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24.1 Basic Newborn Care

Basic care of the newborn involves many important topics. Infant safety is essential, both in the hospital and at home, and nurses must reinforce this topic as often as possible. Nurses teach parents to identify hospital staff by their picture ID badges and, if badges are not easily visible, to ask to see them. Nurses should check parents’ and infant’s ID bands to make sure that the numbers match any time the family has been separated. Parents should not release their baby to anyone without a hospital ID and should never leave their baby in the room unattended. Safety discussions should begin with parents immediately upon admission and continue with reinforcement until both parent and baby are discharged. Safety topics should also include precautions to be taken once the family arrives home.

Breast-feeding and bottle-feeding issues, including establishing feeding patterns, how to feed, when to feed, and how much to feed, all need to be addressed. Each baby is different, and even parents who have had previous children must learn the patterns for the new baby. Stooling needs to be reviewed because this is often a concern of parents and is quite different for breast- and bottle-fed infants. Growth spurts and cluster feeding are another area worthy of review.

Immunizations are a necessary area for education because the newborn will likely get their first immunization shortly after birth. For parents who have chosen to circumcise their newborn son, there is likely much teaching to be done. For those who have chosen not to circumcise their son, care of the uncircumcised penis should be reviewed.

24.2 Care of Common Problems in the Newborn

This section of the chapter examined the pathophysiology, recognition, and treatment of hyperbilirubinemia, hypoglycemia, dermatologic issues, as well as common viral and bacterial infections. By understanding these conditions, nurses can effectively provide optimal care for newborns.

This section reviewed signs of illness in the newborn and when to call the primary health-care provider. This information needs to be reviewed and reinforced with new parents. Although newborns rarely get ill, when they do, they can decline very quickly. Table 24.6 is a great tool that parents can use to prepare for the phone call to the health-care provider. Having this information completed avoids delay in the care and treatment of their ill newborn.

24.3 Newborn Discharge Planning and Parent Education

Hospital stays for childbirth are relatively short, ranging from 2 days or less for a vaginal delivery to 4 days or less for a cesarean delivery. Nurses must use every opportunity to teach parents about caring for themselves and their baby postpartum. When parents have the baby at the bedside, it is an ideal time to educate them about their baby. Teach them about normal behaviors, breathing patterns, and what would be considered abnormal or warning signs, sleep-wake periods, feeding patterns, crying, and so on. It is much easier for parents to understand when the baby is demonstrating what you are talking about, and you will have a captive and interested audience.

Crying is a major source of concern for new parents. They need reassurance that all babies cry and that it is the only way for them to communicate when their needs are not being met. Reassure parents that they will become aware of their infant’s different cries and what they mean, but this may take a little time. When their infant cries, this does not mean that they are a bad parent or that they are doing something wrong. Reinforce with the parents that infants are not spoiled by prompt attention to their needs. Attention provides comfort and security to their infant, who will learn to soothe and settle more quickly. At times a baby will cry for no reason, and then the only thing a parent can do is ensure that the baby’s needs are met and then provide soothing and settling comfort.

Parents are educated regarding infant safe sleep practices, potential risk factors for SIDS, and the recommended guidelines to keep infants safe while sleeping.

Signs of illness in the newborn and when to call the primary health-care provider are other areas that need to be reviewed and reinforced with new parents. Although newborns rarely get ill, when they do, they can decline very quickly.

Provide your patient with as much information as you can about how to safely care for their new baby when they go home. Their job is to ask questions. Provide them with a pen and paper to note questions when you are not available so that they can ask you when you are. This way their questions can be answered before they are discharged. By working with your patient as a team, you can send them home feeling confident in the care they are able to give to their baby.


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