Postpartum and Normal Newborn

colostrum

“liquid gold” with protein, carbohydrates, and antibodies; expressed the first few days after birth

prolactin

hormone for milk production

oxytocin

hormone for uterine contraction and milk production

skin to skin

bonding time for parents within the first hours after giving birth; gold standard

5 to 7 days

timeframe for supressing lactation to occur in non-breatfeeding moms

engorgement

overfilled breasts from milk “coming in” 3-4 days after birth; flu-like symptoms

pumping

will signal body to make more milk supply; avoid excessive to regulate supply

involution

uterus returns to normal size

afterpains

all women will experience after birth due to involution; will occur more in breastfeeding moms due to oxytocin

subinvolution

may occur due to difficult labor, retained placenta parts, infection, full bladder, multiple gestation, overuse of pitocin

atony

flaccid uterus; contributes to blood loss

fundus

top portion of the uterus; should be midline and firm post-delivery

diuresis

may occur up to 24 hours after birth due to fluid shifts

full bladder

displaces uterus up and to the right and may contribute to fundus not being midline or postpartum hemmorhage

constipation

common for slowed bowels post-delivery; use stool softners and increase fiber in diet

lochia

vaginal discharge after birth that continues doe approximately 4-8 weeks

lochia rubra

first stage; dark red in color and lasts about 4 days

lochia serosa

second stage; pinkish in color and lasts about 10 days

lochia alba

third stage; whitish yellow in color and lasts about 10-14 days

redness, edema, ecchymosis, draining, approximation

REEDA - assessment of episiotomy/perineum/epidural site

perineum tear

takes 4-6 weeks to heal; a laceration or cut of the skin and soft tissues that occurs during delivery

100.4

where temp could be in first 24 hours of delivery due to exertion, dehydration, homornes, and lactation

blood pressure

falls within first 2 days, then increases 3 to 7 days PP, and returns to pre-pregnancy levels by 6 weeks

homans sign

calf or deep knee pain elicited by forced or abrupt dorsiflexion of the foot

contact

sensory experiences of touching, holding, and gazing at the infant are part of proximity seeking behavior

emotional state

emerges from the affective experience of the new parents toward their infant and the parental role

individualization

need to differientiate parent needs from infant needs; helps attachment process while still enabling parent to feel a sense of normalcy during postpartum

baby blues

common right after delivery; feeling sad, crying episodes, worry, loss of appetite, difficulty sleeping; due to hormone shift

postpartum depression

thoughts of hurting self or baby; no interest in the baby; occurs 2 weeks after birth

postpartum psychosis

seeing things that aren’t there, thoughts of hurting self or baby, feeling confused, having rapid mood swings

mylicon

medication for gas relief

pitocin

medication for uterine involution

dermoplast

antiseptic and numbing

tucks

witch hazel

rubella vaccine

give to mother postpartum if her titer is low

rhogam

give after testing baby’s blood type; if mom is Rh (-) and baby is Rh (+) the mom will need to this to ensure no antibodies develop for future pregnancies

hemabate and methergine

medication to give if mother experiences subinvolution and postpartum hemorrhage

neonate

28 days

transition

adaptation to extrauterine life in the first 24 hours

foramen ovale

opening between the atria; blood flows from RA to LA; closes within days to weeks

ductus ateriosus

allows blood flow between pulmonary artery and aorta; shunts blood away from lungs; closes within hours to days

ductus venosus

connects umbilical vein to inferior vena cava; closes within hours to days after birth

1-3 months

when concern arises if ductus arteriosus is not yet closed

acrocyanosis

blue limbs; normal within first 24 hours after brith

10%

weight loss of birth weight during first week

conduction

temp loss through contact; think metal table

convection

temp loss through air flow; think fan

radiation

temp loss through proximity; think sun

evaporation

temp loss through wet to vapor; think sweat

cold stress

excessive heat loss requiring compensatory systems

bilirubin conjugation

hemolysis of erythrocytes cause buildup of bilirubin due to immature liver

moro reflex

involuntary startle reflex in newborns

step reflex

instinctive movement where a newborn appears to take steps or dance when held upright with their feet touching a flat surface

fencing reflex

when an infant lies on their back and turns their head to one side, the arm and leg on that same side automatically extend outward straight, while the opposite arm and leg bend at the elbow and knee

harlequin syndrome

causes one side of the face, neck, and sometimes the chest to remain pale and dry while the opposite side flushes and sweats normally

babinski relfex

positive Babinski sign—where the big toe bends upward and the other toes fan out—is completely normal

grasp reflex

an involuntary, primitive muscle response in newborns where an infant automatically curls their fingers to grip an object placed in their palm

24 hours

delay bath during this period to protect health, safety, and development

1 min and 5 min

times to record APGAR scores post-delivery

phenylketonuria

a rare, inherited genetic condition where a baby's body cannot break down an amino acid called phenylalanine, leading to toxic buildup in the blood and brain

moulding

temporary, cone-shaped or elongated change in a baby’s head shape caused by pressure on the soft skull bones while passing through the birth canal during delivery

caput succedaneum

a common, harmless condition in newborns involving a soft swelling or fluid collection in the scalp caused by pressure from the uterus or birth canal during delivery

cephalohematoma

a collection of blood that pools between a newborn’s skull bone and its periosteum, caused by ruptured blood vessels during labor or delivery