Obstetrics for Nurses

by Charles B. Reed

Sleep in the newborn is normally quite deep and almost continuous, probably twenty-two hours a day, for the first week. The rather fast respiration of the child, even when sleeping, is no cause for alarm. A healthy infant breathes about twenty-five times a minute. The child should not be rocked, carried about, exhibited, or handled more than necessary. It should not sleep with the mother, lest it become too hot or too cold, be overwhelmed by bedding, or overlaid by the mother.

Bowels.—The first stools are black and tar-like,—this is meconium. It disappears by the end of the first week. The presence or absence and the character of an evacuation, as well as the number in twenty-four hours, must be daily recorded. For a breast-fed child, there should be three or four a day, for the first ten days and the number should gradually diminish until a routine of two a day is obtained.

The diaper of bird’s-eye linen should be large and thick; two may be used if required. They should be carefully washed after soiling. Bluing must not be used, because where this substance comes in contact with the skin, irritation follows.

Weaning should be brought about by the gradual substitution of other foods, somewhere between the sixth and twelfth months.

Urination should be copious. The child is always wet, and frequent changes are necessary to keep the skin from getting raw and sore.

Both bowels and bladder should be emptied within the first twenty-four hours. Failure to do so should be reported, as an imperforate anus or urethra may exist.

Frequently a piece of ice whittled out like a lead pencil and passed into the rectum will stimulate urination.

Catheterization is practically never necessary. The child may go three days without injury, but the condition of the bladder above the pubes must be attentively watched and its degree of fullness appreciated by percussion.

Nursing.—The child should be put to the breast twelve hours after birth and every three hours thereafter—no more and no less without definite reasons.

If the child is strong and vigorous, only one feeding may be given at night, and even this may be omitted in some cases where the child gets an abundance of food. Six or seven feedings a day are enough. The child should stay at the breast from fifteen to twenty minutes, depending on its activity and the rapidity of the milk flow, and then be removed. It must not be permitted to sleep at the breast.