Random thoughts

RSV parameters:  Runny nose, cough, low grade fever, retraction, nasal flaring, blue around the lips, nail beds are not pink, hard to wake, not feeding well. GBS directions: insert the swab  1-2 inches inside the vagina then pull out like wiping go over and around rectum. Some moms call breast infection a breast cold. If a mom’s bottom is sore and stretching and itching it is usually from healing. If it is painful, sore, or burning it could be infected.  Corn silk, uva ursi, cranberry, lots of fluids, wiping back to front, no powder or heavy soaps used down under, cotton undies, clean undies, and garlic help fight uti. Slippery elm and aloe can be used for constipation. For thrush, drink green tea, black tea bags can be brewed and placed, when cool, on mom’s nipples. Grapefruit seed extract, gentian violet, and acidophilus are all good for fighting thrush infections. Having a good diet, free of dairy foods and sugars can help. Wash hands and nipples often. Boil pacifiers and everything else that goes into baby’s mouth for at least 20 mins each day. A vinegar wash can be used afterwards to help fight infection.  A parsley poultice can be used for sore nipples.

I am going to incorporate breastfeeding education prior to birth. We need to change the language around breastfeeding—instead of saying milk comes in on day 3, we need to say, expect your milk to increase on day 3 or so, to make mothers believe in themselves and in their bodies.  I think that is a huge deal and once they see that they indeed do have milk—they are more relaxed that they are going to be able to adequately take care of their babies.  They just don’t need one more thing to be concerned with after birth and I think that takes away from the anxiety surrounding breastfeeding and awaiting that milk to come in.

My neonatal resuscitation certification is expiring in a few months.  For this new class, a new edition of the book needed to be purchased, the 6th edition, which had many changes.  One of the changes to the new text was baby not being separated from mom, which honestly I do not remember not being in the older text.  I guess I assumed that was obvious, but I also need to remember that this book was intended for in-hospital personnel and not home-based providers in a different healthcare delivery system.  It surprised me how different my perspective was on the material in the class.  It was not like it was all new material, but since I had taken the class almost two years ago, knowing much less about birth, this time around provided much more gravity to the information.  This probably should not surprise me, but it did in an alarming way.  I thought I was prepared to perform neonatal resuscitation, but clearly, I wasn’t.  I am thankful to have had the opportunity to take the class now, but wish I had taken it right before starting my clinical or at least prior to attending births. I feel much more confident in identifying a baby in need of assistance and performing resuscitation, if needed, now even though I wish never to have to do this. 

Another interesting idea is that babies that undergo a hypoxic event will naturally cool themselves, so maintaining heat is no longer indicated for a compromised baby, nor is it indicated for a mother in shock.  In fact, it is best to keep them cooler than hotter—so no hats or heating pads!  We are also moving towards a resuscitation model using less if no oxygen in combination with out pulse oximeter.  Now, I know that pulse oxs are great tools, when you have room to move, have a third person, and need them.  I think it would be a great idea to have access to them.  I honestly think that is one tool I may use often in normal situations, but worry that it is not feasible to utilize in an emergency situation in the field. I wonder, too, what the Amish and other cultures already weary of all the technology we provide will think of one more gadget? Overall, it was an interesting day with lots of great ideas to keep in my back pocket.