How Much Eye Contact Is Normal For 6 Month Old Transitional Assessment – Periods of Reactivity For a Newborn

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Transitional Assessment – Periods of Reactivity For a Newborn

The newborn exhibits behavioral and physiological characteristics that may at first appear to be signs of stress. However, during the initial 24 hours, changes in heart rate, breathing, motor activity, color, mucus production, and bowel activity occur in an orderly and predictable sequence that is normal and indicates a lack of stress. Distressed babies also progress through these stages, but at a slower rate.

first period

For 6 to 8 hours after birth, the newborn is in the first period of reactivity. During the first 30 minutes the infant is very alert, cries vigorously, can suck his fist greedily and seems very interested in his surroundings. At this time, their eyes are usually open, suggesting that this is an excellent opportunity for mother, father and child to see each other. That’s why it has a strong sucking reflex, an opportune moment to start breastfeeding. Mother. This is especially important for clinicians to remember, as it is not unlikely that after these initially highly active states the baby may be quite sleepy and uninterested in nursing. Physiologically, the respiratory rate can reach 80 breaths/minute, wheezes can be heard, the heart rate can reach 180 beats/minute, bowel sounds are active, mucous secretions increase, and the temperature can decrease.

After this initial stage of alertness and activity, the baby’s responsiveness decreases. The heart and respiratory rate decrease, the temperature continues to drop, mucus production decreases, and urine or stool does not usually pass. The baby is in a state of sleep and relative calm. Any attempt to stimulate it usually elicits a minimal response. This second stage of the first reactive period has a general duration of 2 to 4 hours. Due to the continuous decrease in body temperature, it is best to avoid undressing and bathing the baby during this time.

Second period

The second period of reactivity begins when the baby wakes up from deep sleep after the first period. The baby is alert and responsive again, the heart and respiratory rates increase, the gag reflex is active, gastric and respiratory secretions increase, and meconium passage usually occurs. This second reactivity period lasts between 2 and 5 hours and provides another excellent opportunity for child and parent to interact. This period usually ends when the amount of respiratory mucus has decreased. After this stage there is a period of stabilization of physiological systems and a fluctuating pattern of sleep and activity.

After a discussion of the apparently erratic behavior patterns in the newborn, it is clear that in order to identify abnormalities or signs of distress in the respiratory, cardiovascular, or neurological system, the clinician must thoroughly understand the normal features. Observation, not machines, is the physician’s best assessment tool, and the nursing goal is anticipation and prevention of neonatal stress. The timing of nursing care is based on the observation of the physiological state of the newborn. For example, the baby should be dried immediately after birth to minimize evaporative heat loss; the initial bath should be postponed until the body temperature has stabilized; Eye drops should be instilled after the parent and child have established eye contact; and breastfeeding or bottle feeding must be initiated during one of the two reactivity periods.

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