L9 Community support for new mums and newborn

Common issues for new parents in the first few days: [blank_start]Tired[blank_end], overwhelmed – excited, fearful, joy, confusion. [blank_start]Establishing[blank_end] breast feeding. [blank_start]Lochia[blank_end] (vaginal discharge containing blood, mucus, and uterine tissue) – can last up to 6 weeks postpartum After-pains If [blank_start]C-section[blank_end]; stiches, sore, restricted lifting/moving

Pregnant women choose one lead professional, called a Lead Maternity Carer, to provide and coordinate care. Choose the incorrect statement.

The Well child Tamariki Ora Programme - Is free to all children from birth to [blank_start]5[blank_end] years. - Includes [blank_start]12[blank_end] core contacts as well as a general practitioner check at [blank_start]6[blank_end] weeks, linked to the [blank_start]6-week immunisations[blank_end]. - Serve as an important gateway to targeted and [blank_start]specialist[blank_end] health, education and social services for children and families/whānau with additional needs.

Plunket - Is New Zealand's [blank_start]largest[blank_end] provider of support services for the development, health and wellbeing of children [blank_start]under 5[blank_end]. - Plunket is a national [blank_start]not-for-profit[blank_end] organisation and free to all families - PlunketLine support line is available [blank_start]24 hours a day, seven days a week[blank_end] to provide guidance and advice to parents and caregivers - Toy libraries, car seat rental, playgroups, education in schools.

Which is not a benefit of breastfeeding?

Match the issue with solution: - Engorged breasts – [blank_start]cold press, pads[blank_end] - Latching pain – [blank_start]incorrect technique[blank_end] - Sore, cracked nipples – [blank_start]lanolin/shields[blank_end] - Blocked ducts - [blank_start]Dr[blank_end] - Inverted or flat nipples - Tongue-tie – [blank_start]refer to Dr/midwife[blank_end] - Low milk supply – [blank_start]keep feeding/supplements[blank_end]

Bottle feeding: - There should be no marketing of infant formula (formula for babies under [blank_start]6 months[blank_end]). This is to try and promote breast feeding. - Mothers choice - Recommended for babies who are [blank_start]failing[blank_end] to thrive - Need to [blank_start]sterilise[blank_end] bottles and teats before use - You can warm infant formula before feeding it to a baby, but it’s [blank_start]not[blank_end] necessary - Specialised infant formulae [blank_start]subsidised[blank_end] on the pharmaceutical schedule, only appropriate for infants with cows’ milk protein allergy who are unable to be breast fed.

There are three types of depression which can occur after childbirth. 1. Postnatal or maternity blues: are very common and involve a [blank_start]brief[blank_end] period of the mother feeling down and tearful in the week after her baby is born. This feeling passes after a few days. 2 Postnatal depression: a much more [blank_start]serious[blank_end] condition, is also common. The woman becomes seriously [blank_start]depressed[blank_end] in the first months following the baby's birth. 3. Postnatal psychosis (sometimes called postpartum psychosis): is rare and involves symptoms of psychosis (being out of touch with reality) associated with changes in mood – either a depressed or an extremely high mood. It usually begins in the first [blank_start]two weeks[blank_end] after the child is born.

Select symptoms which differentiate PPD from baby blues.

PPD risk factors: - Before pregnancy and birth: past history of [blank_start]depression[blank_end] or other mental health problem, relationship difficulties, especially with the [blank_start]father[blank_end] of the baby or with own mother, having little social [blank_start]support[blank_end], life stresses or difficulties such as [blank_start]money[blank_end] or housing problems. - Risk factors related to the birth: birth [blank_start]complications[blank_end], such as caesarean delivery, birth did not go as planned (eg. birth in hospital or with intervention when the woman wanted a home or natural birth), birth of a [blank_start]brain-damaged[blank_end] or ill baby. - Risk factors after birth: persisting postnatal blues, not wanting to hold the baby or feeling detached, having negative thoughts about the baby, sleep problems, the baby is [blank_start]fussy[blank_end], has problems feeding, or has colic or reflux.

EPDS (Edinburgh postnatal depression scale) is the most commonly used diagnostic tool for PPD.

Treating PPD: - Enhanced social support and psychological [blank_start]therapy[blank_end] should be considered first, especially if symptoms are mild - If moderate depression then SSRI is recommended, [blank_start]sertraline or escitalopram[blank_end] are currently the most preferred (compatible with breastfeeding)

New born skin problems: - Newborn acne is very common. The best way to treat it is to do [blank_start]nothing[blank_end] - don't pick, scrub or treat them. - Dry and peeling skin is simply the shedding of dead skin, and using lotions won't [blank_start]speed[blank_end] up this process - Erythema toxicum neonatorum - affects at least 50% of babies is [blank_start]harmless[blank_end] and requires no treatment. Typically the [blank_start]rash[blank_end], which appears as red marks on the skin. - Cradle cap - scaly rash that [blank_start]commonly[blank_end] affects the scalp of babies. Possible causes include overactive oil producing glands, mum’s hormones and yeasts that live on the skin.

Watery eyes – blocked tear duct - [blank_start]1/3[blank_end] of babies experience this - pus in the eye - crusting eyelids and eyelashes - redness in the [blank_start]inner corner[blank_end] of the eye - the condition resolves itself in [blank_start]90[blank_end] percent of infants by their first birthday. - Gentle [blank_start]cleaning, massage[blank_end]

Red flags for watery eyes: - inflammation - redness - discharge that is [blank_start]yellow or green[blank_end] in colour - pain - changes in eye or eyelid structure - sensitivity to [blank_start]light[blank_end] - itching (your child may [blank_start]rub[blank_end] their eyes often)

Teething - Start around 6 months -1 year - Many babies’ teeth come through without any problems, but for some the gums [blank_start]swell[blank_end] and become sore as teeth break through. - Signs: crying, have a slight [blank_start]fever[blank_end], have [blank_start]red[blank_end] cheeks, drool, not eat or sleep well and want to [blank_start]bite[blank_end] something hard - Gently rub their gums with a clean [blank_start]finger[blank_end] or the back of a cold spoon. You can also wrap ice pack in wash cloth and place the cloth on your baby’s cheek. Give baby something to chew on, such as a clean teething ring.

When to refer to the doctor  Blue [blank_start]lips[blank_end]. Call an ambulance immediately.  Blue, yellow or pale skin.  Yellow [blank_start]eyes[blank_end].  A red, pusy or smelly [blank_start]umbilical[blank_end] cord.  An extreme temperature or fever  Less than [blank_start]six[blank_end] wet nappies a day  Frequent bowel movements, especially with [blank_start]liquid or mucous[blank_end]  Repeated vomiting  Several refusals to [blank_start]feed[blank_end] in a row.  Excessive sleepiness or any other drastic behavior change.