Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=Urination= should be copious. The child is always wet, and frequent
changes are necessary to keep the skin from getting raw and sore.
Both bowels and bladder should be emptied within the first twenty-four
hours. Failure to do so should be reported, as an imperforate anus or
urethra may exist.
Frequently a piece of ice whittled out like a lead pencil and passed
into the rectum will stimulate urination.
Catheterization is practically never necessary. The child _may_ go three
days without injury, but the condition of the bladder above the pubes
must be attentively watched and its degree of fullness appreciated by
percussion.
=Nursing.=—The child should be put to the breast twelve hours after
birth and every three hours thereafter—no more and no less without
definite reasons.
If the child is strong and vigorous, only one feeding may be given at
night, and even this may be omitted in some cases where the child gets
an abundance of food. Six or seven feedings a day are enough. The child
should stay at the breast from fifteen to twenty minutes, depending on
its activity and the rapidity of the milk flow, and then be removed. It
must not be permitted to sleep at the breast.
[Illustration: Fig. 115.—Proper position of mother while nursing child.
(Witkowski.)]
Care must be used that the child gets the nipple _over_ the tongue and
not under it. Many infants have to be taught to nurse. This may be due
to a lack of strong animal instinct in many cases. There may be an
abundance of milk and a good nipple, but the child will not learn to
nurse without a vast expenditure of time, patience, and energy on the
part of the nurse. Squeezing a little milk into the mouth or filling a
nipple shield with milk will sometimes aid in educating the infant, or
even starting the supply with a pump, as many nurses do, is
advantageous. Certain drugs, like castor oil and turpentine, taken by
the mother, may affect the taste of the milk, and be reason enough for
the refusal of the child to take hold. Other drugs like mercury,
arsenic, potassium iodide, and alcohol may go over in the milk to the
nursing child.
If the child is weak or premature, the milk must be pumped from the
breast and fed to it until strength comes. The difficulty about this is
the bad habit acquired, but there is no way to avoid it.
A child should get at each feeding half an ounce of milk to each pound
of weight. The capacity of the stomach at various months is given by
Hirst as, first week, ½ oz.; second week, 2½ oz.; third and fourth week,
3 oz.; third month, 5 oz.; fifth month, 9 oz.; ninth month, 12½ oz. Holt
says that the capacity at birth should be one ounce, and increase at the
rate of an ounce a month up to the sixth month.
Public-domain text, read in full here on John Shaqi.
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