Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=Colic= is a cramp-like pain of the bowels. Previous to the attack the
child is restless, expels some gas, and has the “colic smile,” which
leads the mother to believe the child is quite well. When the attack
comes on, the thighs are flexed on the abdomen, and the legs on the
thighs. The child has a sharp cry, that is nearly continuous, but in
some way related to the nursing period, for the attack comes on a few
minutes, and sometimes an hour, after taking the breast. The belly is
rigid, the arms wave aimlessly. Diarrhœa may be present, and the
movements are accompanied by much flatus. Distention is nearly always
present. When the belly is tapped it gives a drum-like note and the
child belches gas, sometimes accompanied by milk, which seems to
relieve.
_Treatment._—Colonic flushings to relieve the bowel of irritating curds.
The child may be laid face down with a bag of hot water under the belly.
Mixture of asafœtida gtts. xx to xl, or whiskey and hot water should be
given for the attack, followed later by a full dose of castor oil. The
diet should be rigorously investigated.
=Vomiting= may or may not be serious. The child may nurse too rapidly or
too much, and the over-distended stomach simply empties itself. Many
infants “spit up” their excess of milk, and thus relieve themselves.
This is a simple regurgitation, usually of unchanged milk, though it may
be acid from admixture with the gastric juice.
Vomiting, in a breast-fed child, may come during an attack of colic when
the eructations of gas appear. It may be a symptom of gastrointestinal
intoxication, of too much fat in the food, too short intervals between
feedings, or too much sugar in the food.
Projectional vomiting awakens suspicion of a pyloric stenosis or
meningitis, and must be reported to the physician at once.
Vomiting which occurs within twenty minutes after feedings is not
serious ordinarily, even though gas and large curds are expelled, but
all vomiting later than this, is significant of a pathology.
_Treatment._—Regulation of the hours of feeding is most important, and
next, the character of the food. If the child vomits an hour or so after
nursing, it may be that the milk is too rich (fat). Try a longer
interval, or give an ounce or so of cereal water before putting the
child to the breast.
=Prematurity= exposes the child to three distinct dangers, which arise,
respectively, from atmosphere, food, and infection. Very few children
born before the seventh month survive. A child born at the eighth month,
or with a weight of three pounds, or more, can be saved almost always.
The premature child up to the time of birth, has been protected very
carefully against temperature variations by the liquor amnii, and when
suddenly precipitated into a new environment, which its vitality barely
tolerates, the consequences are serious.
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