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<html lang="en" class="hexml-course s2e"><!--[if lt IE 8]> <html class="oldie"> <![endif]--><!--Generated at Wed, 12 Oct 2022 23:23:13 +0000--><head><meta name="author" content='["Carole Dobrich"]'><meta name="course" content="MA03"><meta name="topic" content="4.0"><meta http-equiv="content-type" content="text/html; charset=utf-8"><meta name="copyright" content="2022 Health e-Learning"><meta name="robots" content="NONE,NOARCHIVE"><meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=0"><link rel="stylesheet" href="//static.health-e-learning.com/jigsaw/design/hexml.pack.css?v=1665616993" type="text/css"><script type="text/javascript" charset="utf-8" src="//static.health-e-learning.com/jigsaw/design/hexml.pack.js?v=1665616993"></script><title>MA03: Postnatal Interventions</title></head><body class="loading"><div class="ajax-modal Fixed"></div><div class="watermark"><span>Health e-Learning</span></div><div id="access"><a href="#access" accesskey="a">Access Keys</a><a href="#menu" accesskey="m">Skip to Menu</a><a href="#content" accesskey="c">Skip to Content</a><a href="#footer" accesskey="f">Skip to Footer</a></div><div id="nav"><span class="nav-menu">Maintaining BFHI Education for Nurses and Midwives - Series 2</span><a id="hamburger" href="#"><span class="hamburger hamburger--collapse"><span class="hamburger-box"><span class="hamburger-inner"></span></span></span></a><div class="progress-container"><div id="myBar" class="progress-bar"></div></div></div><nav id="menu"><ol><li><a href="topic_1-0.html"><span class="menu-item-icon">1.0 </span><span class="menu-item-title">Introduction</span></a></li><li><a href="topic_2-0.html"><span class="menu-item-icon">2.0 </span><span class="menu-item-title">Protection of Breastfeeding [Domain 1]</span></a><ol><li><a href="topic_2-1.html"><span class="menu-item-icon">2.1 </span><span class="menu-item-title">A Code History Timeline</span></a></li><li><a href="topic_2-2.html"><span class="menu-item-icon">2.2 </span><span class="menu-item-title">Marketing - the role of the International Code</span></a></li></ol></li><li><a href="topic_3-0.html"><span class="menu-item-icon">3.0 </span><span class="menu-item-title">Understanding the importance of skin-to-skin</span></a><ol><li><a href="topic_3-1.html"><span class="menu-item-icon">3.1 </span><span class="menu-item-title">Infant innate behaviours</span></a></li><li><a href="topic_3-2.html"><span class="menu-item-icon">3.2 </span><span class="menu-item-title">Skin-to-skin and the role of the Health Worker</span></a></li><li><a href="topic_3-3.html"><span class="menu-item-icon">3.3 </span><span class="menu-item-title">Addressing barriers to skin-to-skin</span></a></li><li><a href="topic_3-4.html"><span class="menu-item-icon">3.4 </span><span class="menu-item-title">The loving relationship</span></a></li></ol></li><li class="current mm-selected"><a href="topic_4-0.html"><span class="menu-item-icon">4.0 <i class="fa fa-caret-right" aria-hidden="true"></i></span><span class="menu-item-title">Postnatal Interventions</span></a><ol><li><a href="topic_4-1.html"><span class="menu-item-icon">4.1 </span><span class="menu-item-title">The chemistry of feeding</span></a></li></ol></li><li><a href="topic_5-0.html"><span class="menu-item-icon">5.0 </span><span class="menu-item-title">Special needs and infant challenges [Domain 6]</span></a><ol><li><a href="topic_5-1.html"><span class="menu-item-icon">5.1 </span><span class="menu-item-title">The 'late preterm' 'early term' baby</span></a></li><li><a href="topic_5-2.html"><span class="menu-item-icon">5.2 </span><span class="menu-item-title">Ankyloglossia</span></a></li></ol></li><li><a href="topic_6-0.html"><span class="menu-item-icon">6.0 </span><span class="menu-item-title">Managing common difficulties</span></a><ol><li><a href="topic_6-1.html"><span class="menu-item-icon">6.1 </span><span class="menu-item-title">Engorgement</span></a></li><li><a href="topic_6-2.html"><span class="menu-item-icon">6.2 </span><span class="menu-item-title">Hyperlactation</span></a></li></ol></li><li><a href="topic_7-0.html"><span class="menu-item-icon">7.0 </span><span class="menu-item-title">Supplementation</span></a><ol><li><a href="topic_7-1.html"><span class="menu-item-icon">7.1 </span><span class="menu-item-title">Feeding-line device at the breast or chest</span></a></li><li><a href="topic_7-2.html"><span class="menu-item-icon">7.2 </span><span class="menu-item-title">Cup feeding</span></a></li><li><a href="topic_7-3.html"><span class="menu-item-icon">7.3 </span><span class="menu-item-title">Finger Feeding</span></a></li></ol></li><li><a href="topic_8-0.html"><span class="menu-item-icon">8.0 </span><span class="menu-item-title">Closing session</span></a><hr></li><li class="appendix"><a href="references.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-book i-topic"></i></span><span class="menu-item-title">List of references</span></a></li><li class="appendix"><a href="contents.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-file-text-o i-topic"></i></span><span class="menu-item-title">Course contents</span></a></li><li class="appendix"><a href="full.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-print i-topic"></i></span><span class="menu-item-title">Print version</span></a></li></ol></nav><div id="content"><h1 id="top">4.0 Postnatal Interventions</h1><div class="box"><div class="box-title"><h3>Step 7: Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day</h3></div> <div class="content-node"> <p> <span class="marker"> <strong>(Canada) Step 7: Promote and support mother-infant togetherness.</strong> </span> </p> </div> <img width="1251" height="1251" data-src="images/7_Rooming-in.jpg" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt=""> </div><section class="section" id="Separation_of_mother_birthing_parent_and_newborn"><h2>Separation of mother/birthing parent and newborn</h2> <div class="content-node"> <p>From an evolutionary perspective, skin-to-skin care is the norm. Routine separation of the newborn from its mother/birthing parent soon after birth is unique to the 20th Century and beyond. At the risk of laboring the point, separating the mother/birthing parent and baby after birthing for any reason, other than a medical emergency, is NOT applying best practice care. All indicators of infant well-being and successful extrauterine adaptation are stabilized better and faster when the newborn is in skin-to-skin contact with its mother/birthing parent from immediately after birth for the first few hours, or at least until after the first breastfeeding.</p> </div> </section><blockquote> <div class="content-node"> <p>Because of human infants' extreme immaturity at birth, infants depend on the caregiving context for relatively long periods of time, during which they require specific environmental inputs for the regulation of their biological and behavioral systems.</p> </div> </blockquote><div class="captionBox"><img width="1014" height="690" data-src="images/protest.jpg" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt="Note the protest response being exhibited by this newborn."><p>Note the protest response being exhibited by this newborn. <br>&copy; Cecilia Finoli</p></div><section class="section" id=""> <div class="content-node"> <p>When the mother/birthing parent and infant are separated, the infant's innate behaviors are changed. The infant firstly exhibits distress cries, followed by what is described as "protest-despair" behavior.</p> <p>Separated newborns make 10 times more crying signals than babies in skin-to-skin care, and their cries have a completely different character. During the "protest" response there is intense activity seeking the mother/birthing parent, followed by "despair" behavior which sees the baby withdraw with decreased heart rate and temperature, mediated by a massive rise in stress hormones.</p> <p>Maternal-neonate separation results in a physiological stress-response and has a profoundly negative impact on quiet sleep duration.</p> </div> </section><section class="section" id="Effect_on_oxytocin"><h2>Effect on oxytocin</h2> <img width="550" height="350" data-src="images/oxytocin.jpg" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt=""> <div class="content-node"> <p>Oxytocin levels are highest around the time of birthing. Oxytocin cannot cross from the peripheral circulation into the brain; therefore it is only naturally occurring oxytocin released by the posterior pituitary gland that will have an effect on the mother's/birthing parent's temperament, ie. not oxytocin administered to the mother/birthing parent.</p> </div> </section><section class="section" id=""> <section class="section" id=""> <div class="content-node"> <p>Oxytocin causes, </p> <p>increased uterine contraction limiting postpartum blood loss,<br>
the temperature of the mother's/birthing parent's breast to rise, providing warmth for the infant,<br>
an anti-stress effect, reducing maternal blood pressure and cortisol levels and releasing gastrointestinal hormones,<br>
a state of calmness and social responsiveness,<br>
bonding with their infant, and enhanced maternal behaviors,<br>
milk ejection; important at this time prior to it becoming conditioned by the suckling stimulus.</p> <p>During the time the infant in skin-to-skin contact after birthing is making massage-like movements on the mother's/birthing parent's chest and breasts the maternal serum oxytocin levels rise. The infant begins these hand movements soon after birth and continues until he self-attaches and suckles.</p> <p>The work of Michel Odent is well recognized by those involved in obstetrics. Odent's studies of the effects of oxytocin and other hormones of birthing are worthwhile following.</p> </div> </section> </section><blockquote> <div class="content-node"> <p> <span>The age of cesarean sections on request, epidurals and drips of oxytocin is a turning point in the history of childbirth. Until recently women could not give birth without releasing a complex cocktail of 'love hormones'. Today, in many countries, most women have babies without releasing these specific hormones. The questions must be raised in terms of civilization. This turning point occurs at the very time when several scientific disciplines suggest that the way human beings are born has long-term consequences, particularly in terms of sociability, aggressiveness or, in other words, 'capacity to love'.</span> </p> </div> <p class="cite">Michel Odent, 2001</p></blockquote><section class="section" id="Birth_is_a_sensitive_period"><h2>Birth is a sensitive period</h2> <blockquote> <div class="content-node"> <p>The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.</p> </div> </blockquote> <section class="section" id=""> <div class="content-node"> <p> <span>With this in mind, the importance of skin-to-skin contact for mothers/birthing parents and infants who experience assisted births appears to be even more important. </span> </p> </div> <div class="captionBox"><img width="4000" height="3000" data-src="images/Skin-to-skin_OR.jpg" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt="Importance of skin-to-skin following assisted birth"><p>Importance of skin-to-skin following assisted birth. <br>&copy; Cecilia Finoli</p></div> </section> </section><div id="footer"><a href="topic_3-4.html" rel="prev" class="prev">&laquo; Prev</a><a href="topic_4-1.html" rel="next" class="next">Next &raquo;</a><br style="clear: both"><div class="floating-menu"><button class="theme-toggle" title="Toggle colors (dark or light)"><i class="fa fa-moon-o"></i></button><button class="gotoTop" title="Back to top"><i class="fa fa-chevron-up"></i></button></div><a href="javascript:%20window.print()" id="printLink">Print this page</a><span class="noPrint"> | </span>&copy; 2022 Health e-Learning<p class="printOnly">COPYRIGHT: You are permitted to print ONE (1) copy for your personal use only. No graphics, tables, quizzes, videos, etc, may be used in any form without express written consent. Author: ["Carole Dobrich"]</p><p class="dateUpdated">Updated on Wed, 12 Oct 2022 23:23:13 +0000</p></div></div></body></html>
