Postnatal Nursing Care for Newborns and Mothers
Definition of Postnatal Period:
The postnatal period is usually considered the interval extending from the birth of the baby until 6 weeks after. It is the 6 weeks interval between the birth of the newborn and the rectum of the reproductive organs to their normal non-pregnant state.
Postnatal Nursing Care for Mothers and Newborns:
Postnatal Nursing Care of Mother:
- The importance of having someone nearby for the first 24 hours.
- The importance and recommended timing of postnatal visits.
- The importance of the new mother eating more and healthier foods – discuss in the context of local practices and taboos to ensure women have access to good nutrition. The new mother should also drink plenty of clean, safe water.
- The importance of rest and sleep and the need to avoid hard physical labour.
- Discussion of normal postpartum bleeding and lochia – discuss with women how much blood loss they can expect, for how long. When bleeding is more than normal, they should seek care urgently.
- Discuss the danger signs for the woman and baby and the importance of seeking help quickly.
- Personal hygiene in the context of local practices and the environment. Discuss with women the type of pads they will use and their disposal, and care of episiotomy in the context of home conditions. Hand washing is particularly important to prevent infections. It is also important not to insert anything into the vagina.
- Talk to them about when they can resume sexual relations and the importance of condom use to prevent STI and HIV transmission.
- Discuss infant feeding and breast care and the importance of only taking prescribed medicines when breastfeeding.
- Discuss the importance of the home environment for promoting the health of the baby and recovery of the mother. For example, discuss the need for warmth, good ventilation and hygiene for both mother and baby.
- In an area with malaria, discuss the importance of mother and baby sleeping under an insecticide-treated bed net.
Counseling on nutrition:
- Advise the woman to eat a greater amount and variety of healthy foods, such as meat, fish, oils, nuts, seeds, cereals, beans, vegetables, cheese and milk to help her feel strong and well (give examples of how much to eat).
- Reassure the mother that she can eat any normal foods- these will not harm the breastfeeding baby.
- Discuss any taboos that exist about foods which are nutritionally healthy.
- Talk to her partner or other family members to encourage them to ensure that the woman eats enough and avoids hard physical work.
Monitor danger signs of the women:
Following danger signs:
- Vaginal bleeding has increased,
- Fits,
- Fast or difficult breathing,
- Fever and too weak to get out of bed,
- Severe headaches with blurred vision,
- Calf pain, redness or swelling, shortness of breath or chest pain,
- Swollen, red or tender breasts or nipples,
- Problems urinating, or leaking,
- Increased pain or infection in the perineum,
- Infection in the area of the wound (redness, swelling, pain, or pus in wound site),
- Smelly vaginal discharge,
- Severe depression or suicidal behavior (ideas, plan or attempt).
Postnatal depression of women:
They may also experience any of the following:
- Persistent sad or anxious mood, irritability,
- Low interest in or pleasure from activities that used to be enjoyable,
- Difficulties carrying out usual work, school, domestic or social activities,
- Negative or hopeless feelings about herself or her newborn,
- Multiple symptoms (aches, pains, palpitations, numbness) with no clear physical cause.
Encourage women to do things for themselves that they enjoy such as:
- Meeting a friend,
- Getting out of the home or walking, or things which help them to let their feelings out,
- Singing, drawing or writing,
- Spiritual relief through prayer,
- Meditation.
Postnatal Nursing Care of Newborn:
- It is important to provide mothers, fathers and families with practical advice on how to care for the baby during the first few days.
- Keep the baby warm – a baby should wear 1-2 layers more than an adult. If cold, put a hat on the baby’s head.
- Care for the umbilical cord. Do not put anything on the stump.
- Keep the baby clean. It is not necessary to wash the baby every day, but wash baby’s face and bottom when needed. Make sure the room is warm when undressing baby.
- Provide nothing but breast milk day and night.
- They should see a health worker on day 3 and between 7 and 14 days and 4-6 weeks after birth. At the 6 week visit the baby will be immunized.
- Let the baby sleep on his/her back or side.
- Keep the baby away from smoke.
- It is not recommended to expose the baby to direct sun.
Monitor and treat following danger signs of newborn:
Advice the mother and family to seek care immediately, day or night. They should not wait if the baby has any of these signs:
- Difficulty in breathing or in drawing,
- Fits,
- Fever,
- Feels cold,
- Bleeding,
- Not feeding,
- Yellow palms and soles of feet,
- Diarrhoea.
The mother and family should go to the health center as soon as possible if a baby has any of the following signs:
- Difficulty feeding (poor attachment, not suckling well),
- Is taking less than 8 feeds in 24 hours,
- Pus coming from the eyes or skin pustules,
- Irritated cord with pus or blood,
- Yellow eyes or skin,
- Ulcers or thrush (white patches) in the mouth – explain that this is different from normal breast milk in the mouth.
Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”