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Postpartum
Refer to handout for information on the feelings experienced during the postpartum period, The Baby Blues, Postpartum Depression, Postpartum Psychosis, and Bonding with Baby
Attachment
After noticing in the 1940s that children in orphanages, despite being well fed, displayed slower mental development as well as withdrawn and listless behaviour, several scientists decided to conduct experiments on attachment, believing that the cause was was a lack of a loving relationship
Attachment
Harry Harlowe In 1966 he studied rhesus monkeys to see what
would happen if they were separated from their mother at an early age.
Some monkeys were given a wire monkey with a bottle attached to feed them as well as a cloth monkey with no bottle
Others were simply given the wire monkey with the bottle
http://www.youtube.com/watch?v=OrNBEhzjg8I
Attachment
The monkeys feed from the wire monkey when hungry but spend the majority of their time cuddled up with the cloth monkey for comfort and security when frightened
Monkeys who did not have a cloth monkey failed to grow even though nourishment was provided
Harlowe’s studies showed the importance of touch and contact for the survival and growth of infants
Attachment
Rene Spitz In the 1940s Rene observed children living in
isolated cribs in a hospital and children living with their mothers in prison
Read the article provided “Attachment: Rene Spitz”
Children require physical contact, comfort and love for healthy development – beginning from day 1
Attachment
Mary Ainsworth Children develop different types of attachment to their
parents based on their experiences and interactions in the first year of life
Attachment: use of a preferred person as a secure base from which to explore
A caregiver provides a secure base if he/she is able to:
Detect the infant’s signal Correctly interpret the signal Make an appropriate and timely response
Attachment
3 types of attachments can form Secure: infants are comfortable with the parent and seek
comfort upon his/her return and are easily consoled Anxious Avoidant: infants turn away from parents upon their
return and avoid touch Anxious Ambivalent: infants showed resistance, anger or
hostility when the parent returned and were difficult to console
The best way to foster a secure attachment with infants is to respond consistently to their needs. They then begin to realize that they can trust their caregiver. These bonds are lifelong.
http://www.youtube.com/watch?v=PnFKaaOSPmk
Neonatal Assessments
The APGAR Rating Scale This scale refers to the initial physical check
that a newborn is rated on to determine their health
Refer to your handout for the chart
Neonatal Assessments
Neonatal Behavioural Assessment Scale (NBAS) Comprehensive evaluation Conducted from birth-2 months Includes 28 behavioural items and 18 reflexes Checks 4 Functioning Systems
Autonomic: the newborn’s ability to control body functions such as breathing and temperature regulation
Motor: the newborn’s ability to control body movements and activity level
State: the newborn’s ability to maintain a state (staying alert or staying asleep)
Social: the newborn’s ability to interact with people
Neonatal Assessments
NBAS Harm associated with teratogens produces
lower scores Can predict later development
Reflexes
Unlearned responses that are triggered by a specific form of stimulation
What are some reflexes that you can think of?
Refer to your handouts for the chart of infant reflexes
Newborn States
Alert Inactivity: The baby is calm and attentive, with eyes open; the baby looks as if he is deliberately inspecting his environment
Waking Activity: The baby’s eyes are open, but they seem unfocused; the baby moves her arms or legs in bursts of uncoordinated motion
Crying: The baby cries vigorously , usually accompanying this with agitated but uncoordinated motion
Sleeping: The baby’s eyes are closed and the baby drifts back and forth from periods of regular breathing and stillness to periods of irregular breathing and gentle arm and leg motion
Newborn States
Crying Newborns spend 2-3 hours each day crying or on the
verge of crying Babies have different cries for different reasons
Basic Cry: starts softly, then gradually becomes more intense and usually occurs when a baby is hungry or tired
Mad Cry: more intense version of of a basic cry Pain Cry: begins with a sudden, long shriek, followed by a
long pause and gasping crying
Newborn States
Crying Tricks: lift the baby to the shoulder and walk
or gently rock the baby, sing lullabies, pat the baby’s back, give the baby a pacifier, take a drive in the car seat, swaddling etc.
When/how should you respond to your child’s crying? Why?
Newborn States
Sleeping Newborns sleep 16-18 hours They have a nap cycle every 4 hours
1 hour awake (moving between crying, alert inactivity and waking activity)
3 hours asleep As the baby gets older her/she starts to adjust to
day/night sleep routine (at 3-4 months the baby sleeps through the night)
Exposure to afternoon daylight helps babies sleep at night and entrain the sleep-wake cycle
Newborn States
States of Sleep Rapid Eye Movement Sleep (REM)
Half of a newborn’s sleep is in this state Body is active (move arms and legs, grimace, eyes move
under lids) Heart rate and breathing is more rapid Becomes less frequent as the child gets older: 25% by 1st
birthday. Regular for adults is 20% Purpose?
Older children and adults dream (brain activity is the same as wakefulness)
Stimulates the brain that helps foster growth in the nervous system
Newborn States
States of Sleep Non-REM sleep
Heart rate, breathing and brain activity are steady Lie quietly without twitching
SIDS
Sudden Infant Death Syndrome A health baby dies suddenly for no apparent reason 1 in 1400 Canadian babies die from SIDS More vulnerable if:
Born prematurely or with a low birth weight Parents smoke Baby sleeps on stomach Born during the winter (overheated from too many blankets
and heavy sleepwear)
Less able to handle physiological stress
Meeting the Needs of Infants
Clothing Need clothing to keep them warm and
comfortable Indoor, outdoor, daytime, and nightime Undershirts, sleepers, socks, bibs, diapers Diapers are needed everyday for up to 3
years – you can use cloth diapers, disposable diapers or a combination
Meeting the Needs of Infants Feeding
Two main options are breast-feeding and bottle feeding Both breast milk and formula can be fed by bottle Read through breast feeding handout Colostrum: the fluid secreted by the mother’s breasts right after birth
– it easy to digest and it rich in antibodies to protect against disease Formula is needed by women who can not breast feed, who have
HIV, smoke, or take prescription drugs Formula is harder to digest and does not contain the quality of
nutrients or the antibodies of breast milk but is as close as possible To create a close bond during bottle feeding hold the infant closely
through the duration of the feeding Burping: air trapped in the stomach can be painful. Lift the baby to
your shoulder and gently rub or pat the back (a receiving blanket will protect your clothing)
Meeting the Needs of Infants
Safety and Security Babies need care and supervision around the clock Before moving children can pull things down on
themselves or propel themselves with arm and leg movements
Once they start to move around you may need to Childproof
All equipment should adhere to the required standards
Sleepwear must be flameproof No dangling ribbons or ties Etc.
Meeting the Needs of Infants
Health and Hygiene Need to be bathed and kept clean, dry, and
comfortably warm Objects that go in their mouths need to be sterilized
until immune systems kick in (6 months) Doctor check ups and immunizations Indications of illness: fever, loss of appetite, runny
nose, listlessness, crying Need to sleep, rest and exercise Establish a routine and play and communicate with
them
Meeting the Needs of Infants
Love and Affection Babies respond to touch, smile and voice Respond to their needs quickly and
consistently Holding them, kissing them, rocking them,
smiling and talking to them and carrying them close to the body helps to fuel their growth and development
Questions
Answer the following: Describe parental behaviors that would promote
mistrust in an infant. What advice would you give to a parent who has to
leave his/her child at daycare on how to foster a secure attachment?
What are the different functions of reflexes? Why do you think that newborns spend half or their
sleep time in REM sleep? What would you recommend to a couple that is
worried about SIDS? Describe some potential household hazards that
would need to be childproofed.