POSTNATAL CASE

Recommendations
Individual Level
For the Mother:
• Awareness regarding danger signs during the postpartum period
• excessive bleeding
• fever
• foul-smelling lochia
• burning micturition
• pain and swelling in the breasts
• convulsions
• calf tenderness
• Four Post natal visits on 1, 3,7,42 days of delivery
• Diet
• Increase calorie intake by consuming at least 2 extra meals
• consume more proteins - pulses, dhal, milk, egg, non-veg
• increase iron intake — ragi, red meats, fruits, green leafy vegetables
• increase calcium intake - milk, curds, ragi
• address any food fads and food taboos
• drink plenty of water
• Nutritional Supplements
• Iron and folic acid — 100 mg elemental iron daily for 100 days in thepostpartum
period
• Calcium - 1000mg daily for 6 months afterdelivery
• If episiotomy has been given
• perineal toileting
• warm sitz bath
• diclofenac suppositories for pain relief
• Personal Hygiene
• dailybath
• handwashing

• perineal toileting

• no need to wash breasts before breastfeeding

» Physical Activity

• Importance of rest

• avoid lifting heavy weights

• do simple pelvic floor exercises

• resume sexual relations only after 6 weeks

• Family Planning

• Information regarding the various family planning methods available

• IUD or condom as a spacing method

• male or female sterilisation in case the family iscomp(ete

• Mother-Craft

• Enabling mothersto take care oftheir infants —focus on breastfeeding,

complementary feeds,food recipesforinfants, care ofthe baby during illness

For the Baby

• Awareness regarding danger signs in the newborn

• Fever hypothermia

• Lethargic / difficult to awake

• Difficult / fast breathing

• Yellow discoloration over palms and soles

• Poor sucking I feeding

• Convulsions /Rigidity

• Pus / redness of umbilicus

• Prevent hypothermia

• Keep the baby warm

• Immediate drying

• Covering the head

• Skin to skin care (Kangaroo Mother Care)

• Delaying firstbath

• Rooming- in/Bedding-in

• Prevent infection

• Care of the cord

• Gare of the eyes

• Handwashing before handling the baby

• kangaroo mother care

• Avoid too many visitors handling thebaby

21,

• Six Checkups for the baby 

• Breast feeding

• Earty initiation

• No pre lacteal feeds

• Exclusive breastfeeding for the first 6 months

• Breastfeeding on demand

• Proper positioning and attachment

• Complementary feeds at 6 months

• Continue breastfeeding for at least 2years

• Immunisation

• At Birth - Hepatitis B vaccine —birthdose

• oral polio vaccine

• BCG

• Maintain immunisation card carefully

Family level

• Encourage the family to support themother—emotionally (watch outforsigns of 

depression), inthe care ofthe baby, adequate nutrition forthemother, postnatal ViSits

• Birth Registration for the infant

• Hand washing, including before handling the baby

• Address any food taboos and harmful culturalpractices

• Awarenessregarding theschemes availed fromthegovernment like supplementary nutrition 

at the Anganwadi, Bhagyalakhsmi scheme (for female child), Janani Shishu Suraksha

Karyakram.

Community Level

Improving awareness in the community regarding

• Nutrition for postnatal mothers

• Infant and young child feeding practices

• Immunization

• Maternity and infant benefitschemes

• Family planning

Viva Questions

1. Define postpartum period, perinatal and neonatal period.

2. How many post natal visits are recommended? And when? (Days 1,3,7 and 42. For home based newborn care visit

by ASHA on days 3,7,14,21,28,42)

3. What is the normal involution pattern of uterus after delivery?

4. What are the complications in the postnatal period?

5. What are the symptoms or signs of puerperalsepsis?

6. Whatadvicewillyougive toapostnatalmother? (Dangersigns, visits,diet, exercise, IFAtablets,personalhygiene,

breastfeeding,familyplanning, care ofthenewborn)

7. When can PPIUCD be inserted in the post partum period (PPIUCD within 10 mins of delivery of placenta or

during LSCS after removal of placenta, or within 48 hours of delivery. It can also be inserted at 6 weeks

postpartum)

8. What is the extra nutrition required by a lactating mother?

9. What are the preferred methods of contraception after the birth of a child?

10. What do you understand by APGAR score?

11. What is the first milk called? What is itsimportance?

12. What is exclusive breast feeding? For how long should breast feeding be continued?

13. What are the advantages of breast feeding?

14. What is good positioning and good attachment?

15. What is rooming in?

16. What is baby friendly hospital initiative?

17. When should complementary feeding begin? What are the ideal complementary foods?

18. What are the normal birth weight, height, and head circumference of a child?

19. Who is an at-risk infant?

20. What is kangaroo mother care and what is its advantage?

21. What are the danger signs in a newborn?

22. What are main causes of infant mortality?

23. List some socio-cultural practices that are followed commonly during postpartum period (harmful practicesto

avoid, beneficial practicestobe encouraged)

24. What is Low birth weight? What are the common causes of LBW?

25. What are the vaccines given to a newborn?

26. What isEssential Newborn Care? (Draught—free NBCC with radiant warmer with neonatal mask and bag,

Resuscitation, Warmth, Early initiation of breastfeeding,