27-2 I. CARE OF MOTHER AFTER GIVING BIRTH Pregnancy and childbirth can really take away a lot of a woman’s strength and leave her very tired. In the first 6 weeks after birth, mothers need enough rest and good nutritious food. With these she will be able to get back her strength and be able to care for her baby. She may need special care if she falls ill. Some of the problems of mothers after they give birth to a child are discussed so that we know how to support a new mother.1. Food for the new mother: New mothers CAN and SHOULD eatevery kind of food that is nutritious and which they like. She need NOTavoid any kind of food. These foods are especially good for the motherand must be included in her diet: Rice, daal, beef, lean pork, mutton, fish, milk, eggs, green leafy vegetables, fruits, red/ yellow vegetables and fruits, soyabeans, groundnuts etc.2. Cleanliness: Mothers can take a bath from the first day after givingbirth. They may use water that is lukewarm (not too hot nor too cold).Regular bathing is good for the new mother but she should avoid bath-ing in a river or stream as she can get infections.3. Care of the breast: The thick yellow milk in the first two days calledcolostrum is good for the baby. It has a lot of antibodies which keeps thebaby from getting sick. It is nature’s gift from the mother to the baby tofight diseases. IT MUST NEVER BE THROWN AWAY. Give the childcolostrum.Usually, if the mother has enough to eat and has nutritious food, she canmake any amount of milk that the child needs. If the child is given otherfood or milk, it may stop sucking well and this makes the breasts pro-duce lesser milk. If the baby is ill and cannot suck well, squeeze the milk out, or else it may get germs4. Fever: The mother may feel feverish for a day ortwo after giving birth. This is normal. But if tem-perature continues to remain high and pulse rate isalso high (above 90 a minute), it could be childbirthfever. This could be because some germs have en-tered into the womb while giving birth (germs couldbe from unclean hands of the birth attendant or uncleanclothes). What to do in Childbirth Fever?Signs of Childbirth Fever Clean the genital area with boiled water & soap. Ap- Fever with chills ply warm compresses. Low back pain Headache Start AMOXYCILLIN 500 mg three times Swelling of the belly daily. Childbirth fever can be serious. If A foul smelling /bloody the mother does not improve soon, refer her discharge from the vagina to a doctor.
27-3 5. Breast Abscess If breast is hot, swollen and painful, it may have an abscess (boil). STOP feeding the child and throw the milk from that breast. Feed the baby only from the healthy breast. Use hot compresses and you may give PARACETAMOL tablets. Start AMOXYCILLIN. Breasts get too full: At times the breasts produce more milk than the baby can drink. At such times, the breasts feel full and are painful. The mother can even get infected. Ask the mother to empty the overflowing breast by squeezing out the milk by hand. Way to squeeze out excess milk from the breastII. CARE OF NEWBORN AFTER BIRTH As soon as the baby is born: Clean the mouth of the baby gently with your finger. Wipe baby’s skin dry with wet towel/ cloth. If cold weather, wrap the baby and give it to the mother. If hot weather, better to keep the baby naked. Baby should be given to the mother within a few minutes of birth. Let the child suck at the mother’s breast. It helps start the Put baby to breast milk and also prevents too much bleeding in the third stage immediately of childbirth / delivery (when placenta & bag comes out). after birth.a. Care of Cord: Keep the cord dry and clean. If home is clean and there are no flies,leave it open. If there are flies and dust, cover the baby’s belly with clean and sun-dried (or ironed) cloth.b. Eyes: Clean eyes with clean cloth and boiled water (which has been cooled). If mother has infection of vagina, then clean the baby’s eyes and put GENTAMICIN / CIPROFLOXACIN eye drops. Otherwise the baby might get infection after a few days.
27-5c. Cleanliness of baby: Keep baby without nappies or change nappies time and again to help its soft skin. After cord falls off in a few days, bathe baby daily with warm water. Use mosquito net for baby. Keep it away from smoke or dust.d. Feeding: Breast feeding is best. It is better than any of thepowder, tin, packed or canned milk that we can get in themarket. Mother’s milk is warm, without germs and hasantibodies from the mother which can keep the baby fromfalling sick. A mother must eatImportant to Know 2 ½ times her nor-For the first few days, the mother may not produce milk. THIS IS NOR- mal amount ofMAL. She needs to nurse her baby more often. Anything else given to the food and alsochild will satisfy the child and the child will not suck hard enough. Thiscould lead to mother giving less milk all through! DO NOT FEED drink lots of fluida baby with ANYTHING except breast milk for at least 4 months. Not to make enougheven water must be given. milk for the baby. What to do if a newborn is sick?If the new born baby has:a. Pus or bad small from the cut cord or na- c. Vomiting: Baby may vomit whenval : Clean the cord with boiled and cooled wa- she burps (brings out air). After feed- ter and a clean cloth. You may crush ing we should help the baby bring up open a capsule of AMOXYCILLIN and air. Teach the mother to hold the baby sprinkle the powder on the site. Start against her shoulders with its head AMOXYCILLIN Syrup three times a up and gently pat its back till the air day. comes out with a burp.b. Difficulty in Breathing: Clean the nose as it d. Diarrhoea : Tellmay have something in it. Count the number of the mother to con-breaths per minute. If the baby is breathing 50 or tinue to breastfeedmore breaths a minute, has got blue and the skin even if the baby hasbetween its ribs is sucked in when it breathes, then it may be having pneumonia. Start diarrhoea. If the soft AMOXYCILLIN and refer if necessary. spot is sunken, give the baby plenty of fluids like ORS. When to refer a newborn baby Refer a new born if she: Does not breathe as soon as she is born. If her heart rate cannot be felt or heard or is less than 100 per minute. If she does not move her arms or legs on her own when you pinch it. If she has difficulty in breathing. Is she is too white, yellow or blue after 5 minutes of beginning to breathe. Has not sucked the breast even after four hours of birth or stops sucking after a few days. If the baby vomits green / yellow or vomits violently, rush to a hospital!
27-5 Know the Answers Care of Mother & Newborn after Birth I. Please fill in the blanks: 1. A breast feeding mother must eat _____ times her normal diet. 2. Childbirth fever can be seen by the following signs: a. _____________________ b. _____________________ c. _____________________ d. _____________________ e. _____________________ 3. _____________________ antibiotic is safe in breastfeeding mothers and maybe given for ____________ fevers and Abscess. 4. If the newborn baby’s breathing rate is faster than __________ per minute, she may be having Pneumonia and must be started on Syrup _____________________. 5. A newborn must be referred to a doctor if she has: a. ___________________________ b. ___________________________ c. ___________________________ d. ___________________________ e. ___________________________II. Please mark if “right” or “wrong”: 1. The mother must rest after labour and the baby must be given to given to her only after 24 hours. 2. The newborn’s cord maybe left open after it is cut when the baby is born. 3. In Summers, a newborn must be given at least one glass of water every day or else it will get dehydrated. 4. If the baby brings out (vomits) its mother’s milk, it should be given half a tablet of METOCLOPRAMIDE. 5. Meat, eggs, green leafy vegetables, fruits etc. in the diet of a new mother bring out lots of milk.
27-6 Children’s Growth Development (0-6 months) ACTIVITY 1 month 2 month 3 month 4 month 5 month 6 month 2.5 to 3 kg 3.5 kg 6 kg If child is lifted up, After 2 months, By the 5 thLEARNING the head falls if child is pulled month, child is If held, child can TO SIT behind; hold to sitting posi- sit up, but slips able to pull up head while lifting tion, she starts back if hands are her head and up. holding the left off. chest with help. hand.LEARNING While lying on By 6 th month, By 4 th month,TO CRAWL belly, newborn At 2 months, the child learn to child is able to lifts part between part between take support of support herself waist and knees waist & knees be- arms. on her spread above her legs come parallel to out arms. and hands and ground; legs start keep legs folded. opening up.LEARNINGTO STAND By 4 th month, child can be kept standing by holding her hands.LEARNING TO USE HANDS When newborn’s During 3 rd hand is touched, month, baby Between 3 rd she closes her fist. starts sucking and 4th month, her closed fist. child is able to hold some- thing in her hand. These are normal stages of development in children. If any child is late by one or two months in doing any of these activities, send to a doctor.
Children’s Growth Development (7-12 months) 27-7ACTIVITY 7 month 8 month 9 month 10 month 11 month 12 monthLEARNING In 9 th month, In 10th month, Child can turn By 1 year, TO SIT From 7 to 10 In 8 th month, child can bend head from one months child child can sit child can sit for child can turn 10 minutes forward to pick side to another around all can sit up while resting on without fall- things up. while sitting. parts of body without sup- soles. port. ing. while sitting.LEARNINGTO CRAWL Child can Child bends to Child starts crawl with crawl and tries crawling on hands and to drag her knees and feet on the body forward elbows. ground. by usisng hands.LEARNINGTO STAND When sup- Can take sup- Starts walking If child is made port of some Child tries to If both hands while one hand to stand with ported, child furniture or wall move while are held, child is held; later support, her legs can stand and to stand for a holding on to can stand walks without start bearing her her legs can short time. furniture or straight. support. weight. bear her weight fully. wall.LEARNING TO USE HANDS Starts picking Learns to Learns to dig Starts picking Starts picking Starts up cup or glass clap. or scratch with up things up something collecting with both her finger. with thumb or the other. small things. hands. and finger. These are normal stages of development in children. If any child is late by one or two months in doing any of these activities, send to a doctor.