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Principles of hygiene needs: for the baby
■ clean container and cooled boiled/sterile water
■ paper towel/bag or disposable tray
•
Wash and dry hands, apply gloves.•
Pour the water into the container.•
Using a cotton wool ball moistened with water, wipe from the inner edge of the eye outwards, using the cotton wool ball once only.•
Dispose of the used ball and repeat with another cotton wool ball.•
Repeat until the eye is clean then undertake for the other eye.•
Dispose of the equipment correctly.•
Remove gloves, wash and dry hands.•
Discuss ongoing care with the parents, e.g. when to repeat the procedure, signs to be aware of.•
Document the indings and act accordingly.•
Evidence relating to the use of bath additives, shampoos, emollients and baby wipes is constantly evolving and the midwife must keep up-to-date with these changes.•
The baby does not need to be bathed every day.•
Shampooing the hair is not necessary during each bathing.•
Bathing the baby can be an enjoyable process for all involved but attention must be paid to keeping the baby warm, safe and secure.•
The use of alkaline soaps and bath additives disrupts the acid mantle of the skin, predisposing to infection;the use of plain water is recommended.
•
The baby’s eyes should not be cleaned unless discharging.•
Nappies may be disposable or reusable, with three ways of folding the latter.•
The cord should not be cleaned routinely in low-mortality settings as this can delay separation and increase the risk of infection.chlorhexidine in high-mortality settings and suggest it reduces the risk of death by 23%, although it does delay cord separation by 1–7 days. Karumbi et al (2013) found the use of 4% chlorhexidine within the irst 24 hours reduced neonatal mortality in community settings for topical cord care in Kenya. Suliman et al (2010) report on the use of triple dye (brilliant green, crystal violet, prola-vine hemisulphate) with and without rubbing alcohol several times a day until separation. While this may be advantageous in reducing colonization with Staphylococcus aureus, it does increase cord separation times. Erenel et al (2010) caution against the use of triple dye as animal studies suggest it may have toxic and carcinogenic effects.
The current management for babies not at high risk of infection, including those who have had a lotus birth, con-tinues to revolve around scrupulous hand hygiene, keeping the cord clean and dry, and using water when bathing or nappy changing.
ROLE AND RESPONSIBILITIES OF THE MIDWIFE These can be summarized as:
• keeping up-to-date with the changes to cleansers and baby wipes
• completing the procedures safely and correctly
• recognizing deviations from normal and taking appropriate action
• educating the parents
• correct documentation.
SUMMARY
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Meeting the hygiene needs of the baby is an important skill for the midwife, who not only undertakes this but also educates the parents on how to do this.SELF-ASSESSMENT EXERCISES
The answers to the following questions may be found in the text:
1. What advice can a midwife provide to parents who are enquiring which cleansing agent to use?
2. How can the midwife ensure the safety of the baby during bathing?
3. Describe how a baby bath is undertaken.
4. What advice can a midwife provide to parents who are unsure whether to use baby wipes or just water?
5. Demonstrate the different ways to apply a reusable nappy.
6. When would the midwife clean the baby’s eyes and how is this done?
7. What advice can be given regarding cord care?
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Principles of hygiene needs: for the baby
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Principles of elimination management: micturition and catheterization
Chapter
LEARNING OUTCOMES
Having read this chapter, the reader should be able to:
•
deine micturition, describing the adult normal urine volumes•
discuss the changes to the urinary tract that child-bearing brings•
describe how to facilitate normal micturition, including the correct use of a bedpan•
describe, with rationale, the equipment chosen for urinary catheterization•
describe how to insert and remove a urethral catheter.Care of the urinary tract, supporting normal micturition, or using a catheter is an important aspect of care for the childbearing woman. This chapter reviews the factors that inluence micturition, the direct effects of childbearing on the urinary tract, the safe use of bedpans, urinary catheterization, and correct (short-term) indwelling cathe-ter care.