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Feeding newborn babies at risk

By etavares On 30 November, 2010 Open Space | 2010 Comments Off on Feeding newborn babies at risk No tags

One of the first questions Prof. Gomes-Pedro asked me was: “What does a Speech Therapist do with a newborn baby? Do you play with the baby? Talk to the baby? My answer was: “I help newly born babies with feeding difficulties”. Thanks to assistance and knowledge passed on by Prof. Gomes-Pedro, I later realised that we were talking about one of the first touchpoints in the life of a baby, and that this stage offers an excellent opportunity to develop communication.

In the Paediatric Unit, this is how my work as a Speech Therapist with newborn babies at risk and their parents starts. At that point, I attend one of Prof. Gomes-Pedro’s classes and observe how he establishes with mastery a relationship based on trust with those parents and baby. He starts by asking them “What is the name of your baby?” Parents reply: “This is Tomás”. Further on, with a large smile, he asks them: “would you like to embark on a journey of discovery of Tomas?” It is in this sensitive and affective way, as exemplified by Prof. Gomes-Pedro, that I became directly more involved with the touchpoints methodology, which I want to discover and know more about.

I then pose the question to myself: what is this thing of helping to feed a newborn baby at risk? What are we talking about and what does it mean for the lives of these parents and babies? At what point in life does “bath water”, which Prof. Gomes-Pedro talks about in such an engrossing and passionate way, enter the feeding process?

I do realise that feeding their babies is a “sacred mission” for all parents. Accordingly, parents have doubts and ask: Will my baby have enough strength to be able breastfeed? Won’t he become tired? Should we insist? When should we stop? Is it safe?

It is important that parents know and learn to carefully observe the feeding of their child. A more fragile baby needs time to get himself organized, and never feels totally prepared when he is given the bottle or the breast. The baby needs to have a taste of the milk on his lips, so that he can look for and taste the food that is on its way.

For this reason, it is important to help him suck, swallow, and breathe, so that he can demonstrate signs of pleasure and comfort while feeding. The whole process takes time and it is necessary to learn how to recognise the signs the baby gives us, to ensure that feeding is done safely. Accordingly, it is important that parents meet a professional, a specialist in feeding who can help them in this task, enabling weight gain, the development of sucking ability, and release from hospital.

Prof. Gomes-Pedro also told me: “As a speech therapist, the most important in a special newly born unit, is to be able to transmit passion, wherever it may be found, to parents and professionals! Only then can we establish a relationship based on trust, believing that the true feeding specialists are the parents, and that our role is to help them understand their strengths and discover the baby as a human being.” I then start looking at the baby as a unique and individual human being, with his own will and preferences.

And from now on, how to establish this communication passion that Prof. Gomes-Pedro refers to? I observe him in his classes, once more, and I begin to discover what babies’ own language means, and what sharing behaviours and feelings about babies implies. At this point, the alliance and partnership with parents is established.

Another frequent question parents ask me is: Will our baby ever succeed to breastfeed? He looses interest, becomes very tired, the bottle is easier…what we want is for the baby to put on weight so that we can take him home…but I would like so much to be able to breastfeed him.”

Breastfeeding a baby can be a major challenge for parents, and is not an easy task. However, at the end of the day, it can be very rewarding both for the mother and the baby. When the mother puts the baby to her breast for the first time, he starts to smell, feel the temperature and the heart beat of the mother. It is an environment he is familiar with, and, at this point, feeling confident, he licks and looks for the source of food. Bonding thus begins, the mother learns how to touch and hold the baby, to rock him, talk to him and be in harmony with the baby. This is a very special occasion in terms of communication, interaction, knowledge of each other’s rhythms, and mutual adaptation. Often, these babies are still learning how to coordinate sucking with swallowing and breathing. However, the most important point is to create several opportunities, give the baby and the mother enough time. Breastfeeding enables the baby’s growth and development, preparing him to later eat with a spoon, chew and, at a later stage, talk.

In order to be able to know the baby’s rhythm and suction pattern, first one needs to know who is this baby and his parents, Therefore, following an invitation of Prof. Gomes-Pedro, I ventured into the Neonatal Behavioral Assessment Scale (NBAS) to better understand babies, their answers, their timings and personalities. I am thankful to Prof. Gomes-Pedro for showing me, in a true and passionate way, how the touchpoints methodology is vital for our work with parents and children. This methodology has become a core part of my personal and professional approach.

Joana de Sousa Rombert
Child and Health Department of Santa Maria Hospital
Developmental Unit
joanarombert@gmail.com

 

Bibliography:

1. Brazelton TB, Sparrow J. A criança e a alimentação. Lisbon: Editorial Presença 2004
2. Fucile S, Gisel EG, Lau C. Effect of an oral stimulation program on sucking skill maturation of preterm infants. Dev Med Child Neurol 2005; 47:158-162.
3. Lester, B, Sparrow J. Nurturing Children and Families: Building on the legacy of T. Berry Brazelton. New Jersey: John Wiley & Sons 2010
4. Nugent JK, Petrauskas B, Brazelton TB. The Newborn as a Person: Enabling Healthy Infant Development Worldwide. New Jersey: John Wiley & Sons 2009

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Index - News # 17 | out/nov. 2010
 Editorial Note
 Hospital for Small Children
 Recorded interview with Professor Gomes-Pedro
 Interview Professor Paulo Ramalho 
 T. Berry Brazelton, MD – João Carlos Gomes Pedro Homage
 Cultural Soirée of the 100th anniversary of FMUL
 Last Lecture by Professor João Carlos Gomes-Pedro
 Opening of the 2010/2011 Academic Year Ceremony – University of Lisbon
 Medicine Evening 2010
 Medical Students Street Party
 Facilities, Equipments, and Information Technologies Unit
 Invitation to Participate in the 13th “Education for Science” Workshop
 Publications FMUL/HSM/IMM
 Lecturers’ Participation in Academic Examination Panels in other institutions(by 31 October 2010)
 FMUL students awarded prizes at the 5th YES Meeting
 IMM Seminars
 An ongoing PhD thesis in Pediatric Research: Interventions and Outcomes in Clinical Trials of Bronchiolitis
 Words to Professor J. Gomes-Pedro
 Bags and Rucksacks: “weights” today and “burdens” tomorrow (PART I)
 Feeding newborn babies at risk
 Valuing Differences
 Sexual education in schools
 Health at Schools Programme
 Cardio-pneumologists at the Paediatric Laboratory For Respiratory Function Studies
 Neonatology, The perspective of a neonatologist at Santa Maria Hospital 
 Introduction to Medicine – Subject Development and Episodes in the Life of a Member of Staff
 Paediatric Origins of Chronic Pulmonary Disease in Adults
 Breastfeeding the Turning Point in 2010
 The importance of a multidisciplinary team in child development
 Science and Health Research 
 Hospital Indicators of the Pediatric University Unity
 Social Values Stock Exchange: “Is Laughing the Best Therapy?” Project
 Swine Flu (H1N1) Pandemics in Portugal (1918-2009): echoes and schisms of the past in the present
 Course “ABC of Clinical Genetics” 2010
 14th Annual Meeting of the Portuguese Society of Human Genetics – 18-20 November 2010
 Workshop “Looking for the Clown Inside You” – 20 November
 Food Bank Against Hunger – 27 and 28 November
 Caminho Book Market – From 29 of November to 17 of December
 ENJOY Med’10 – Deadline for submitting abstracts: 30 November
 Grande Prémio Fundação AstraZeneca 2010
 Obituary
My Company

100 AnosPropriedade e Edição: Faculdade de Medicina da Universidade de Lisboa NIPC: 502662875  Periodicidade: Mensal  Diretor: Prof. Doutor Fausto J. Pinto Conselho Editorial: Prof. Doutor Fausto J. Pinto, Profª. Doutora Ana Sebastião, Prof. Doutor Mamede de Carvalho, Prof. Doutor António Vaz Carneiro, Prof. Doutor Miguel Castanho, Dr. Luís Pereira  Equipa Editorial:  Ana Raquel Moreira, Cristina Bastos, Isabel Varela, Joana Sousa, Maria de Lurdes Barata, Rui Gomes, Sónia Teixeira  Colaboração:  Gabinete de Relações Públicas, Internacionais e Comunicação  Versão Inglesa: AP|PORTUGAL- Language Services  Conceção: Metatexto, Lda. e-mail: news@medicina.ulisboa.pt  Sede do Editor e Sede da Redação: Avenida Prof. Egas Moniz, 1649-028 Lisboa Estatuto Editorial Anotado na ERC 

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