Case Study Part IV
Postpartum, Newborn, Breastfeeding
1. What’s the baby’s Ballard Score? a. Term – baby is 40 weeks (score 41) b. Preterm c. Post term 2. What’s important to do in the first 72 hours post partum for Esperanza? * Esperanze must receive a Rhogam injection within the first 72 hrs because her baby’s BTG is A positive. 3. What is probably going on with the baby’s state of conciousness? * Newborn infants undergo a transition period from intrauterine to extrauterine during the first 8 hours of life. Esperanza’s baby went through a period of decreased responsiveness characterized by his sleepiness (lasts 30m – 2hrs) and then followed by a second period of reactivity. (can last 10m – several
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5. Describe possitions and latching techniques that can help Esperanza in breastfeeding. * In preparation for latch-on the mother should add a few droplets of colostrum or milk and spread it over the nipple. This lubricates the nipple and may entice the baby to open the mouth as the milk is tasted. * The mother should support the breast during feeding for the first few days until the baby adapts to breast feeding. * The mother should tickle the baby’s lower lip with the tip of her nipple to stimulate the mouth to open. If the breast is pushed into the baby’s mouth the baby will close his mouth too soon, which will preclude the latch-on. * (4) Basic Positions for breastfeeding: * Football hold – the mother can easily the baby’s mouth as she guides the infant on to her nipple. (Recommended for moms who delivered by cesarean) * Accross-the-lap hold – works well for early feedings, especially with smaller babies. * Side-Lying position – allows the mother to rest while breastfeeding. Preferred by women with perineal pain and swelling. * Cradling – commonly used for infants who have learned to latch on easily. 6. What would be of concern on your assessment and in the labs, and what is the management of both normal and abnormal findings?
- Hgb 10.9 (Normal: 12-16 g/dl) – slightly low, however normal for postpartum women as their expected to have a Hgb level between 10.4 – 18.0 g/dl. Unless it