestyle. The health, activity level and nutrition available to the mother can affect the child's
development before birth.[54] Some mothers, especially in relatively wealthy countries, eat too much and
spend too much time resting. Other mothers, especially if they are poor or abused, may be overworked and
may not be able to eat enough, or not able to afford healthful foods with sufficient iron, vitamins, and
protein, for the unborn child to develop properly.

Newborn parenting, is where the responsibilities of parenthood begins. A newborn's basic needs are food,
sleep, comfort and cleaning which the parent provides. An infant's only form of communication is crying,
and attentive parents will begin to recognize different types of crying which represent different needs such
as hunger, discomfort, boredom, or loneliness. Newborns and young infants require feedings every few
hours which is disruptive to adult sleep cycles. They respond enthusiastically to soft stroking, cuddling and
caressing. Gentle rocking back and forth often calms a crying infant, as do massages and warm baths.
Newborns may comfort themselves by sucking their thumb or a pacifier. The need to suckle is instinctive
and allows newborns to feed. Breastfeeding is the recommended method of feeding by all major infant
health organizations.[56] If breastfeeding is not possible or desired, bottle feeding is a common alternative.
Other alternatives include feeding breastmilk or formula with a cup, spoon, feeding syringe, or nursing
supplementer.

The forming of attachments is considered to be the foundation of the infant/child's capacity to form and
conduct relationships throughout life. Attachment is not the same as love and/or affection although they
often go together. Attachments develop immediately and a lack of attachment or a seriously disrupted
capacity for attachment could potentially do serious damage to a child's health and well-being. Physically,
one may not see symptoms or indications of a disorder but the child may be emotionally affected. Studies
show that children with secure attachment have the ability to form successful relationships, express
themselves on an interpersonal basis and have higher self-esteem[citation needed]. Conversely children who have
caregivers who are neglectful or emotionally unavailable can exhibit behavioral problems such as post-
traumatic stress disorder or oppositional defiant disorder [57] Oppositional-defiant disorder is a pattern of
disobedient and defiant behavior toward authority figures.
BIBLIOGRAPHY

Book 'Right from the Start' available from Women's and Children's Health Network and Parenting SA.
http://www.cyh.com/SubContent.aspx?p=467

Raising Children Network

• Newborns (0-3 months)

http://raisingchildren.net.au/newborns/newborns.html
• Bonding with your newborn
http://raisingchildren.net.au/articles/connecting_with_your_newborn.html
• Attachment
http://raisingchildren.net.au/articles/attachment.html
• http://raisingchildren.net.au/articles/pip_bonding.html/context/280
• https://en.wikipedia.org/wiki/Parenting#Factors_that_affect_decisions
 MANIBA BHULA NURSING COLLEGE
BARDOLI

SUB : OBSTRATIC AND GYNAECOLOGY NURSING

TOPIC : NEEDS OF NEW BORN AND PARENTING PROCESS

SUBMITED TO SUBMITED BY
LACTURERE KINJAL I TANDEL
HIRAL MISTRY FY MSC NURSING
DEPARATMENT -OBG DEPARATMENT -OBG
MBNC MBNC

DATE:1/8/19