Nantale Flashcards
what NIPE risk factors can be identified in Nantale’ case?
- alcohol
- rubella
- breech
- sickle cell
what things can impact Nantale’s holistic health?
- tender c/s wound
- nipple pain
- mental health
- language barrier
- seeking asylum
how can tender c/s wound impact Nantale’s holistic health?
Physically Nantale can be felling unwell, as it sounds as if her wound could be infected. This then can take toll on her emotional wellbeing, with the mobility issues which already come with a c-section on top of the infection, Nantale may began to feel overwhelmed, emotional. If this prolongs this can then result in baby blues which then can develop into PND. Which can also impact bonding and social health such as relationship and socialising. Referrals may include advising Nantale to attend triage to be seen by medical staff, and on-going midwife support checking in on how she is coping. If this impacts her mobility then physio maybe necessary.
what is the impact of nipple pain on Nantale’s holistic health?
physically, this can lead to infection and things like mastitis, which can begin to make Nantale unwell, and this can impact how much she can do such as caring for Penny. This can take a toll on her emotional health as she may feel very deflated because BF is a struggle, she may feel upset/disheartened about her breastfeeding journey. Mental health implications can involve feeling anxious if baby isn’t feeding, having depressive episodes due to feeling like a failure with feeding. Social aspect would be that she may struggling with going out etc.
how can mental health impact Nantales holistic health?
physically, she may not be looking after herself, keeping up with hygiene with the scar, or scar massage etc and may be very anxious about baby. This can make her feel worse if she isn’t looking after herself. Emotional health she may not feel like she’s coping, overwhelmed, and emotional. This can impact her day-to-day life, socialising, relationships and bonding. The more this prolongs the worst and more permanent this could be.
how can language barrier impact Nantale’s holistic health?
Nantale requires translation as she understand little English. Physically, there isn’t a interpreter here then Nantale could misunderstand things said which can lead to mistakes. Social this can be hard to communicate and hard to understand any questions which may make Nantale feel as if she doesn’t want to socialise due to this issue. Furthermore, her mental health may decline as she may be anxious, and her needs aren’t met dur to the language barrier. Therefore, an interpreter is important for attending this appointment. Her spiritual health may be impact as she may be trying to communicate some of her beliefs, and I may not be able to honour these as I cannot understand.
how can seeking asylum impact Nantale’s holistic health?
Nantale is seeking asylum from her home country, this may cause financial and housing issues during this time. Therefore, midwifes can support by referring her to citizens advise, local council etc. as this can have physical impact on her health as she may not have the money to buy healthy food, money to get vitamins and her housing situation may be unclean or impractical which can impact her overall health. This can affect her emotional health as she may feel unable to cope causing stress and then impacting her mental health as she already mention have PTSD and anxiety due to this which can in then impact social health.
is aspirin safe fore breastfeeding?
Aspirin (Dispirin®) as a painkiller should be avoided because of the increased risk of Reye’s syndrome in paediatric viral infections. The amount transferring is a very small but as there are suitable alternatives, it is best avoided.
(Breastfeeding Network) Low dose Aspirin required as a blood thinner – It is not uncommon for breastfeeding mothers to need to take low dose aspirin, sometimes for reasons in pregnancy or after cardiac events. Whilst it isnt recommended regularly as a painkiller at a dose of 600mg four times a day it is compatible with breastfeeding in low dose of 75-150mg daily. (Breastfeeding Network)
is co codomal safe during breastfeeding?
Codine is no longer recommended as routine medication for Breastfeeding mothers. Using the half life of codeine as 3 hours – it takes 15 hours for a dose to be regarded as no longer in breastmilk.
Neonatal complications –
- Breathing Problems
- Lethargy
- Poor Feeding
- Drowsiness
- Bradycardia
how can we help with Nantale’s c-section pain?
Natale cannot have Ibuprofen due to being asthmatic and she dihydrocodeine may be given in reduced dose with asthma and doctors should be informed of her asthma. However, it is not recommended with breastfeeding. Therefore, liaise with obstetric staff to see what alternative they can provide. Ensure she is taken the right dose and frequency of paracetamol which is 500mg-1g 4-6 hourly maximum of 4g.
hydrocortisone and breastfeeding?
Hydrocortisone – no effects, however if using while breastfeeding remove beforehand, apply 1-2 times a day 8-12 hours in between.
what is the breastfeeding plan for sore nipples?
- beginning
- P+A
- Effective feeding
- sore nipples solving
- supplementation and hand expression
how do we BEGIN to help a mum with sore nipples?
- Women centred approach demonstrated throughout (1)
- Observing and listening during conversations (1)
- Feeding assessment
- Discusses hands off approach (1)
- Clear relevant information shared (1)
- Mentions use of leaflets, analogies, props 1
- Identify signs of instinctive behaviour in baby:
- Rooting (1)
- · Head bobbing (1)
- · Mouthing the nipple (1)
- Fingers in the mouth
- · …and helps mother to recognise them (1)
- Skin to skin – mention helps with oxytocin, helps with milk, helps calm babies
- Remind her that there will be continuous support and who are available to help her if she wishes
How do we help with P+A?
- Baby held close (1)
- Baby held/supported with head and body inline (1)
- Baby’s head free to tilt back (1)
- Baby held with nose opposite nipple (1)
Component of Assessment - Attachment Points offered Achieved - Watch for baby to have a wide open mouth (1)
- Mother moves her baby to her breast with head tilted back, chin leading (1)
- Bottom lip touches breast well away from the base of the nipple (1)
- Nipple aimed towards the rear of the roof of the baby’s mouth (1)
how do we assess EFFECTIVE FEEDING?
- Mother comfortable/pain free during feed (1)
- Baby’s mouth is wide open (1)
- Baby’s chin indents the breast (1)
- Baby’s cheeks are full and round (1)
- Nipple aimed towards the rear of the roof of the baby’s mouth (1)
- Suckling is appropriate to age of baby:
- Usually rapid initially, then deep (1)
- Rhythmic with pauses (1)
- 2:1 suck swallow ratio
- Audible swallows (1)
- Areola: If any is visible, then more will be visible above the baby’s top lip (1)
- The baby is contented and stays on the breast (1)
