Breastfeeding offers one of the most fundamental global health benefits for babies. Breastmilk is lifesaving, providing not only nutrition but immunologic benefits and as such is strongly supported by the World Health Organization and leading healthcare associations worldwide. When the COVID-19 pandemic started in 2020, the impact of the restrictions to prevent the spread of the disease created challenges and questions about provision of safe, quality care, including breastfeeding practices, in a new ‘normal’ environment. Mothers were temporarily separated from their babies where infection was present or suspected, parents were prevented from being present on neonatal units and vital breastfeeding support was prevented. This discussion paper provides an overview of essential areas of knowledge related to practice for neonatal nurses and midwives who care for breastfeeding mothers and babies, in the context of the COVID-19 pandemic and the latest global guidance. Three areas will be discussed; the protective benefits of breastfeeding, keeping breastfeeding mothers and babies together and supporting mothers to breastfeed their babies. Finally, care recommendations are presented to serve as a summary of key points for application to practice for neonatal nurses and midwives.
Continuing on from two previous Fact sheets discussing specific Neonatal Biology as compared to the older child and/or adult, this third issue focuses on the neurological, sensory, behavioural, musculoskeletal and integumentary (skin) systems and includes a summary of physiological parameters to compare neonatal values with other age groups.
Neurological SystemThe brain comprises a higher percentage of total body weight compared to the adult with a much higher glucose requirement for growth. The central and peripheral nervous system is not fully complete at birth although the autonomic nervous system is. Myelination still has to complete within the central nervous system (CNS) and development of more refined coordination, motor and developmental milestones along with higher cognitive functions that continue to mature over the childhood years.Neonates in the early weeks are reflexive in nature with the presence of reflexes indicating normality in the CNS e For example; Moro, ventral suspension, sucking, rooting, grasp (palmar), plantar, tonic neck reflex. Eventually, the higher centres within the cortex will take precedence over the reflexive primitive behaviours and the neonate
The emergence of viral diseases, such as COVID-19, represents a global public health threat, particularly the high-impact animal viruses that have switched hosts and are able to be transmitted within human populations. Pandemics threaten the general population; however, there are special groups, such as pregnant women and their babies, which may be at a higher risk of, or more severely affected by infection. Pregnancy is considered a unique immunological condition; therefore, current challenges include decisions on preventing and treating infections during pregnancy and the possible implications for the fetus and newborn infant. This integrative review, the first of a two-part series, analyses selected literature on COVID-19 within maternal and newborn care, drawing on key themes relating to the impact on the pregnant woman. The themes discussed are: the nature of the immune system in pregnant and newly birthed mothers, maternal risk, mode and timing of birth, care during pregnancy and childbirth, and the transition to parenthood including the implications for practice for maternal mental wellbeing.
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