Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=Diet in Normal Cases.=—There is no restriction on the kind of food the
patient may take, so long as she can digest it cleanly and without gas.
Acids or alkalies, cold or hot, rich or otherwise, fruits, meats or
vegetables, all go to the formation of good milk if properly digested.
The old idea that acids should not be eaten is fallacious. There is more
acid in the stomach normally, than could be added in a meal made up
entirely of citrus fruits. At the same time, the heavy foods should be
avoided on account of the serious demand on the liver and kidneys in the
absence of exercise.
On the other hand, if the breasts are engorged, the fluids must be
reduced to a minimum, and a relatively dry diet enforced.
The patient loses about one-ninth of her previous body weight in the
course of labor and the puerperium.
=The breasts= are made ready for lactation twelve hours after delivery
by cleansing with sterile green soap and warm water and bathing in 50
per cent alcohol. Next, the nipple is attended to, and the infant is put
to the breast.
The nipple is prepared by cleansing it with an applicator soaked in
fresh boric acid solution, and after nursing, the same process is
repeated. This is routine, whether the mother is in bed or walking
about. In the latter case, the mother must be taught to care for her own
breasts.
The child is put to the breast every three hours and given six feedings
a day. This leaves a six hour interval at night, which is very necessary
for the mother’s rest and for the child. If the babe is feeble, seven or
eight feedings in the twenty-four hours may be required for the first
two weeks.
At first the breast only secretes a thick, yellowish secretion called
colostrum, of which the child gets from a drachm to an ounce. It is a
mild laxative.
The irritation of the nipple by the child’s mouth is begun as early as
possible in order to stimulate the breasts to secrete milk and the
uterus to contract, and thus aid involution and the preservation of the
maternal figure.
The milk usually “comes in” on the third day and is accompanied by a
sense of distention and moderate pains in the breasts. The glands may be
hot, hard and swollen, but normally there is no rise of temperature with
the inflow of the milk, except with nervous women who stand pain badly.
There is no such thing as milk fever. If fever appears at this time, an
infection must be suspected.
The engorgement of the glands may become so great that the nipples are
drawn in and nothing is left for the child to grasp. If the engorgement
becomes too painful, fluids are removed from the diet list, and saline
cathartics administered, while ice packs are applied to both breasts.
Heat should never be used _except_ for the purpose of hastening
suppuration.
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