Hilary Lumsden Debbie Holme

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 May 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 CERT ED (HE) MA Lynne Paterson RGN RM ENB 100 405 A19 DIP Senior Lecturer, School of Health, University of NEONATAL NURSING SCIENCES BSC MSC AND POST REG DIP ED Wolverhampton, Walsall Nurse Consultant, Neonatal Unit, James Cook University Hospital, Middlesbrough Carole England RN RM CERT ED (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) ENB A19 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 AND HIGHER Senior Lecturer, University of Wolverhampton, AWARD MSC Walsall Advanced Neonatal Nurse Practitioner, Neonatal Unit, Sandwell and West Birmingham Hospitals NHS Hilary Lumsden RN RM BSC(HONS) MSC RMT Trust, Birmingham ENB 405 Senior Lecturer, University of Wolverhampton, Linda Wylie RGN RM BA MN RMT CERT ED (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 Teachers is of reputation. to concentrate on the recognition of common problems 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. Attachment adult. This was reinforced by John Bowlby’s work following 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,

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