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Ten steps to successful breastfeeding





baby-led feeding infant feeding initiated in response to demand from baby. Also applies to weaning, when solid foods are introduced, baby dictating what and when s/he wishes to eat.


baby massage touch and massage techniques for baby, performed by mother; enhances mother–baby relationship; contributes to improved physical and cognitive development, enhances immune system, reduces stress in babies born prematurely; relaxes mother.


Bach flower remedies complementary therapy similar to homeopathic principles, in which liquid plant remedies are used for emotional and psychological disorders. See also rescue remedy, homeopathy.


bacille Calmette–Guérin (BCG) vaccine for inoculation against tuberculosis, given during first week of life to infants of tuberculous mothers.


bacilluria presence of bacilli in urine.


bacillus rod-shaped organism, mostly Gram-negative except for Koch’s b. and Döderlein’s b., which are Grampositive (see gram stain). Pl. bacilli.


backache common pregnancy symptom, due to exaggerated lumbar lordosis from increased progesterone and relaxin levels, worsens as weight increases; often accompanied by sciatica and/or symphysis pubis discomfort. Postural correction, wearing lumbar support and/or physiotherapy, osteopathy or chiropractic may help.


bacteraemia bacteria in blood.


bacteraemic shock rare condition associated with septicaemia caused by Gram-negative organisms, especially Escherichia coli, Clostridium welchii, beta-haemolytic streptococci, which release endotoxins causing widespread dilatation of arterioles in liver, lungs, other organs; diminished venous return causes profound shock; signs similar to hypovolaemic shock but rigors also occur. Urgent antibiotic administration is required.


bacteria microscopic unicellular organisms, universally distributed. Beneficial to health when part of the normal flora, e.g. döderlein’s bacillus. Pathogenic bacteria cause disease by producing toxins, causing inflammation, formation of granulomas, or hypersensitivity reaction. Bacteria are Gram-positive or Gram-negative based on reaction to Gram stain. Aerobic bacteria require oxygen; anaerobes only grow in absence of oxygen; facultative anaerobes adapt to either environment. Some Gram-positive bacteria produce endotoxins, potent poisons causing hypotension, fever, disseminated intravascular coagulation, shock. Other toxins include haemolysins and leucocidins, which destroy red and white blood cells respectively; kinases, which lyse blood clots; enzymes, which attack tissue. Sing. bacterium.


bacterial pertaining to bacteria. B. vaginosis (BV) vaginal flora overgrowth, e.g. Gardnerella vaginalis, causing vaginal discharge with fishy odour; not sexually transmitted but may relate to increased sexual activity, stress, other infections, feminine hygiene products; occurs in 15–29% of pregnant women; linked to pelvic inflammatory disease, preterm labour, recurrent urinary tract infections, postpartum infection, uterine infection following termination, surgery or insertion of intrauterine contraceptive device; treated with antibiotics.


bacteriological examination microscopic examination of body fluids or tissues to identify bacteria.


bacteriology science of study of bacteria.


bacteriophage virus that infects bacteria.


bacteriostatic able to prevent multiplication of bacteria.


bacteriuria bacteria in urine, 105 organisms/mL is significant. Asymptomatic b. occurs in 5% of pregnant women; if untreated, can progress to pyelo nephritis.


bag of membranes amnion and chorion containing amniotic fluid and fetus; amniotic sac.


ballottement literally, bouncing. Tapping structure in fluid, e.g. fetus in amniotic sac, causes it to rebound against examining fingers. Internal b. elicited by inserting two fingers per vaginam at 16–18 weeks of pregnancy to tap fetus, causing it to float away and quickly return to examining fingers. External b. elicited during examination per abdomen when head not engaged; fetal head is tapped sharply on one side, floats away and returns against examining fingers.


Bandl’s ring extreme thickening of retraction ring of normal labour, occurring in obstructed labour; palpable as transverse ridge across abdomen; sign of imminent uterine rupture.


barbiturates large group of hypnotic drugs, derivatives of barbituric acid; dependence and tolerance occur readily.


Barlow’s test neonatal test to diagnose congenital dislocation of hip (CDH). Baby lies on back, feet pointing towards examiner, who grasps each leg with knees and hips flexed, places middle fingers of each hand over greater trochanters and thumbs on inner aspect of thighs. Thighs are abducted and middle finger of each hand pushes greater trochanter forward; if hip is dislocated, femoral head will ‘click’ as it enters acetabulum; femoral head can be displaced backwards out of acetabulum by exerting slight pressure when hips are flexed and adducted (Barlow’s sign). See also ortalani’s test.


Barr body small dark-staining body seen in nucleus of normal female cells, often obtained from smear of buccal cavity and examined microscopically.


barrier contraception mechanical barrier to prevent sperm from entering cervical canal, e.g. condom, diaphragm.


barrier nursing precautions taken by staff to prevent infection from one patient spreading to others or to staff; normally involves caring for patient in separate room or cubicle. Staff wear gowns, gloves, masks, overshoes when caring for patient. Reverse b. n. aims to protect patient from external infection, e.g. after organ transplantation.


bartholinitis inflammation of one or both bartholin’s glands, leading to abscess or cyst.


Bartholin’s glands two glands situated in labia majora, with ducts opening in vagina, just external to hymen; secrete lubrication for vulva.


basal body temperature temperature of body at rest.


basal metabolic rate (BMR) minimum heat produced by person at rest after fasting for 18 hours; test measuring amount of oxygen consumed, expressed as percentage above or below norm; in pregnancy BMR increases 30%.


base 1. lowest part, foundation. B. of fetal skull two temporal, one ethmoid, one sphenoid bone, part of occiput, fused together. 2. main ingredient of compound. 3. non-acid part of a salt; combines with acids to form salts, essential for maintaining normal acid–base balance; excess concentration leads to alkalosis and pH rises.


baseline measurement of clinical factors, used as basis for comparison B. variability on cardiotocograph, fluctuations in fetal heart rate of more than two cycles per minute, based on amplitude, i.e. peaks and troughs seen on printout. Persistently minimal or absent baseline variability is most significant sign of fetal compromise.


basic life support measures taken in event of cardiac arrest or other lifethreatening events; all midwives should be trained to provide Basic Life Support to internationally agreed standards or advanced life support in obstetrics. Principles of basic life support are A. airway; B. breathing; C. circulation. See appendix 2.


basophil leucocyte with affinity for basic dyes.


battledore placenta placenta with umbilical cord attached to margin. See also placenta.


Bell’s palsy facial paralysis due to oedema of facial nerve, may occur in pregnancy, usually temporary.


beneficence ethico-legal term dictating that healthcare practitioner should act in best interests of patient/ client.


benzodiazepines group of drugs with similar molecular structure, including sedative-hypnotics (anti-anxiety agents), e.g. diazepam, and anticonvulsants, e.g. clonazepam. Prolonged use may cause dependence.


bereavement loss through death, separation, adverse change in health, wealth, position (e.g. redundancy); produces psychological reaction with ‘stages’ of anger, denial, disbelief, acceptance.


beta- β, second letter of Greek alphabet; used to denote second position in classification system. B.-adrenergic receptors specific sites in cells that respond to epinephrine. B.-blockers (e.g. antihypertensives) drugs which block action of epinephrine at betaadrenergic receptors on cells of effector organs. Examples include propranolol, labetalol, which reduce heart rate and stroke volume. Adverse effects include reduced fetal growth if taken before 28 weeks’ gestation, neonatal hypoglycaemia, bradycardia if used in late pregnancy. Contraindicated in women with asthma as may cause bronchoconstriction. Excreted in breastmilk but considered safe during breastfeeding. B. haemolytic streptococcus See streptococcus. B. sympathomimetics tocolytic drugs, e.g. ritodrine, terbutaline, salbutamol; lowest possible dose should be given to avoid risk of serious maternal side effects, including palpitations, tremor, nausea, vomiting, headaches, chest pain, breathlessness, tachycardia. Pulmonary oedema is usually associated with fluid overload. Monitoring should include blood sugar levels as may increase and diabetic ketoacidosis can develop in diabetic mothers; serum potassium, urea, electrolytes. B. thalassaemia See thalassaemia.


betamethasone sodium phosphate synthetic glucosteroid, most active of anti-inflammatory steroids; may be given intramuscularly in two 12-mg doses 12 hours apart to women threatening preterm delivery to decrease risk of respiratory distress syndrome by stimulating rise in lecithin levels in fetal alveoli.


bi- prefix meaning ‘two’.


bicarbonate salt of carbonic acid (H2CO3) in which one hydrogen atom is replaced by base, e.g. sodium bicarbonate, NaHCO3, used to correct acidaemia.


bicornuate having two horns. B. uterus congenital malformation of uterine body is partially or completely divided vertically; normal pregnancy and labour are possible but associated with miscarriage, malpresentation, retained placenta.


bifid cleft into two parts or branches. In spina bifida, spinous processes of one or more vertebrae fail to unite, remain divided.


bifidus factor present in human milk; promotes growth of Gram-positive bacteria in gut flora, particularly Lactobacillus bifidus, preventing multiplication of pathogens.


bifurcation fork or separation into two branches; bifurcation of uterus leads to inability to carry pregnancy successfully to term.


bilateral pertaining to both sides.


bile dark-green substance secreted by liver cells, stored in gallbladder, passed into intestine, assists digestion by emulsifying fats, activating lipase; passes through bile ducts from liver and gallbladder to intestine. B. pigments bilirubin and biliverdin. Adj. biliary.


bilirubin yellow/orange bile pigment, results from haemoglobin breakdown; fat soluble, unconjugated until rendered water soluble, i.e. conjugated, by liver, when excreted as stercobilin in faeces. Interruption of process leads bilirubin to pass into skin and sclera, causing jaundice.


bilirubinometer instrument for measuring serum bilirubin concentration.


biliverdin green bile pigment, oxidised bilirubin.


Billings’ method contraceptive method involving recognition of changes in cervical mucus occurring 3–4 days before ovulation so that intercourse can be avoided around that time. Cervical mucus increases, becomes thinner around ovulation, to facilitate passage of spermatozoa through cervix.


bimanual using both hands. B. examination examination, usually of pelvic cavity; one hand is on abdomen and other has one finger in rectum or one or two fingers in vagina. B. compression of uterus manoeuvre to arrest severe postpartum haemorrhage after placental delivery when uterus is atonic. Right hand is introduced into vagina and pressed into anterior vaginal fornix. Left hand, on abdominal wall, pulls uterus forwards so that anterior and posterior walls are pressed firmly together, enabling direct pressure to be applied to placental site to stop bleeding.


image
Bimanual compression of uterus



binovular twin pregnancy (dizygotic, dichorionic, fraternal twins) pregnancy with two ova fertilised; two complete gestation sacs, each with fetus, placenta, chorion and amnion gender of the babies may be the same or different. About five times more common than uniovular twins.


bioavailability amount of drug which, after administration, reaches site of physiological activity.


biochemical screening tests for conditions or diseases through analysis of biochemical markers; in pregnancy, maternal serum screening for fetal Down syndrome or inherited metabolic disorders; newborn blood-spot screening test relies on biochemical markers to identify babies with conditions such as cystic fibrosis.


biochemistry chemistry of living matter.


biophysical profile assessment of fetal well-being, based on fetal adaptations to declining placental function in presence of fetal growth restriction or maternal disease; assesses fetal body or limb movements, tone, breathing movements, amniotic fluid volume and cardiotocograph and gives each a score of 0 or 1, with healthy fetus achieving score of 5.


biopsy removal of tissue from body for microscopic examination and diagnosis.


biorhythm cyclic biological event affecting daily life, e.g. menstrual cycle, sleep pattern.


biparietal diameter (BPD) measurement of distance between two parietal eminences of fetal skull. Assessed in pregnancy using ultrasound to confirm gestational age; accurate to within 1 week. When BPD has passed through maternal pelvic brim, head is engaged. crowning

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Jun 18, 2016 | Posted by in MIDWIFERY | Comments Off on B

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