Babies can "transition" in their mother's room, unless they are sick.
I've done the frequent checks on babies at Mom's breast, with just a
quiet "I need to peek at the baby now." You can see color, listen for
heart and breath sounds, check vital signs, and yes even see retractions
on a babe at breast. In an LDRP, the nurse is there with the Mom after
the birth for some time anyway. Why not do the baby checks right along
with the Mom's, and never separate them at all? Mom shouldn't have to
tell us the baby is grunting.
To get a little more specific about nursery levels, as stated, level one
is normal healthy newborns, Level 2 is for sick or premature babies,
adding services like umbilical lines, IV therapy and meds, O2 via hood,
CPAP, or short term vents. Level 3 is able to care for micropreemies,
critically ill infants, babies requiring surgery. Some people add a
level 4 to designate centers that do ECMO or use NO or do open heart
surgery.
Hope this helps.
Anne Stringer, RN
Michigan, USA
> Reason 1: Because of liability issues in the US, our hosp staff MUST
> record
> Vitals every 15 minutes for the first hour, then every 30 mins for the
> 2nd
> hour, every hour for the next 2 hours, & every 4 hours from then on. I'm
> told that retractions are best observed when baby is naked in the
> warmer or
> wearing a t-shirt, but not easily seen when baby is tucked in bed w/mom.
> I'm told that retractions rarely begin after 4 hours of age. Our hosp
> Admin
> is not willing to risk one baby with undetected retractions. Also, mom
> may
> not know what grunting is. I know I didn't when I first started working
> there. I commented in the nursery, solely in the spirit of conversation,
> about a baby who was "singing". It started an examination that sent the
> baby to NICU. If I had heard one of my babies do this, I don't think I
> would have considered it something to tell the nurse about.
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