Handbook of neonatal health education
Key points of neonatal home nursing
1, keep warm:
After the newborn is born, its body temperature changes greatly due to environmental changes. At this time, the function of neonatal thermoregulation center is not perfect, and the body temperature is unstable. Because of its thin subcutaneous fat and relatively large body surface area, it is easy to dissipate too much heat, leading to hypothermia and scleredema. On the other hand, due to the poor regulation and concentration function of newborn kidney on water and electrolyte, dehydration fever may occur when the room temperature is too high or the water intake is insufficient in hot season. Therefore, newborn clothes and schoolbags should be loose and soft (it is best to heat them in advance before wearing them), and don't wrap them too tightly. In cold weather, a thermos bottle or other warm-keeping appliances can be placed outside the quilt to keep the temperature of the newborn at 36~37℃. Avoid catching a cold when breastfeeding, changing diapers and taking a bath.
2. Keep the indoor air fresh and prevent respiratory infection.
Because the newborn's breathing is shallow and irregular, the breathing frequency is generally 40~45 times/minute, the cough reflex is weak, and the tracheal secretions are not easy to cough up. At the same time, the function of the sphincter of cardia is not perfect, the stomach capacity is small, the position of the stomach is horizontal, and it is easy to overflow or spit milk after breastfeeding. On the one hand, keep the indoor air fresh, the room temperature is 22~24℃ and the relative humidity is 60% ~ 65%; On the other hand, keep the respiratory tract unobstructed to prevent accidents caused by mechanical obstruction of the respiratory tract. Don't cover the newborn's face with quilts and clothes for observation.
3. Actively promote breastfeeding:
Promote the benefits of breastfeeding, guide pregnant women to breastfeed correctly, insist on breastfeeding as needed, and try not to substitute milk.
4. Prevention of infection:
Neonatal immune function is not perfect, once infected, it is easy to spread and even life-threatening. Therefore, newborn equipment is special, keep it clean. Newborn clothes and diapers should be made of soft, easy-to-dry, absorbent cotton cloth, washed frequently, changed frequently and dried in the sun. Take a bath often. Do not use a bath before the umbilical cord falls off. Keep umbilical cord dry to prevent bath water and urine pollution. After shedding, the scab skin will fall off by itself. Pay attention to skin cleanliness, avoid using irritating soap, absorb moisture with a soft towel after bathing, and dry and powder skin wrinkles such as neck, armpit and groin; Wash and dry the anus with warm water in time after each defecation, and apply grease after washing the anus with increased defecation times to prevent red buttocks; Keep your face, ears, mouth, nostrils and eyes clean. Mothers should wear masks when suffering from respiratory infection, and other relatives and friends should avoid contact with newborns to prevent cross-infection.
5, parents pay attention to observe:
Throughout the neonatal period, we should pay attention to the child's demeanor, complexion, breathing rhythm, sucking ability, weight gain and defecation. If there is any abnormality, we should consult a doctor in time to make it through the neonatal period smoothly and grow up healthily.
Key points of home care for premature infants discharged from hospital
Premature infants refer to newborns whose gestational age is less than 37 weeks. Because of the early delivery, the organs are not yet mature, the function is not perfect, the resistance is poor and the vitality is not strong. It is one of the main causes of neonatal death. Strengthening the care of premature infants can continuously improve the survival rate of premature infants.
First, the living environment after discharge
1, keep the proper temperature. Generally, the suitable room temperature for premature infants is 24℃~28℃. Air conditioning can be used to adjust the room temperature to the best state, so that the underarm temperature of premature infants can be kept at 36~37.5℃, and the body temperature should be measured once every morning and evening. If it exceeds this range, corresponding measures should be taken to adjust and keep the body temperature stable.
1) The amount of clothes worn by the baby should be increased or decreased according to the specific environment. The general standard is to have one more dress than an adult in the same environment.
2) Cold weather keeps premature babies warm and reduces heat dissipation.
3) If you turn on the air conditioner indoors, you should pay attention to cleaning the air filter every week and thoroughly ventilate the room twice a day. Can be indoors
Hang the thermometer.
4) Avoid convective wind blowing on the baby's face when turning on the air conditioner.
5) Without air conditioning, you can put your baby next to your mother to keep warm.
2. Noise has an impact on the developing brain of premature infants, which will cause apnea, so try to create a quiet environment.
3. Light has a great influence on the brain development of premature infants, which can increase the incidence of retinopathy of prematurity and slow down the growth and development. Continuous light can change the biological regulation and sleep deprivation of premature infants. Therefore, measures must be taken to reduce the stimulation of light on premature infants, such as using dark curtains to avoid direct exposure of light to baby's eyes.
Second, review after discharge
1. Go to the hospital for reexamination on time according to the doctor's requirements. The main review contents include hearing examination, fundus examination, physical development and neurobehavioral development.
2. Generally within 1 year, check 1 time every 3 months; 1 year, check every six months 1 time; After 3 years of age, if the growth and development are good, the review can be stopped.
If there are special circumstances, you should go to the hospital in time.
Third, feed attention.
1. Premature infants insist on breastfeeding.
2. If you can't breastfeed, you should choose special formula for premature infants. The general feeding amount depends on the tolerance of premature infants, and the principle is not to have abdominal distension and vomiting.
3. Premature infants who are exclusively breastfed should be supplemented with appropriate vitamin K 1 month after birth to prevent bleeding.
4, 1 month began to supplement vitamins, iron to prevent anemia, cod liver oil to prevent rickets. No complementary food was added for 4 months.
Fourth, home care precautions.
1, keep breathing effectively: take the right position after breastfeeding, and be careful not to cover the baby's nose and mouth; Always observe the baby's face. If there is apnea or the baby is holding his breath, you can bounce the soles of your feet and pinch the earlobe to stimulate breathing. If he has recurrent attacks, he should be sent to the hospital for treatment in time.
2, according to the season to decide the number of baths: you can take a bath every day in summer and every week in winter 1? 2 times; When taking a bath, the room temperature is 30℃ and the water temperature is 38? 40℃ is appropriate; Dry thoroughly after bathing to prevent catching cold.
3. Maintain a comfortable posture: make bedding (bird's nest) for premature babies with towels or sheets, so that their hands and feet can touch objects and feel safe. In addition, when wrapping the baby, it is necessary to ensure that the baby's hands can touch the face, which is conducive to head-hand interaction, changing sleeping positions frequently, paying attention to the head shape, and preventing persistent physical, psychological and social adaptation difficulties caused by flat head. Prone position can increase the occurrence of sudden death and should be paid attention to.
4. Paying attention to the intimate contact time between parents and children will have a far-reaching impact on the establishment of parent-child relationship in the future. Including: touching, kissing, hugging, staring face to face, parents participating in baby care, etc.
5, proper baby exercise, nursing baby swimming.
6, to prevent infection: it is best to fix the nursing staff, do not change frequently. Wash your hands and put on clean clothes before and after taking care of your baby. It is best to wait until the baby is full-term before giving it to relatives and neighbors. If you find any abnormality in your baby, such as abnormal body temperature and breathing, you should send it to the hospital in time.
5. How to judge whether the growth and development of premature infants are good?
Under normal circumstances, premature babies can gain 25 grams of weight every day. If the baby's length and body shape are consistent with other corresponding months, it is considered that the growth and development are good.
Sixth, the correct way to give children medicine:
1, note that medicine and milk cannot be taken at the same time.
2, tablets: first crushed and dissolved in sugar water, fed with a bottle or a spoon; The syrup should be shaken well before taking it.
3. When children cry or make noises, please don't take medicine to avoid accidental inhalation of trachea.