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Predictable Newborn Patterns

Predictable Newborn Patterns. Birth & Beyond California: Breastfeeding Training & QI Project. Objectives. Identify three infant states of consciousness Identify nursing responses and interventions Infant is sleepy, difficult to awaken Infant is crying, difficult to soothe

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Predictable Newborn Patterns

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  1. Predictable Newborn Patterns Birth & Beyond California: Breastfeeding Training & QI Project

  2. Objectives • Identify three infant states of consciousness • Identify nursing responses and interventions • Infant is sleepy, difficult to awaken • Infant is crying, difficult to soothe • Describe the normal infant feeding pattern • Identify three infant feeding cues • Describe practices that maximize infant behaviors in the first hours and days of an infant’s life

  3. Infant States of Consciousness Crying Active Alert Quiet Alert Drowsy Active Sleep Quiet Sleep Three Awake States Transition State Two Sleep States Thoman, Early development of sleeping behavior in infants, 1975

  4. Latch 1,2,3Troubleshooting Breastfeeding in the Early Weeks The Healthy Children Project 4

  5. The Interactive Baby State Infants breastfeed and families bond during the Quiet Alert State De Chateau, Develop Med Child Neurol, 1977

  6. Predictable Infant Responses To wake a sleeping baby To calm a crying baby

  7. Predictable Infant Responses Variety to awaken Repetition to soothe

  8. Variety to awaken Skin to skin Rubbing Patting Humming Singing Talking Diaper off Cool cloth Eye to eye Visitors removed Others? Repetition to soothe Skin to skin Humming Singing Swaddling Rocking Walking Visitors removed Others? Predictable Infant Responses

  9. Why Do Some Moms Not Know How to Quiet or Wake Their Baby? “The Lost Art”

  10. Societal Shift: From Villages to Nuclear Families Compartmentalized System Vertical System

  11. Activity:Newborn Infant Feeding Pattern Sleep/Wake Cycling Effect on Infant Feeding Pattern

  12. Baby A Q4H 2 X X Q2H 2 X X Q1/2H 8 X X X X X X X X

  13. The Normal Infant Feeding Pattern is Cluster Feeding • Feeding pattern characterized by closely bunched feedings • May be followed by extended periods of sleep • Normal newborn feeding behavior • Usually starts on second night • Often interpreted as sign of insufficient milk

  14. Baby’s Second Night • Baby misses the habitat of the womb • Mother’s chest is the new “habitat” • Baby’s second night pattern: Feed – Snuggle – Sleep • Newborn sleep cycle: Drowsy – Active Sleep – Quiet Sleep

  15. Soft sounds: grunts Wiggling Hand to mouth Lip smacking Sucking motions Rooting Feeding Cues

  16. Feeding Cues CRYING is a LATE feeding cue!

  17. How Often Should I Feed My Baby? • If she opens her mouth, bring her to the breast to latch on • She needs all the colostrum she can get • Your breasts need as much stimulation as possible to establish a good milk supply • Take every opportunity – no matter how short

  18. Recommended NewbornFeeding Frequency “During the early weeks of breastfeeding, mothers should be encouraged to have (at least) 8 to 12 feedings at the breast every 24 hours, offering the breast whenever the infant shows early signs of hunger…” AAP Breastfeeding Policy Statement, Pediatrics, 2005

  19. Definition of a Feeding • Baby actively initiates suckle • Baby has a wide gaping mouth • Baby’s jaw glides • Baby’s swallow is audible • Baby ends the feeding • Baby is satisfied

  20. When Left Skin-to-Skin in the First Hours After Birth • Lifts head and lunges to breast • Searching behaviors • Ability to self attach Klaus, Your Amazing Newborn, 1998

  21. Breastfeeding: Baby’s Choice

  22. Maximizing Infant Behaviors: Immediately Following Birth • Skin-to-skin • Allow familiarization time • Do not rush breastfeeding • Delay bath and procedures AAP Breastfeeding Policy Statement, Pediatrics, 2005

  23. Maximizing Infant Behaviors: The First Few Days • Skin-to-skin • Allow babies to “re-boot” if needed • Encourage and explain cluster feeding • Refer babies who “refuse” the breast to the lactation consultant

  24. Amazing Talents of the Newborn:A Video Guide for Health Care Professionals and Parents Video provided by Marshall Klaus, MD

  25. Babies Need Their Hands • Hands help to initiate feeding and to soothe • Take off the blanket • Take off the mittens

  26. The breast is home Let the Baby Do It

  27. Summary • Newborns have predictable sleep-wake cycles and feeding patterns • Parents may need to be taught: • What feeding cues are and when to feed the baby • The normal pattern of cluster feeding • Interventions to wake a sleepy baby • Interventions to calm a crying baby

  28. Photo Credits • Slide 1 – Die Gattin des Kunstlers by Josef Danhauser circa 1839 • Slide 5 – courtesy Marshall Klaus • Slide 6 – by Microsoft Clipart • Slide 7 – by Microsoft Clipart • Slide 9 – Mothers and Children c. 1912 • http://commons.wikimedia.org/wiki/Image:Mothers_and_children_I.jpg • Slide 16 – Skin to skin, hand to mouth, courtesy Miller Children’s Hospital

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