The Postnatal Period


The period beginning immediately after the birth of a baby and extending for about six weeks is post natal period and it’s a very crucial period for both the mother and the newborn. Immediately after birth, most of the babies are often awake, alert and watchful. Please note, the following precautions and procedures are followed in case the baby is born in a hospital set up

  • The umbilical cord is clamped and cut. Eventually the dried piece of cord turns black, dries up and usually falls off five to seven days later.
  • The APGAR score is recorded. This is a check of your baby’s health including breathing, heart rate and color. This is done at one minute and at five minutes after birth. The APGAR score simply tells your doctor how well your baby has made the journey from inside the womb to outside world.

The APGAR Scale

 

Description / Score

0

1

2

A

Activity
(muscle Tone)

Absent

Flexed arms
And legs

Active

P

Pulse

Absent

Below 100

Over 100 bpm

G

Grimace
(Reflex irritability)

Floppy

Minimal response to stimulation

Prompt response to stimulation

A

Appearance
(Skin Color)

Blue: Pink

Pink body
Blue extremities

Pink

R

Respiration

Absent

Slow and irregular

Vigorous cry

Please note, a total score 7 to 10 is considered normal. A lower score is a sign that the babies need special medical attention and follow up with child specialist.

  •  The baby’s weight is recorded.
  •  The nurse will apply an external oxygen saturation probe on your baby’s right wrist, to monitor oxygen levels and heart rate while breastfeeding.
  • Two identification bands with your details will be applied on your baby’s feet. These must stay on at all times during your hospital stay and if they fall off, let your nurse / midwife know and your baby will have them replaced.
  • You may notice that your baby has some swelling or bruising, or your baby’s eyes may look a little puffy. Babies who have been born with the help of forceps or vacuum suction may also have a slightly misshapen head from the birth. This is all very normal and is only temporary
  •  The baby’s first poo-feces (called meconium) will be black and very sticky. After a few days it will turn yellow.
  •  There is a soft spot on top of the baby’s head (called the fontanelle) where the bones have not yet come together. It is safe to touch this spot gently.
  •  The genitals can sometimes be swollen in boys and girls. Girls may also have some white or bloody vaginal discharge caused by mother’s hormones.
  •  A rash can appear on the face or body in the first days after birth. This is common and will fade away but your baby will be checked everyday

 

Routine Management

  • It is recommended that all babies be given a single dose of Vitamin K injection or three doses orally, the first within a few hours of birth. Newborns may be low in Vitamin K in the first eight days of life. Vitamin K is needed to help the blood clot and to prevent bleeding.
  • It is recommended that all babies have a newborn screening test to identify those at risk for rare, but serious medical conditions, Phenylketonuria (PKU), hypothyroidism and cystic fibrosis. In most cases, if the diseases are found they can be treated and the baby will grow and develop normally.
  • A small number of babies are born with a hearing loss that could affect their speech and language skills. Hearing loss may not be obvious in the first few weeks of life, but can be detected by a hearing screen. You will be given the results as soon as the screen is completed.
  • Some serious medical conditions can be picked up early at the six week check, such as: Hip problems, Eye problems, Heart problems, Developmental problems, etc
  • Immunizations Schedule: When your baby is eight weeks old. Your baby will be immunized for: Diphtheria, Tetanus and Whooping Cough (DPT), Hepatitis B, Polio, Haemophilus influenzae type B (Hib), Pneumococcal disease, Rotavirus, etc. When your baby is older immunizations are given for: Measles, Mumps, Rubella (German Measles) (MMR),  Meningococcal C (one form of meningitis), Varicella (Chicken Pox), etc

Possible complications and its management with the newborn

  1. Thermal care for preterm babies and low birth weight infants
  2. Advise on support of early initiation of breastfeeding
  3. Promotion and provision of hygienic cord and skin care
  4. Neonatal resuscitation with bag and mask for babies who do not breathe at birth
  5. Presumptive antibiotic therapy for the newborn at risk  of bacterial infection
  6. Case management of neonatal sepsis, meningitis and pneumonia
  7. Kangaroo mother care for preterm babies
  8. Extra support for feeding the small and preterm baby
  9. Prophylactic use of synthetic surfactant
  10. Therapeutic surfactant use for respiratory distress  syndrome
  11. Continuous positive airway pressure (CPAP) to manage  pre-term babies with respiratory distress syndrome
  12. Management of newborns with jaundice


If you have any concern about your child postnatal development and want to know more about child development, please mail us at helpicd@gmail.com

 

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