if bilirubin is slightly elevated try to correct it through breast feeding

If bilirubin is slightly elevated try to correct it

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if bilirubin is slightly elevated, try to correct it through breast feeding ! vitamin K shot IM help prevent babies from bleeding out; 25 G 5/8 needles (similar to insulin needles); 90 degrees in the thigh o synthesized in intestinal flora which is absent in neonates ! GI system in newborns are slow; bowel sounds can be hypoactive ! Characteristics of stools o Meconium – sticky, thick, black, odorless; may take up to 2 days for newborn to pass o Transitional – little bit of meconium and little bit of how stool will look like in the future; day 3-4 of life
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12 o Breastfeed – pasty stool, golden yellow, semi-formed stool o Formula feed – pale yellow, formed stool o DIARRHEA IS NEVER NORMAL " loose and green o * * BREASTFED NEONATES TEND TO HAVE MORE STOOLS PER DAY THAN FORMULA-FED NEONATES * * ! glomerular filtration rate is initially low but doubles by 2 weeks of age ! Delay/decrease urinary output " mothers received magnesium sulfate during labor (blocks neuromuscular transmissions and can cause urinary retention) ! Will lose 5%-10% of birth weight within first week of life; will regain weight within 10 days ! Active immunity – acquired type through vaccinations; body produces antibodies ! Natural immunity– exposure to antigens after which the individual produces antibodies (flu) ! Passive immunity – obtain from mothers via uterine ! Lymphocytes function at immature level ! Colostrum – IGA ! Head to toe assessment in newborn –latex gloves, measuring tape, thermometer, weighing scale, stethoscope, warm environment, 14 French catheter o Mother’s history – Magnesium sulfate(baby will be sleepy) o How long did bag of water rupture – would like to deliver within 12 hours o Normal for newborns to have irregular breathing, apnea (under 15 seconds is normal), O 2 sat can stay under 90% for first 10 minutes o Flexed posture, best time to do assessment is after feeding when baby is more calm o Assess skin for color, birthmarks, birth trauma # Swollen eyes for chemical pressure o Hypertonic, can be hypoglycemic o Head circumference : above ears and eyebrows (33 cm – 35.5 cm) # Microcephaly: head circumference is below the 10 th percentile # Macrocephaly: head circumference is above 90 th percentile o Chest circumference – across nipple line (2 cm – 3 cm lesser than head circumference " 30.5 cm - 33 cm) o Length (19-21 inches; 45 cm – 53 cm) o Weight (2500 - 4000 g is normal) o Thermoregulation – assessed in 15 minutes interval for first hour o Respirations may be irregular; can hear crackles due to amniotic fluids; 30-60 normal range o Blood pressure is usually never done in postpartum setting; usually in NICU o Milia will go away on its own o Lanugo – fine downy hair; usually seen mostly in premature babies o Mongolian spots – similar to a bruise; will go away within couple of years o Pilonidal dimple - right dimple above the sacrum; associated with sinus problems o Molding o Fontanels – anterior ( diamond )/posterior( triangle ); anterior takes longer to close # Will be sunken if dehydrated # Bulging may indicate intracranial bleeding o Caput succedaneum #
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