PREGNANCY

BREAST FEEDING

Postnatal Care

 
 

 

Introduction

 





GUIDELINES
Routine postnatal care for women and babies
Patient-centred care is the driving force behind the recommendations in the NICE guideline.




Do not separate the woman and her baby within the first hour. Routine weighing, measuring and bathing should be carried out later, unless the mother requests differently.

Encourage skin-to-skin contact

Do not ask about feeding method before skin-to-skin cntact has been made.

Encourage initiation of breastfeeding within the first hour.

Offer skilled breastfeeding support from the first feed

Do not give formula milk to breastfed babies unless medically indicated.

Do not distribute commercial packs that contain or advertise formula milk

Give culturlly appropriate information on the benefits of colustrum, breast feeding and timing of the first breastfeed

Promote parent-and-mother baby attachment

Offer support and information to fathers

Encourage social networks



The NICE guideline on postnatal care aims to place mothers and babies at the centre of their care. It establishes the principle of enabling women to make informed choices in a supportive environment and is not concerned with the management of a condition or an acute situation.


The guidance, which is based on the concept of healthcare professionals working in partnership with mothers and their infants, states that postnatal care should be individualised to meet the needs of each mother and baby. It aims to identify the essential 'core care' that every mother and baby should receive, as needed, during the first six to eight weeks after birth.



MULTIDISCIPLINARY APPROACH
The multidisciplinary approach required by the guideline was reflected in the composition of the guideline group, which included an obstetrician, a community paediatrician, midwives, a GP, health visitors and three lay representatives. The aim was to provide practical guidance based on a combination of clinical evidence and common sense.



The guidance is specific on such things as recording the woman's BP and urine voiding within the first six hours. It also deals with a range of common problems, such as backache, constipation, haemorroids, faecal incontinence, urinary retention and incontinence; perineal hygiene, dyspareunia and resumption of contraception. Emotional well-being and signs of postnatal depression are discussed.


The baby should be examined within 72 hours of birth and again at six to eight weeks; the guideline specifies what these examinations should cover. It addresses the vitamin K question, recommending 1M administration, because that has the best evidence of efficacy, but stating that if the parents are not happy with this, oral vitamin K may be given in two doses. Routine immunisations are also considered.





Links to reference abstracts.

 

 

 

 

 

 
 

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