Title: " Medical - Psychological work with mothers in the neonatal department"

Professor: Adik Levin (Estonia)

Principles of working with mothers:

Nowadays there are existing two basic principles of working with mothers in neonatal units all around the world.

At first:

! Mothers are not hospitalised to the special care units with their sick babies, but are discharged from maternity hospitals directly to their homes.

! Mothers are allowed to be with their babies at day-time feedings, but at night they are in the special hotel rooms of the hospital.

! After spending the day with their infants mothers leave the hospital for the night. We consider this method to be harmful for children because they can catch various virus infections and it makes other difficulties for staff work.

! A week before the infant is discharged, mother and child are took up to separate room to faster mother’s adaptation to the child.

! Mothers and other family members may come to see the child at the hospital whenever is suitable for them in most neonatal units in Western countries.

!The common feature of all these methods is that the child is in contact with a continously changing medical and nursing staff.

Second:

Preterm and high-risk full-term newborns are with their mothers 24 hours every day, so long as the child is staying in the hospital. That kind of method is minimising the child’s contacts with continously changing medical and nursing staff. For the baby there are created conditions which are similar to the conditions at home.

The contact between a sick baby and a mother is a basic principle of humanistic neonatal medicine.

Mother’s personality reactions during the stress:

! To deny the baby’s bad condition as a reaction of defence.

! Unreliability to the doctor and searching different kind of indirect methods of treatment.

! Aggression (offence) against the medical and nursing staff.

! To carry aggression on the other objects (dissatisfaction with a ward, neighbours etc)

! Passive conciliation (occures often with women who have delivered the preterm child).

Doctors visits à mothers participation

mothers Groups:

- young mothers;

- "old" mothers;

- mothers who have delivered their first baby;

- mothers with several children;

- mothers who have delivered preterm baby;

- "new......................." (Russians, Estonians); national peculiarities of mothers

medical-psychological WORK in breastfeeding

Psychocorrectional work:

- individual work with mothers (nurse, doctor, psychologist, therapeutist, gynaecologist);

- groupwork (mothers’ school);

important:

Condemnation and discussing of action not a person.

- individual work with fathers;

- groupwork with fathers;

50 : 50

person No. 1

person No. 2

person No. 3

The basis of medical-psychological work is:

At first:

! Taking necessary action to improve preterm and sick newborns health.

This trend is working not only against the disease but at the same time optimising the psychosomatic potential of individual.

Second:

! Family’s adaptation with baby’s disorders has an strict influence to the psycho- somatic health of every member of a family i.e. to their personal life and to their working- and social potential.

Third:

! Interadaptation of family and child especially in early stages of child’s developing creates a basis of the later growing-up process - forming out of personality and also health. [ for example: not contacting child]

The working methods with mothers and family:

! individual

! groupwork (mother’s schools, father’s schools etc.)

Team consists of:

- doctors + nurses;

- psychologists ;

Reception of mother and child in neonatal care unit:

- from III level intensive care unit;

- from maternity house (co-operation with maternity houses);

- from home;

important:

! First hours in the unit.

! Visual lessons (stands, photos etc.).

! Mother’s contact with other mothers present in the unit.

! Mother’s contact with doctor.

Formation of mother feeling.

A quality new social status of woman (new features of personality of woman-mother). psychological umbilical cord - closed psychosomatic system.

abjected children!

Sanitary explanatory work???

Sanitary educational work !