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  • Title: Postpartum care -- what's best for mother and baby.
    Journal: Safe Mother; 1997; (24):4-8. PubMed ID: 12321360.
    Abstract:
    This special feature focuses on the care of mothers and infants during the postpartum period. Postpartum care should include prevention, early detection and treatment of complications and disease, and provision of advice. Most maternal mortality is due to postpartum hemorrhage within 4 hours of delivery, especially among anemic women. The uterus should be well contracted, and blood loss should be minimal. Sepsis, as indicated by fever, should be treated with antibiotics, but preventive measures include cleanliness and hygiene at delivery. Infections are more likely after cesarean section, prolonged labor, and early rupture of membranes. Handwashing prevents infection. Women should be encouraged to pass urine in the first 12 hours after delivery. Bathing frequently relieves painful episiotomy. 85% of neonatal deaths are due to preterm birth and low birth weight. Keeping the baby warm helps prevent low body temperature and infections. Parents need social support in adjusting to congenital defects. Infants with infections should be recognized on time, managed correctly, and referred to a district hospital. Breast feeding should start immediately or within the first hour of birth. Mothers need adequate rest and a nutritious diet. Breast tenderness is common during the first 4 days after delivery. Breast feeding on demand and proper hygiene helps to prevent infections and breast tenderness. Postpartum depression requires support from families and expert advice. Exclusive breast feeding inhibits ovulation until menstruation returns. Family planning may begin during lactation with a progestin-only pill, IUD, or diaphragm. HIV-positive mothers should discontinue breast feeding and take extreme care to mix formula with clean water. Mothers should be immunized with two doses of tetanus toxoid. Pregnant mothers need iodized oil and vitamin A supplements. Reproductive tract infections should be treated.
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