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Mothers Class

Maternal & Infant care

PHILIPPINES
Agenda

I. Introduction
II. Objectives of Mothers Class
Program
III. Some Statistics
IV. Part 1- Pre, during and post
delivery
V. Part 2 At Home: Post delivery
I. Maternal Care
II. Infant Care
Why are we doing this?
-Objectives-
Educate mothers on Maternal & Infant care
How to take care of yourselves
How to take care of your newborn babies

Through this program, it is the aim of IMAP and J&J to:


1. Uplift the Filipino lives through empowerment
2. Minimise maternal and infant mortality rates
Some statistics

Did you know


that..
Annual Livebirths

1.6M-2M
additional 3 persons/minute
Some statistics
Did you know that..
10 women die/ 24hrs
from causes related to
pregnancy & childbirth

3,650/yr
(rural areas)
What do women die of & where?
(Maternal mortality, obstetric causes -Regional
report,1998)
1. ARMM* 165
2. Region 9* 137
3. Region 12* 105
4. Region 7** 100
5. Region 5*** 97
6. Region 8* 94
7. Region 10*** 83
* hemorrhage, hpn/eclampsia & infection
** hemorrhage, hpn/eclampsia & abortion
*** hemorrhage, hpn/eclampsia
Part 1
Prenatal
During Delivery
Post partum
Maternal Care
Pre natal
Importance
Normal Changes
When to go to an HCP
Maternal Care
Importance of prenatal care:
Nutrition
Immunization
Breast feeding
Responsible parenthood
Exercise
Normal changes in a body of
pregnant women
Normal changes in a body of
pregnant women

UTERUS PROGRESSIVE INCREASE IN SIZE


IRREGULAR CONTRACTIONS

INCREASE IN VASCULARITY
VAGINA &
INCREASE IN VAGINAL
VULVA SECRETIONS

REDDISH STREAKS STRIAE


ABDOMINAL
GRAVIDARUM
WALL
BROWNISH BLACK MIDLINE
PIGMENTATION LINEA NIGRA
Normal changes in a body of
pregnant women

BROWNISH PATCHES ON
SKIN FACE AND NECK
MASK OF PREGNANCY

INCREASE IN SIZE;
TENDERNESS
BREASTS
NIPPLES ENLARGED AND
DEEPLY PIGMENTED
When to go to a HealthCare
Professional..
Midwife, Nurse and Doctor
When to go to a HealthCare
Professional?
Headache
Blurring of vision
Epigastric pain
Vaginal spotting/bleeding
Frequent uterine contractions
Generalized edema
Adjustment in Appetite(hi or low)
Nausea is normal but excessive vomiting is not
Maternal Care
During Delivery
Birth Plan
What to do on day of
delivery..
You should have a birth plan what to
do, what to bring, who to call etc
Maternal Care
Post partum
What to do
When to go to an HCP
What to do after delivery
Hygiene to prevent infection
Discharge first 3-5 days reddish then pinkish
3-5 then brown (all not foul if foul go to
MW/MD
Nutrition to recover fast
Exercise
Care of breast, wound
When to go to a HealthCare
Professional..
Midwife, Nurse and Doctor
When to go to a HealthCare
Professional?
Fever over 38C
Foul vaginal discharge
Excessive bleeding
Painful swelling of the
leg
Swelling of the breast
When to go to a HealthCare
Professional?
Urinary difficulties

Pain in the pelvic or perineal region

Severe headaches, blurred vision

Swelling of the face or feet

Severe mood swings

Thoughts of harming self or baby


Part 2
When mom & baby goes home
Maternal Care
Infant Care
Maternal Care

Feminine Hygiene
Infant Care
Immunization
Newborn screening
Breast feeding
Bathing
Skin Care
Cord Care
Touch
Infant care
Immunization prevention of diseases
at birth hepa B
DPT 6 weeks after
BCG

New born screening to prevent life- time chronic


inborn diseases, but can be screened early on
(diseases such as neural tube defect, goiter etc.)
Breastfeeding

Early and exclusive


breastfeeding

Influence of nipple
stimulation by the
baby on uterine
contractions and
postpartum blood loss
Advantages of Breastfeeding
B est for baby & Best for Mommy - Best for baby because of bonding & satisfies sucking
reflex, best for mommies because of bonding & satisfaction the mom gets for
feeding her baby. It also prevents breast cancer & pregnancy
R educe Allergy - Colostrum provide antibodies
E radicate feeding difficulties - No materials to prepare in feeding the child
A llergen free
S terile & Pure - No need to store in the refrigerator
T emperature is optimal
F reshness - Never goes off
E conomical - No feeding bottles & No Milk formula to buy
E asy to prepare - No bottles to wash, No formula to mix
D evelops bonding - Tremendous satisfaction
I mmediately available
N utritious
G astroenteritis greatly reduced
Inflammation of the lining of the stomach due to proteins found in milk formula; Breast milk contains iron that is easily
digested by the infant
Assessing readiness to Breastfeed

Activity
Alertness
Sucking and swallowing coordination
Absence of respiratory distress
Absence of abdominal distention
Breast milk is the BEST for infants

Colostrum
Preterm vs. term human milk
Foremilk and hindmilk
Why breastfeed?
1. Benefits to infants
Easy digestion
Provision of nutrients
Transfer of antibodies
Why breastfeed?
2. Benefits to mothers
Return of body to non-pregnant state
Enhance normal uterine contractions
Reduced risk for osteoporosis
3. Benefits to both mothers &
infants
Physical and emotional
bonding
Sense of Security
Improved mothering skills
Positioning during Breastfeeding

Cradle / Across- Clutch hold Side-lying position


the-lap hold
Burping your baby

Face down on your lap


Upright against your shoulder
Seated on your lap
Tips for breastfeeding
success
1. Get an early start:
Nursing should begin
within an hour after
delivery if possible,
when an infant is
awake and the sucking
instinct is strong.
Tips for breastfeeding success

2. Proper positioning:
Baby's mouth should
be wide open, with the
nipple as far back into
his or her mouth as
possible.
(minimizes soreness
for the mother)
Tips for breastfeeding success

3. Nurse on demand
4. No supplements
5. Delay artificial nipples
6. Air dry
7. Watch for infection
8. Expect engorgement

Eat right, get rest!


Infant Care

Bathing
Infant Bathing:

Sponge bath Tub bath


Proper bathing of your infant
Most babies do not need a bath every single
day
With all the diaper changes and wiping of
mouth and nose after feedings, most
babies may only need to be bathed two or
three times a week or every other day
Proper bathing of your infant
Baths can be given any time of day
Bathing before a feeding often works well
Sponge baths are required at first
Bathing in a tub of water should wait until
the baby's umbilical cord falls off and a
baby boy's circumcision heals to prevent
infection
Equipment needed
thick towels or a sponge-
type bath cushion
soft washcloths
basin or clean sink
cotton balls
baby shampoo and baby
soap (non-irritating)
hooded baby towel
clean diaper and clothing
Sponge bath
1.Make sure the room is
warm - about 75 F
2.Gather all equipment
and supplies in
advance.
3.Add warm water to a
clean sink or basin (warm
to the inside of your wrist or between 90
and 100 F.).
Sponge bath

4. Place baby on a bath


cushion or thick
towels on a surface
that is waist high.
5. Keep the baby
covered with a towel
or blanket.
Sponge bath

6. NEVER take your


hands off the baby,
even for a moment.
If you have forgotten
something, wrap up
the baby in a towel
and take him/her with
you
Sponge bath
7. Start with the
baby's face - use
one moistened, clean
cotton ball to wipe
each eye, starting at
the bridge of the nose
then wiping out to the
corner of the eye.
Sponge bath

8. Wash the rest of the baby's face with a soft,


moist washcloth without soap.

9. Clean the outside folds of the ears with a


soft washcloth.
DO NOT insert a cotton swab into the baby's
ear canal because of the risk of damage to the
ear drum.
Sponge bath
10. Add a small amount of baby soap to the water
or washcloth and gently bathe the rest of the
baby from the neck down.

Uncover only one area at a time.


Rinse with a clean washcloth or a small cup of water

Be sure to avoid getting the umbilical cord wet.


Sponge bath
11. Wash the baby's head last with a
shampoo on a washcloth.

Rinse, being careful not to let water run


over the baby's face.

Holding the baby firmly with your arm


under his/her back and your wrist and
hand supporting his/her neck, you can
use a high faucet to rinse the hair.
Sponge bath

12. Scrubbing is not necessary, but most babies


enjoy their arms and legs being touched
with gentle strokes during a bath.
Sponge bath

13. Wrap the baby in a


hooded bath towel
and cuddle your clean
baby close.
14. Follow cord care
instructions given by
your baby's
physician.
Sponge bath
15. Use a soft baby brush to comb out your baby's hair.
DO NOT use a hair dryer on hot to dry a baby's
hair because of the risk of burns.

16. Expect your baby to cry the first few times you
bathe him/her. Usually, this is just because a bath is
a new experience.

However, be sure to check that the water is not too


warm or cold or that soap has not gotten in your
baby's eyes if your baby suddenly starts crying
during a bath.
Tub bath

Once your baby's


umbilical cord has fallen
off and the stump is
healed, and after a boy's
circumcision has healed,
you can give your baby a
tub bath

Talk softly or sing and try


some bath toys if your baby
protests
Infant Care

Skin Care
Cord Care
Infant Skin Care
Use clinically proven mild
products made especially for
babies

Lotions may be needed if


baby's skin is dry

When using any powder, put


the powder in your hand and
then apply it to the baby's skin
Caution: It can cause chemical
pneumonitis if inhaled.
Infant Skin Care

A baby's soft and delicate skin needs special care.


Generally, it is best to use products made
especially for babies

Unless the baby's skin is dry, lotions really are not


needed
Infant Skin Care
Powders should be avoided, unless they are
recommended by your baby's physician

When using any powder, put the powder in


your hand and then apply it to the baby's skin

Shaking powder into the air releases dust and


talc which can make it hard for the baby to
breathe
Shampoo

Wash once or twice a week

Don't be concerned about injuring the anterior


fontanelle (soft spot on the head) because it is
well protected
Umbilical Cord

Try to keep the cord dry


Put rubbing alcohol on the base of the cord (where
it attaches to the skin) twice a day (including after
the bath) until 1 week after it falls off.
Best to use an isopropyl alcohol (70%) that kills
99.9 % of germs within 10 seconds.
Umbilical Cord
Although using alcohol can delay the separation
of the cord by 1 or 2 days, it does prevent cord
infections
Air exposure helps the cord stay dry and
eventually fall off, so keep diapers folded down
below the cord area
If you are using disposable diapers, you can cut
a wedge out of the diaper scissors so the cord is
not covered
Prevention of Cord infection
Cutting the cord should take place with sterile
instruments
Disposable
From the clean delivery kit
Decontaminated by sterilization
Clamp the cord
Keep clean and dry until it falls off
Refer quickly if umbilical stump is red, with pus or
foul smelling
Infant Care

Touch Therapy
Advantages of Touch Therapy
It stimulates mother and baby to get
acquainted with each other
(Mother-Infant Bonding)

After birth babies are colonized by


bacteria-it is advantageous that
they come into contact with their
mothers' skin bacteria
(so that they are not colonized by
bacteria from caregivers or from a
Hospital)
Advantages of Touch Therapy

Early suckling/breast-feeding should be encouraged, within


the first hour after birth
WHO/UNICEF 1989
FACE : Smile therapy

Relaxes the facial muscles


BACK: Back & Forth
Therapy

Develops muscles that will


support the spine
LEGS: Milking Touch

Promotes flexibility
CHEST: Butterfly
Touch/ I Love You

Tones the lungs & the


heart
ARMS: Squeeze & twist
Touch

Releases tension & tones


the muscles
STOMACH: Sun &
Moon Massage

Relieves constipation
QUESTIONS?
PHILIPPINES

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