Baradine was born at term in a small country hospital. He became slightly jaundiced soon after birth and the advice from the midwife to Apari (his mother) was to breastfeed regularly. The first night went well, Baradine was breastfeeding and sleeping between feeds however, during the following night, Apari found she was feeding almost constantly, and her nipples had become very sore. On day three the midwife performed a heel prick which showed Baradine’s bilirubin levels had risen and that he required phototherapy. The midwife told Apari that she and Baradine would be required to transfer to the main hospital, an hour away, as the country hospital did not have a paediatrician. Apari and Baradine were transferred by ambulance. On admission to the hospital Baradine was admitted to NICU and the diagnosis was physiological jaundice. Baradine was commenced on phototherapy (zipped into a blue bag and placed in a Bilibed). Baradine’s admission weight was 5% lower than his birth weight. Apari wishes to continue breastfeeding.
Baradine’s jaundice has resolved as is now ready for discharge and Apari wishes to continue breastfeeding but is anxious once at home Baradine will revert to not latching on correctly and therefore will not get enough milk.
QUESTIONS:
Nutritional/Feeding strategies
Describe the nutritional/feeding strategies for the condition in the chosen scenario including:
Promoting family centred – infant-parent dyad
Critically discuss the midwife/nurse’s role in nurturing and supporting the infant-parent dyad role within a family centred lens and the importance of this within a home environment including:
The scenario presented involves Baradine, a newborn experiencing physiological jaundice, who requires phototherapy for treatment. Baradine’s mother, Apari, wishes to continue breastfeeding but is concerned about potential challenges once they return home. This essay will discuss nutritional and feeding strategies for Baradine’s condition, including breastfeeding at home and the benefits of multidisciplinary support. Additionally, the midwife/nurse’s role in promoting family-centered care and supporting the infant-parent dyad within the home environment will be critically explored, acknowledging potential parental stress and challenges.
Continuing breastfeeding is essential for Baradine’s health and well-being, even after his jaundice has resolved. To ensure successful breastfeeding at home, Apari can employ several strategies:
Frequent and On-Demand Feeding: Baradine should be breastfed frequently and on-demand, usually every 2 to 3 hours or whenever he shows signs of hunger, such as rooting or sucking on his fingers. This will help maintain a steady milk supply and promote Baradine’s weight gain (American Academy of Pediatrics, 2012).
Proper Latch and Positioning: Ensuring a correct latch and positioning during breastfeeding is crucial to prevent nipple soreness and ensure that Baradine receives enough milk. The midwife/nurse can provide guidance and support on proper latching techniques (World Health Organization, 2017).
Breast Compression: If Baradine shows signs of ineffective sucking, breast compression can be utilized to increase milk flow and ensure he receives enough hindmilk, which is richer in fat and calories (Mohrbacher, 2010).
Continuing breastfeeding at home has numerous benefits for both Baradine and Apari. Breast milk provides optimal nutrition, immune protection, and promotes mother-infant bonding (Horta et al., 2007). Baradine will receive the necessary nutrients to support his growth and development. For Apari, breastfeeding can enhance maternal-infant attachment and provide emotional support (Radesky et al., 2018).
However, there may be challenges, such as nipple soreness and potential difficulties in maintaining a sufficient milk supply. The midwife/nurse can address these issues by providing guidance, reassurance, and support, thus minimizing potential risks.
In supporting Baradine’s feeding journey, a multidisciplinary team can play a crucial role. This team may include lactation consultants, pediatricians, and nutritionists, among others. The benefits of multidisciplinary support include:
Holistic Care: A multidisciplinary team can address various aspects of Baradine’s well-being, providing comprehensive and holistic care (Dinsdale et al., 2016).
Expertise: Each member brings specialized knowledge and skills, ensuring the best possible support and advice for Apari and Baradine’s unique needs.
Collaboration: Collaboration among healthcare professionals fosters a cohesive approach, leading to more effective care and improved outcomes (O’Keeffe et al., 2016).
Family-centered care is a model of healthcare that recognizes the family as the primary source of support and care for the infant (Shields, 2019). The midwife/nurse can promote family-centered care by:
Engaging in Shared Decision-Making: Involving Apari in decision-making regarding Baradine’s care fosters a sense of empowerment and ensures that care aligns with the family’s values and preferences (Duffield et al., 2019).
Providing Emotional Support: The midwife/nurse can offer emotional support to Apari, addressing any concerns or anxieties she may have about breastfeeding and caring for Baradine.
Offering Education and Resources: Providing relevant information and resources about breastfeeding, infant care, and community support groups empowers Apari to make informed choices (Leith et al., 2017).
The transition to home from the hospital can be challenging for new parents like Apari, leading to potential stress and anxiety (Moghadam et al., 2016). Factors such as sleep deprivation, self-doubt in parenting abilities, and lack of social support can exacerbate parental stress.
The midwife/nurse can address these challenges by providing empathetic listening, offering practical support, and facilitating access to social support networks. Implementing family-centered care principles can help mitigate stress, as the focus is on empowering Apari and ensuring her active involvement in Baradine’s care.
In conclusion, nurturing and supporting the infant-parent dyad during Baradine’s transition from the hospital to home is essential for his continued well-being and optimal development. Employing proper nutritional/feeding strategies, such as on-demand breastfeeding and correct latch and positioning, can support Baradine’s growth. Multidisciplinary input, including lactation consultants and pediatricians, can offer comprehensive care, while family-centered care principles prioritize Apari’s involvement and preferences in Baradine’s care. Recognizing potential parental stress and addressing social and psychological challenges are crucial aspects of providing holistic support for Baradine and Apari during this critical period of their lives.
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