CASE STUDY 1

A normal infant weighs 3000 g at birth. By day 4 the infant’s weight has dropped to 2850 g. The infant
has tongue tie, and the mother thinks that this is preventing the infant from sucking well. The policy in
the hospital is to keep all normal infants in the nursery where the mothers can visit at feeding time.

Question:

1. Is the weight loss of 150 g normal for this infant?

 A weight loss of 5% to 10% of the birth weight days after the delivery is considered
normal.
2. Does tongue tie prevent an infant from sucking normally?
 An infant's ability to suck normally is not affected by a tongue tie. It normally has no
side effects and improves on its own. It doesn't need to be treated.
3. Why is it important to assess whether an infant sucks well if the weight gain after birth is
poor?
 Poor weight gain due to ineffective sucking may suggest a problem that needs to be
assessed as well as given intervention immediately for the newborn may not be
getting sufficient nutrients.
4. What do you think of normal infants being kept in the nursery?
 Skin to skin contact of the newborn with the mother is highly suggested. Rooming in
is the practice that is now implemented rather than staying in the nursery. This is to
promote bonding between the newborn and the mother while also lowering the risk
of infection.
5. When should this infant be immunized?
 Before the infant is discharged, BCG and polio drops should be given. For the rest of
the routine vaccines, they will have to go to the well baby clinic.
6. When can this infant be discharged home?
 A health mother and baby can be discharged as early as 6 hours after the delivery or
as soon as she is ready, however, some hospitals may keep them for 1 to 2 days.

CASE STUDY 2

Starch powder is sprinkled onto the umbilical cord of a newborn infant twice a day to hasten drying. The
cord is then covered with a linen binder. The mother is worried that the infant has enlarged breasts. As
the ward is cold at night, she puts the infant into her bed. The grandmother says this is dangerous as she
may roll onto the infant during the night.

Question:

1. What do you think of the method of cord care in this infant?

 Leaving the cord alone is the best option. Sprinkling of starch powder to hasten
drying may not only prolong the healing process but may also cause infection to the
cord. It is also best to leave the cord to be air dried instead of covering it with a
binder as this is not effective.
2. What treatment is needed for the infant’s enlarged breasts?
 There is no need for treatment. The mother must be informed that the breast
enlargement would go away on its own after a few months therefore, she should not
do anything about it and avoid squeezing the breasts.
3. What would you advise the mother about sleeping with her infant?
 The baby can sleep with the mother especially to keep her warm. The baby and
mother's skin-to-skin contact is beneficial, which is why sleeping next to one other is
not harmful.