Care of the Newborn by Ten Teachers (Hodder Arnold Publication)

206 Pages·2010·3.23 MB·English

by  Hilary Lumsden

This page intentionally left blank
Edited By
Hilary Lumsden RN RM BSC(HONS) MSC RMT ENB 405
Senior Lecturer in Midwifery,
University of Wolverhampton; and
External Examiner, University of Sheffield
Debbie Holmes RN RM BSC(HONS) PCGE (HE)
Senior Lecturer in Midwifery,
University of Wolverhampton; and
External Examiner, King’s College, London
First published in Great Britain in 2010 by
Hodder Arnold, an imprint of Hodder Education, an Hachette UK Company
338 Euston Road, London NW1 3BH
http://www.hodderarnold.com
© 2010 Hodder Arnold (Publishers) Ltd
All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced,
stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case
of reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the
United Kingdom such licences are issued by the Copyright Licensing Agency: Saffron House, 6–10 Kirby Street,
London EC1N 8TS.
Whilst the advice and information in this book are believed to be true and accurate at the date of going to press,
neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that
may be made. In particular (but without limiting the generality of the preceding disclaimer) every effort has been
made to check drug dosages; however it is still possible that errors have been missed. Furthermore, dosage schedules
are constantly being revised and new side-effects recognized. For these reasons the reader is strongly urged to consult
the drug companies' printed instructions before administering any of the drugs recommended in this book.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress
ISBN 978 0 340 968 413
ISBN (ISE) 978 0 340 971 550 (International Students Edition, restricted territorial availability)
1 2 3 4 5 6 7 8 9 10
Commissioning Editor: Naomi Wilkinson
Project Editors: Joanna Silman and Jane Tod
Production Controller: Rachel Manguel
Cover Designer: Lynda King
Indexer: Shirley M ay
Typeset in 9.5 pt Minion by Phoenix Photosetting Ltd, Chatham, Kent, UK
Printed in India
Cover image © Anna Kern/Etsa/Corbis
What do you think about this book? Or any other Hodder Arnold title?
Please visit our website: www.hodderarnold.com

Some figures in the printed version of this book are not available for inclusion in the eBook for copyright reasons.
Contents
The Ten Teachers vi
Preface vii
Acknowledgements viii
CHAPTER 1 Parenting –attachment, separation and loss 1
Sandra Sandbrook
CHAPTER 2 Transition to extrauterine life 11
Debbie Holmes
CHAPTER 3 Newborn screening and immunization 23
Linda Wylie
CHAPTER 4 Examination of the newborn 34
Hilary Lumsden
CHAPTER 5 Hereditary problems and genetics 51
Debbie Holmes
CHAPTER 6 Infant feeding 65
Debbie Holmes
CHAPTER 7 Neonatal skincare 78
Sharon Trotter
CHAPTER 8 Thermal care of the newborn 89
Hilary Lumsden
CHAPTER 9 Care of the jaundiced baby 99
Carole England
CHAPTER 10 Infection in the newborn period 113
Lynne Paterson
CHAPTER 11 Neonatal respiratory problems 122
Carole England

CHAPTER 12 Neonatal withdrawal syndromes 133
Hilary Lumsden
CHAPTER 13 Birth injury 146
Jane Henley
CHAPTER 14 Cultural and religious aspects of neonatal care 159
Marcia Edwards
CHAPTER 15 Teaching resuscitation to parents 168
Gillian Warwood
CHAPTER 16 Frequently asked questions 178
Debbie Holmes and Hilary Lumsden
Index 187
The Ten Teachers
Marcia Edwards RN RM ADM CERTED(HE) MA Lynne Paterson RGN RM ENB 100 405 A19 DIP
Senior Lecturer, School of Health, University of NEONATALNURSINGSCIENCESBSCMSCANDPOSTREGDIPED
Wolverhampton, Walsall Nurse Consultant, Neonatal Unit, James Cook
University Hospital, Middlesbrough
Carole England RN RM CERTED(FE) ENB 405
BSC(HONS) Sandra Sandbrook BA(HONS) RN RM ADM MTD CERT
Midwife Teacher, School of Nursing, Midwifery and ED(FE)
Physiotherapy, University of Nottingham Senior Lecturer, School of Health, University of
Wolverhampton, Walsall
Jane Henley RN RM ENB 405 DPSN BSC(HONS)
ENBA19 MSC Sharon Trotter RM BSC
Advanced Neonatal Nurse Practitioner, Manor Midwife, Breastfeeding Consultant and Neonatal
Hospital, Walsall Skincare Advisor, TIPS Limited
Debbie Holmes RN RM BSC(HONS) PCGE (HE) Gillian Warwood RGN RM ENB 405 A19 ANDHIGHER
Senior Lecturer, University of Wolverhampton, AWARDMSC
Walsall Advanced Neonatal Nurse Practitioner, Neonatal
Unit, Sandwell and West Birmingham Hospitals NHS
Hilary Lumsden RN RM BSC(HONS) MSCRMT Trust, Birmingham
ENB405
Senior Lecturer, University of Wolverhampton, Linda Wylie RGN RM BA MN RMT CERTED(HE)
Walsall Programme Leader BSc Midwifery, University of
West of Scotland, Paisley
Preface
The inspiration for this text came from many years’ addressing some of the less common conditions. In-
experience of teaching the post-qualifying neonatal depth knowledge providing theoretical underpinning
nurses’ course. It was identified that there are several and contemporary practice is core to each chapter.
suitable textbooks to support intensive care of the Professional guidance is underpinned by the rules and
newborn but very few concentrate on the midwives’ code of practice for midwives, which are explicitly
role and essentially normal neonatal care. The aim of referred to throughout.
this book is to inform pre- and post-registration The contributors were recruited as enthusiastic
midwives about normal neonatal care in the UK and it experts in neonatal and midwifery care and come
is seen to be an excellent addition to the Ten Teachers from wide geographical and practice areas. We see this
series. The majority of undergraduate midwifery as being a significant strength of Care of the Newborn
students will have to study many aspects of newborn by Ten Teachers that readers will find invaluable to
care as well as having hands-on experience of neonates their studies. The original proposal was made upon
in both the community and hospital settings. The individual practitioner contributions and has resulted
book is designed to support both theory and practice. in a comprehensive collection of chapters by teachers
The aim of Care of the Newborn by Ten Teachersis of reputation.
to concentrate on the recognition of common prob-
lems associated with newborn babies that student Hilary Lumsden and Debbie Holmes
midwives will encounter on a daily basis as well as 2010
Acknowledgements
We would like to thank our families, friends and Finally to our colleague and friend Pauline Lim
colleagues for their support, time and encouragement for her expert help, support and contributions to
during the writing and editing of this book. Chapter 6.
Special thanks also goes to student midwives at the
University of Wolverhampton who contributed so read- Hilary Lumsden
ily to Chapter 16 by providing their own questions as Debbie Holmes
well as those of parents they have cared for in practice.
CHAPTER 1
PARENTING –
ATTACHMENT,
SEPARATION AND LOSS
Sandra Sandbrook
Attachment ...................................................................1 Caring for bereaved parents ..........................................9
The birth of a sick or premature baby ............................6 References .................................................................10
Loss and bereavement ..................................................7 Further reading ...........................................................10
Attachment and loss .....................................................8
OVERVIEW
This chapter explores the attachment relationship parents develop with their baby. Attachment is an interactional process
that starts as acquaintance during pregnancy and develops through reciprocal interaction to become an exceptional, endur-
ing and important relationship. Midwives should be aware of the many factors that may affect the developing relationship
during pregnancy, childbirth and the early days following birth. The development of the relationship between the parents and
their baby has implications for the parents if they are separated from their baby due to illness resulting in admission to a
neonatal unit or due to the baby’s death.
This chapter will examine the possible psychological implications for the parents when they are separated from their baby
due to illness or prematurity and how midwives and nurses can provide support to give the woman or couple confidence in
their ability to parent. It ends with a discussion on attachment and loss, the devastation that can result from bereavement
at the beginning of life. Grief and mourning will be considered, together with how the midwife can sympathetically facilitate
the process of mourning and provide empathetic support.
adult. This was reinforced by John Bowlby’s work fol-
Attachment
lowing the Second World War on the profound emo-
When perinatal and infant mortality rates were high tional and cognitive consequences of maternal
and infant death was the norm, parents did not expect deprivation during the early years of a child’s life. In
to rear all their children to maturity. Child-rearing his Report for the World Health Organization in 1951,
practices emphasized discipline and were aimed at Maternal Care and Mental Health, Bowlby stated that
promoting survival and moral strength. As mortality essential for a child’s mental health is a reciprocal
rates improved, with the expectation that the majority ‘warm, intimate and continuous relationship’ with a
of children would survive childhood, the emphasis mother or caregiver (Figure 1.1). Bowlby is consid-
changed from survival to providing sensitive child- ered the ‘Father of Attachment’ and this is the begin-
rearing practices that would promote the physical and nings of attachment theory that has evolved through
psychological well-being of the child. research in the twentieth and twenty-first century.
Sigmund Freud acknowledged that within suc-
cessful child-rearing the mother–child relationship The attachment relationship
was of primary importance. He further identified that
early childhood experiences were critical as they could Attachment describes the unique and enduring rela-
affect the normal psychological functioning of the tionships each individual seeks to forge with its care-