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The new Postnatal Notes for Baby
are to be used in conjunction with
Postnatal Notes for Mother. The dual
documents ensure support of the mother-baby
dyad whilst acknowledging that mother
and baby are individuals. At the
end of the period of midwifery care,
both booklets are returned to the
unit for filing.
Where the baby is with carers other
than the mother, the Postnatal Notes
for Baby booklet stays with the baby.
Where the baby is admitted for neonatal
intensive care or transitional care,
then the Postnatal Notes for Baby
booklet can be used in conjunction
with that documentation.
The new Postnatal Notes intend to
facilitate delivery of an improved
standard for postnatal care tailored
to the individual needs of the woman,
the baby and her family. They reflect
the NHS Agenda around public health
offering an equitable service which
is accessible, flexible, and culturally
sensitive. Evidence based information
is provided to enable mothers and
their families to make informed choices,
allowing them to engage in their
plan of care based on:
1. The Guideline for Routine Postnatal
Care which supports the need for
offering parents information and
guidance to enable them to assess
their baby’s condition, identify
warning signs if their baby is unwell
and how to contact a healthcare professional
or emergency services if required
[1, 2]. This requires:
- Effective transfer of information and communication at significant
times
- A reduction in conflicting advice [3]
- Increased awareness of risk [4, 5]
- A reduction of poor postnatal outcomes [2]
2. The Children’s NSF which promotes individualised, multi-disciplinary
management placing emphasis on
helping new parents prepare for parenthood [3]. This requires:
- Care that identifies and responds in a systematic way to babies’ health
needs based on best evidence
- Parent education specifically to equip families with parenting skills
- Robust feedback of neonatal screening results
- Enhanced and extended post birth care
- Improved access and flexibility for all
- Extended service provision with local options for care
The postnatal notes provide prompts
for identification of risk factors
to enable action to be taken, by
appropriate personnel, which can
be communicated effectively, supported
by efficient documentation of the
management process [1, 3, 4, 6].
The new Postnatal Notes
for Baby contain:
• Explanatory notes on ‘what
to expect’. Mothers want ‘information
that is up-to-date and evidence based,
answers common problems, discuss
options and offers practical advice’;
socially disadvantaged mothers want
at least as much information as other
groups [5].
• Prompts for midwives to discuss various public health issues which are
relevant during the postnatal period – e.g. general baby care, safety,
infant feeding, sudden infant death [1, 6, 7].
• Further prompts to discuss individual needs.
• Information on neonatal screening tests consistent with aims of the National
Child Health Screening Committee [8]; prompts to confirm that information has
been given to allow informed choice.
References
1. Guideline for Routine Postnatal
Care (NICE, June 2006)
2. Bick, Macarthur and Knowles et al. Postnatal Care. Evidence and Guidelines
for Management. 2002
3. National Service Framework for Children, Young People and Maternity
services. Standard 11, Maternity Services. www.dh.gov.uk/childrensnsf
4. Confidential Enquiry into Stillbirths and Death in Infancy – 8th
Annual Report
5. Singh D & Newburn M. 2000. Access to Maternity Information and
Support. Experiences and needs of women before and after giving birth.
National Childbirth Trust, London.
6. UNICEF UK Baby Friendly Initiative – www.babyfriendly.org.uk
7. Department of Health. Reduce the risk of cot death – www.dh.gov.uk
8. National Child Health Screening Committee - www.nsc.nhs.uk
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Page
1: Lists personal
details, mothers name
and contact number.
The first feed
summary is the
documentation of the
midwife’s assessment
of the feed prior to
leaving the mother and
baby after a home birth
or prior to transfer
home or to the postnatal
ward. There is space
to record details of
parent education relating
to baby care and contact
numbers for
carers if
the baby is not with
the mother.
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2: Baby
alerts are listed
and any which apply to
the baby are ringed. These
are then transferred to
the key to risk highlighting
the need for vigilance,
alerting carers to possible
need for further investigations,
treatment or referral.
Clinical findings from
the first baby
assessment are
completed after a home
birth or prior to early
transfer home or after
admission to the postnatal
ward. |
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Page
3: Management plan provides
space to document specific
care requirements, based
on the baby’s needs, also
identified by the mother’s
history, the baby alerts
and key to risk. Follow-on
sheets with a gummed strip
are available, to be attached
on top, so that the most
recent documentation is
always on display. |
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Pages
4: Baby
checks are outlined,
including some of the
more common postnatal
complications. This text
can be referred to as
and when necessary, so
that the mother has information
to keep after it has
been explained by the
health professional.
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Page
5: Provides
space to record clinical
findings from the assessments
of baby well-being.
Free text can also be
documented in the tables.
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Page
6: Baby
checks are outlined,
including some of the
more common postnatal
complications. This text
can be referred to as
and when necessary, so
that the mother has information
to keep after it has
been explained by the
health professional.
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Page
7: Provides
space to record clinical
findings from the assessments
of baby well-being.
Free text can also be
documented in the tables.
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Page
8: Provides
space to record clinical
findings from the assessments
of baby well-being.
Free text can also be
documented in the tables.
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Pages
8 & 9
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Page
9: Provides
space to record clinical
findings from the assessments
of baby well-being.
Free text can also be
documented in the tables.
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Page
10: Provides
space to record clinical
findings from the assessments
of baby well-being.
Free text can also be
documented in the tables.
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Pages
10 & 11
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Page
11: Provides
space to record clinical
findings from the assessments
of baby well-being.
Free text can also be
documented in the tables.
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Pages
12: Provides
space to record clinical
findings from the assessments
of baby well-being.
Free text can also be
documented in the tables.
Follow-on sheets with
a gummed strip are available,
to be attached on top
of this page, so that
the most recent documentation
is always on display.
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Page
13: Free
text pages for
all professionals providing
care to document chronologically
the care during the postnatal
period, over and above
the space on the assessment
of baby well-being pages.
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Page
14: Free text pages
for all professionals
providing care to document
chronologically the care
during the postnatal
period, over and above
the space on the assessment
of baby well-being pages.
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Pages
14 & 15
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Page
15: Free text pages
for all professionals
providing care to document
chronologically the care
during the postnatal
period, over and above
the space on the assessment
of baby well-being pages.
Follow-on sheets with
a gummed strip are available,
to be attached on top
of this page, so that
the most recent documentation
is always on display.
This page also has an
important Special
Features box
for key points relating
to risk factors. Detailed
action plans as a result
of problems can be recorded
on the management plan
(page 5).
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Page
16: Information
is provided on general
baby care, including
baby-led feeding, sleeping
positions, taking the
baby out and safety aspects
relating to the dangers
of sleeping with a baby.
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Page
17: Information
on breastfeeding,
based on the Baby Friendly
Initiative, includes
the benefits for mother
and baby, positioning
and attachment, milk
production and expressing.
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Page
18:
Outlines the general
principles of breastfeeding for
mothers and provides
a checklist for midwives
to document that all
information has been
given to promote successful
breastfeeding in line
with UNICEF recommendations.
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Pages
19: Outlines
the general principles
of bottle feeding for
mothers and provides
a checklist for midwives
to document that all
information has been
given to promote successful
bottle feeding in line
with DOH recommendations.
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Page
20: General
information provided
on important symptoms
of some of the more common
postnatal complications
for babies. These can
be referred to as and
when necessary, so that
the mother has access
to written information.
Details are also given
on the potential healthcare
professionals involved
in postnatal care. How
to register the
birth is explained,
with space provided to
document local registration
information.
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Page
21:
Gives information on neonatal
screening relating
to the physical examination
of the newborn, newborn
hearing screen, blood
spot test and early
immunisations.
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22: Where
the Personal Child Health
Record (Red Book) is used,
copies of page 3 and page
4 for the neonatal examination
of the newborn are filled
in and attached to page
22 using the gummed strip.
Where the red book is not
used, the findings are
recorded directly onto
page 22. |
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Page
23: Where the
Personal Child Health Record
(Red Book) is used, copies
of page 5 for baby discharge
summary, early immunisations,
and vitamin K, and copies
of page 6 for newborn hearing
screen are attached to
page 23 using the gummed
strip. Where the red book
is not used, the findings
are recorded directly onto
page 23. |
| Page 24: Important
symptoms and reducing
the risk of cot death are
highlighted with prompts
for how to access help
in an emergency. Space
is provided to record the signatures of
every professional who
writes in these notes. |
Page 24
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NOTE:
Frequent reference is made
to the web address, www.preg.info where mothers and professionals
are able to gather further
information. It also has
a link to the DOH website,
allowing mothers to view
the Birth to Five Book using
a search engine to access
individual topics. For professionals,
there are references and
links to evidence and guidelines
to support the statements
made in the Notes. |
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