Neonatal Care
1. Normal neonatal body temperature is between 36.5 and 37.5 degrees Celsius.
Before taking the temperature of a newborn with a thermometer, the mercury scale of the thermometer should be thrown below 35 ° C. To measure the temperature of the newborn, the end of the mercury column of the thermometer should be placed in the baby's armpit and the thermometer should be clamped for about 5 minutes.
2. The normal number of breathing times in newborns is 40 to 45 times per minute.
3. Normal neonatal heart rhythm fluctuations are large, generally 100 to 140 times per minute.
4. Newborns can sleep quietly for 90 minutes/time, gain 30 to 50 grams per day, and increase more than 600 grams (600g to 1500g) in the first month is normal. If the growth rate is slow, it may be recommended that the mother add appropriate formula to the newborn.
5. The number of stools in newborns is generally about 8 times a day, of which:
(1) Breastfeeding has about 8 times of stool per day, into a golden paste, thin paste, not formed, and the number of urinations is about 10 times;
(2) Mixed feeding has about 2 to 6 times of stool per day, showing a pale yellow soft strip, and the number of urinations is about 8 times;
(3) Artificial feeding of bowels and bowels is similar to mixed feeding.
6. The amount of feeding of newborns born at term for 1 to 2 weeks is 60 to 90 mL each time, and 90 to 120 mL each time at 3 to 4 weeks.
7. The feeding time of the newborn on the side of breast milk is 15 to 20 minutes.
8. After 12 hours of birth of newborns and 48 hours after birth of dystocia babies, BCG vaccine can be vaccinated.
9. If there is a condition in the newborn room, the temperature should be maintained at 24 ~ 26 ° C.
10. The newborn bath should be carried out 30 minutes to 1 hour after feeding, the water temperature is 38 ° C ~ 40 ° C, and the time should be 10 to 15 minutes. You can use a special shower gel for the body when bathing, or you can use a baby soap, which can be used 1-2 times a week.
11. The time for the umbilical cord to fall off in newborns is 7 to 14 days, and the newborn umbilical cord should be wiped 2-3 times with a 75% concentration of medical alcohol swabs before and after bathing.
12. The temperature of the formula milk powder is 45 ~ 50 ° C, and the boiling and disinfection time of the milk utensils is 10 ~ 15 minutes.
13. Infants and young children can be guided to drink water from a cup after 6 months.
14. The room temperature should be about 28 ° C when the newborn is touched, each action should be repeated 4-8 beats, and all the actions should be completed within about 10 minutes, 1-2 times a day.
15. During visual training, you can hang some colorful toys and pictures at a distance of 20 cm directly above the crib. Audiovisual stimulation to infants should not be excessive, 2 times a day for 20 minutes.
16. Most newborn physiological jaundice appears 2 to 3 days after birth, peaks at about 7 days, and subsides around 14 days.
17. Newborns in the confinement should choose diapers with better breathability, which can generally be replaced once every 2 to 3 hours.
18. If a newborn has a mild red buttocks, it should expose the buttocks more, 2 to 3 times per day, each time for about 10 minutes. Apply tannic ointment after each exposure, and to prevent red buttocks, buttocks cream should be applied after washing your ass.
19. The newborn's saliva towel clothes and bedding should be washed separately, washed and placed in the sun for about 1 hour to achieve the effect of disinfection.
Maternal Care
1 General care 1. Observation of body temperature, pulse, breathing, and blood pressure
Measure body temperature, pulse, breathing, and blood pressure twice every day, and if there is an abnormality, you should find the cause and seek medical attention if necessary.
2. Diet care:
Guide women to strengthen nutrition, with enough protein, vitamins, calorie foods as the main food, diversification of varieties, eat more soups with prolactin effect, generally eat light and easy to digest semi-liquid on the day after childbirth, eat general food after a day after childbirth, encourage women to drink more water, eat more fiber-containing foods, and keep the stool unobstructed.
3. Breaks and activities:
Create a clean, tidy, quiet and comfortable environment for women to recuperate, bed rest should be within 24 hours after childbirth, after 24 hours should be encouraged to get out of bed proper activities, to assist women to take care of their own living, appropriate activities are conducive to the restoration of the uterus, the discharge of lochia, the smoothness of bowel and bladder and the recovery of body shape.
4. Observation of urination:
Pregnant women should be encouraged to urinate on their own 2-4 hours after childbirth, and excessive bladder expansion can affect uterine contractions and cause postpartum hemorrhage. Pay attention to whether the lower abdomen is raised, if the bladder is inflated, the woman should be encouraged to urinate, let the woman listen to the sound of running water or do perineal irrigation to induce the mother to urinate, and if necessary, report urinary catheterization.
5. Observation of lochia:
The blood, mucus, etc. discharged from the vagina after childbirth are collectively referred to as "lochia".
"Bloody lochia" for the first 3 to 4 days;
Later, the blood gradually decreases and becomes brown, which is "serous evil";
At about 10 days, it is yellowish white due to the large number of white blood cells and mucus, called "white lochia", which can last for several weeks.
Normal lochia has a bloody smell, but it doesn't stink.
If there is a bad smell, an infection should be considered.
If bloody lochia persists for more than 2 weeks, uterine insufficiency or placental tissue or membrane remnants should be considered. The total amount of normal lochia is 250-500ml.
6. Vulvar care:
Use disinfectant sanitary napkins and teach the mother to wipe the vulva with disinfectant toilet paper after each defecation to keep the vulva clean and prevent wound infection.
7. Skin care
Postpartum sweat glands are active, a lot of sweating, milk spillage, lochia excretion, coupled with the need for the mother to breastfeed the baby, the requirements for skin hygiene at this time are higher than usual, such as for the normal delivery of the mother, 24 hours after the birth of the mother can be wiped on the bed of the mother, the 2nd day can be showered. The temperature of the bath water is 50-52 °C, and the room temperature is 24-25 °C. Shower water temperature 40-45 ° C, room temperature is preferably 24 ° C. Quickly dry with a towel after bath to prevent colds, generally 1-2 times a week, and tub baths are prohibited for one month after childbirth
8. Promote the recovery of the uterus after childbirth:
About 4 weeks after delivery, the cervix will not return to its normal size. To promote uterine recovery, the following four methods can be followed:
(1) Postpartum urination should be timely: do not overswell the bladder or often be in a state of expansion.
(2) Long-term lying position should be avoided during the puerperium: 6-8 hours after childbirth, the mother can sit up after the fatigue is eliminated, and the next day should get out of bed to move, in order to facilitate the recovery of physical physiology and physical strength, help uterine recovery and lochia discharge. If the uterus has been tilted backwards, it should be corrected by reclining the knee and chest.
(3) Timely breastfeeding after childbirth: Because the baby's sucking stimulation will reflexively cause uterine contractions, thereby promoting uterine recovery.
2 Guidance on breastfeeding
The United Nations Health Organization advocates exclusive postpartum breastfeeding for 4-6 months, which is the most primitive, scientific and effective feeding method, which is conducive to maternal and child health.
Measures to ensure successful breastfeeding include:
1. Early contact, early sucking Within half an hour after childbirth, milk and skin contact can be opened to stimulate milk secretion and breastfeed as needed.
2. Feeding method: before breastfeeding, the tissue around the areola should be squeezed, so that a small amount of milk spillage stimulates the baby's mouth, the nipple and most of the areola areosum are placed in the baby's mouth, and the mother gently supports the breast with one hand to prevent breast compression from blocking the baby's nostrils. At the end of breastfeeding, the indicator finger gently presses down on the baby's jaw to avoid damaging the nipple.
3. Nutrition: Maternal nutrition to ensure the growth and development of newborns, increase protein, calories, supplement calcium, iron vegetables, fruits and cereals and other nutrients. Do not eat spicy and irritating foods, avoid smoking, drinking alcohol, drinking coffee, etc.
4. Precautions
Wash your hands before breastfeeding, scrub your breasts and nipples with water, and assist mothers and newborns in a comfortable position to breastfeed.
After breastfeeding, squeeze out a small amount of milk and apply it to the surface of the nipple to prevent the nipple from cracking
Take turns sucking up the breast during each breastfeeding, and after breastfeeding, pick up the baby and pat it on the back for 1-2 minutes to drain the air in the stomach to prevent spitting;
Women should ensure adequate sleep to maintain a pleasant mood and exercise appropriately after childbirth.
3 Breast abnormality care 1. Breast swelling or insufficient milk production
The main cause is the failure to open milk early and breastfeed on demand, which makes the mammary ducts unobstructed. Pregnant women should be instructed to breastfeed early, breastfeed as needed, make milk, unblock, hot compresses and massage before breastfeeding, and empty breasts after breastfeeding.
Processing method:
When you feel that your breasts are swollen and indulgued or your milk is not produced, you should first apply a hot damp compress with a hot towel, then massage the areola with your index and middle fingers, then support your breasts with one hand and gently press the breasts with the other hand for a rotary massage. Then hold the breast with one hand and shake it up and down, left and right, 20-30 times a day. Pinch the nipple with the thumb, index finger and middle finger for 20-30 strokes once a day. Make the milk ducts dilated and unobstructed.
2． The nipples are flattened and concave
First use a hot towel to apply to the breast, and then pull the nipple, when breastfeeding, let the baby suck the flat nipple first, because the baby is hungry when the sucking force is strong, easy to suck out the milk; when the baby sucks enough, you can borrow the breast pump to suck up the excess milk. If milk stasis occurs, it should be reported to the doctor and nurse in time and dealt with in time to avoid inducing mastitis.
3. Cleft nipple care
After each breastfeeding, a 10% cod liver oil tincture or a compound benzoate tincture may be applied to promote healing.
4. Guide proper breastfeeding
Common breastfeeding positions are sitting and recumbent positions, trying to make the mother and child natural and comfortable. Mother and baby are close, the mother holds the newborn with one hand, supports and gently squeezes the breast with the other hand, promotes the outflow of milk, and places the nipple above the newborn's tongue, so that the baby's mouth contains the nipple and part of the areola, paying attention to prevent the breast from blocking the baby's nostrils
Other points
1. The daily calorie intake during confinement should be about 3000 calories.
2, confinement mother can take a bath, wash your hair, bathing room temperature should be adjusted to about 26-28 ° C. The temperature of maternal bath water should be 42-46 ° C. How long can I wash my hair after giving birth? The washing method for vaginal birth and caesarean section is not the same
3, confinement can brush teeth, pregnant women brush their teeth with warm water, 1 to 2 times a day, use a soft bristle toothbrush to brush gently.
4. The mother combs her hair, washes her hair, washes her feet, washes her perineum, changes her underwear frequently, and keeps her body clean.
5, bathing with a shower is advisable, the time is about 10 minutes.
If it is a bath, after childbirth, if it is a shower, we recommend that normal delivery can be washed after 7 days, and caesarean section is generally washed after 10 days, and the wound is almost good
6. Women who give birth normally can get out of bed and walk around the next day after giving birth. Caesarean section 3-4 days of bedtime activities, appropriate activity and reasonable exercise to help the mother recover. But avoid squatting and labor that increases abdominal pressure.
7. Tummy relaxation: The abdominal band can play an excellent role in the physiological recovery and maintenance of the postpartum relaxed abdominal muscles. The tight abdomen of the mother should not be too tight. Caesarean section, which generally wraps the abdomen with a girdle within seven days after surgery, is necessary to promote wound healing. However, it is not advisable to use the abdominal band for a long time after the abdominal stitches are removed.
8. During childbirth, the maternal physical exertion is very large, and she often feels thirsty after childbirth, so it is better to drink some brown sugar water and eat a thin, soft and light semi-liquid diet, and you can resume a normal diet after 24 hours.
9, the new mother because she has just given birth to a baby, but also to breastfeed, so the correct care of the breast is particularly important, postpartum women sleep correctly, to lie on their back is better.
10. When feeding your child for the first time, you should wipe the nipple clean first. Wash your hands before each feeding. After breastfeeding, some breast milk can be squeezed to moisturize the nipple, and if there is damage, it should be treated in time.
11, 1-3 days after childbirth, the amount of lochia is more, the color is redder, the color is lighter after the color is lighter, the amount is small, it is pale yellow after 10 days, generally in 4 to 6 weeks will completely disappear; if the lochia has large blood clots, foul odor or abnormal phenomena such as blood outflow, the medical staff should be notified immediately.
12. For elderly women, they are very weak after childbirth, and they must eat some foods that replenish qi and blood, but they cannot eat red ginseng and other large supplements to prevent deficiency from being replenished. Than 7 is guiyuan, birds and chickens and other warm supplements.
13, under the milk is difficult: just drink soup is not enough, but also have to eat the ingredients in the soup, drink more water, the water in the fruit is also very rich, if you are afraid of the cold fruit, you can heat a hot or boiled and then eat.
14, after giving birth to the baby sweating more, this is the performance of "hypothermia", do not covet a moment of cool and make yourself cold, especially pay attention to the waist to keep warm.
15, nipple cracking: the egg yolk oil is applied to the mother's nipple, so that even if it is eaten by the baby, it is safe, and the effect is fast, two or three days.