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INTRODUCTION

As concerning the bringing up, nourishment and giving of suckle to the child, it shal be beste that the mother give her child sucke her selfe, for the mothers milk is more convenient and agreeable to the infant than any other woman’s or other milke.

THOMAS RAYNALDE, THE BYRTHE OF MANKYNDE (1540)

Education for the puerperium and caring for the baby should begin during pregnancy so that a new mother is familiar with the basic principles of motherhood, especially infant feeding.1 The puerperium is defined as the period of approximately 42 days from the completion of the third stage to the return of the normal physiological state.

It is important to educate postpartum women on care of the baby and breastfeeding, self-care, healing of the genital tract, sexual life and contraception, nutrition and what happens to their bodies and preventive issues. The uterus involutes to non-pregnant size by 6 weeks and the cervical os should be closed by 2–3 weeks post delivery.2

POSTNATAL CONSULTATIONS

The two-week consultation

Mother:

  • take history of birth and any perinatal complications

  • check blood pressure, weight (BMI)

  • assess how she is adjusting to motherhood

  • look for signs/symptoms of postpartum depression

  • provide encouragement and advice

  • check breastfeeding

Baby:

  • measure weight, height and head circumference

  • routine baby examination by checking the following:

  • – fontanelles

  • – eyes (observation, corneal reflexes, white pupil)

  • – cardiovascular examination

  • – femoral pulses

  • – hip tests for dislocation

  • – testes fully descended

  • – genitalia

  • – anal region

  • – skin

  • – reflexes

The six-week consultation

This is basically a repeat of the previous consultation—a checklist is presented in TABLE 109.1.

Table 109.1Checklist for postnatal check at 4–6 weeks

CONTRACEPTION

Lactational ...

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