Prolonged jaundice in neonates
Dr Siba Prosad Paul, is specialty trainee year 5 in paediatrics, Great Western Hospital, Swindon and Honorary Paediatric Registrar, St Richard’s Hospital, Chichester;
Professor Valerie Hall, Professor of Midwifery, University of Brighton;
Dr Timothy Mackford Taylor is Consultant Paediatrician at St Richard’s Hospital, Chichester(June 2016)
Jaundice is common in neonates and is often the reason for a parent to consult a community midwife or health visitor. It is known that up to 40 per cent of breastfed infants are jaundiced at 14 days of age and a proportion of these infants are referred to paediatric services for assessment and blood investigations. Most often the investigations reveal a high bilirubin level but otherwise normal liver function results, leading to a diagnosis of breastfeeding jaundice, with no treatment required other than reassurance to the parents and monitoring. A recent clinical audit is presented which evaluates current clinical practice and the results reflect breast feeding as the main reason for prolonged jaundice. This is followed by some guidance for the community health practitioners with the aim of reducing referral of otherwise well neonates with jaundice and reducing invasive investigations.
Contraception: a guide for midwives
Sarah Snow, Programme leader and lead midwife for education at the University of Worcester
Women will generally spend more of their reproductive lifetime preventing pregnancy than experiencing it. The choice of contraceptive methods can be confusing for women, each one having its own set of advantages and disadvantages. For new mothers, a method of contraception is important if a reasonable gap between pregnancies is the desired outcome. Given that ovulation can resume four weeks following childbirth, midwives have a clear role in the provision of up to date contraceptive health advice to women, including the availability of emergency contraception. Midwives, especially those working in the community, also need to be familiar with the range of contraceptive health clinics in their locality, together with a working knowledge of the various services offered by them.