Post-natal Plan for an Infant Suffering from a Respiratory Disorder
Respiratory disorders are common in newborns, especially those born preterm or with congenital heart defects. They can cause respiratory distress, which is characterized by tachypnea, grunting, retractions, nasal flaring, and cyanosis. Respiratory distress can lead to complications such as bronchopulmonary dysplasia, persistent pulmonary hypertension of the newborn, and death. Therefore, it is important to provide appropriate post-natal care for infants with respiratory disorders.
The post-natal care for infants with respiratory disorders should include the following components:
– A full clinical examination within the first hour of birth and before discharge, including assessment of vital signs, oxygen saturation, chest auscultation, and chest radiography.
– Monitoring of sedation and analgesia, especially if the infant is on mechanical ventilation or has a chest tube.
– Respiratory support tailored to the infant’s condition and gestational age, using noninvasive methods such as nasal cannula, oxygen hood, or nasal continuous positive airway pressure (nCPAP) whenever possible . Invasive methods such as intubation and mechanical ventilation should be used only when necessary and with minimal settings to avoid lung injury. Surfactant therapy may be indicated for infants with respiratory distress syndrome.
– Management of respiratory disorders according to the underlying cause and severity, such as antibiotics for pneumonia or sepsis, inhaled bronchodilators for wheezing or stridor, diuretics for pulmonary edema, or nitric oxide for persistent pulmonary hypertension of the newborn .
– Screening for critical congenital heart defects using pulse oximetry after 24 hours of birth but before hospital discharge. Infants with suspected or confirmed congenital heart defects should be referred to a specialist neonatal cardiac center for further evaluation and treatment.
– Involving, supporting, and informing parents and carers about the infant’s condition, prognosis, treatment options, and potential complications. Parents and carers should be encouraged to participate in the infant’s care, such as kangaroo mother care, breastfeeding, or skin-to-skin contact.
– Discharge planning that includes education on home care, follow-up appointments, warning signs of deterioration, and emergency contacts. Infants with respiratory disorders may require oxygen therapy, medications, or special equipment at home. They should also receive regular developmental assessments and immunizations.
: Postnatal Care for Mothers and Newborns. World Health Organization (WHO). 2015. https://www.who.int/docs/default-source/mca-documents/nbh/brief-postnatal-care-for-mothers-and-newborns-highlights-from-the-who-2013-guidelines.pdf
: Hermansen CL, Mahajan A. Newborn Respiratory Distress. Am Fam Physician. 2015;92(11):994-1002. https://www.aafp.org/pubs/afp/issues/2015/1201/p994.html
: Specialist neonatal respiratory care for babies born preterm. NICE. 2019. https://www.nice.org.uk/guidance/NG124
: Care plan: Dyspnea or Respiratory Distress (Pediatric ED). Elsevier. https://elsevier.health/en-US/preview/dyspnea-respiratory-distress-peds-cpg
: Respiratory Care for Neonates With Congenital Heart Disease. AAP. 2022. https://publications.aap.org/pediatrics/article/150/Supplement%202/e2022056415H/189881/Respiratory-Care-for-Neonates-With-Congenital