Maternal and infant care basics

A.Y. 2019/2020
7
Max ECTS
105
Overall hours
SSD
MED/38 MED/40 MED/45 MED/47 MED/49
Language
Italian
Learning objectives
- To know the main issues related to the state of health and illness in the obstetric field;
- To know the physiology of fetal development;
- To know the factors that can damage the embryo and the fetus during intrauterine life and birth;
- To acquire an adequate knowledge of the main preventive methods in the developmental age;
- To acquire the knowledge related to the mechanisms that regulate adaptation to extrauterine life;
- To acquire an adequate knowledge of the physical and functional characteristics of the healthy newborn;
- To acquire the knowledge of the basics of growth and psychomotor development that characterize the different pediatric ages;
- To acquire the knowledge of the nutritional principles to be applied in different care settings across the pediatric age range;
- Evaluate the nursing care needs of children in different age groups, from a biophysiological, psychological and socio-cultural point of view, related to health status;
- Study methods of data collection, observation, interview, direct physical survey and planning methods according to criteria of priority and continuous evaluation of the interventions carried out and the results obtained in relation to the satisfaction of pediatric nursing care needs ;
- Evaluate evidence-based studies of nursing interventions aimed at complying with the needs of pediatric nursing care;
- To apply data collection methods for the identification of pediatric nursing care needs. Planning and documentation of nursing care needs, according to the theoretical reference model (Professional Laboratory 1);
- To apply the procedures aimed at complying with the needs of nursing care, according to planned interventions and actions based on scientific evidence (Professional Laboratory 1).
Expected learning outcomes
Knowledge and understanding
- general and clinical nursing issues for the understanding of pediatric nursing's fields of intervention, clinical method leading to effective clinical approach intervention techniques and evidence supporting the decision making and the delivery of the pediatric nursing care;
Ability to apply knowledge and understanding
- integrate the knowledge and skills stemming from the nursing discipline, from biomedical, socio-cultural and humanistic features to recognize the care needs of the newborn and the family and provide appropriate, effective and evidence-based pediatric nursing care;
- apply the nursing care on the basis of the reference disciplinary theoretical models to assess and diagnose health status and care needs in their physical, psychological and socio-cultural dimensions, plan goals, implement and evaluate the care provided and outcomes achieved;
- conduct a complete and systematic evaluation of data relating to the care needs of the newborn to facilitate growth, development and adaptation in health promotion, maintenance and recovery;
- analyze and accurately interpret the data collected through clinical reasoning;
- interpret and apply the results of research to nursing practice and link research paths to the theoretical development of the nursing discipline;
- provide nursing care in different care settings, both in- and out- of-hospital settings
Course syllabus and organization

Unique edition

Responsible
Prerequisites for admission
This is a first year exam, first semester, so there are no specific prerequisites different from those required for access to the degree course.
Assessement methods and criteria
Performance of the exam: written and oral exam
The written exam consisting of a test with different types of questions: true-false, completion, correspondence, multiple choice with one or two correct answers, is considered passed if all the modules are sufficient.
In the oral test the main criteria to be considered in the assessment of the response are the clarity of the exposition, the completeness and correctness of the contents, the ability to link the knowledge
Pediatria generale e specialistica
Course syllabus
Epidemiological aspects related to neonatal and pediatric age
Levels of pediatric and neonatal care
Fetal life as a preparation for birth
Adaptation to extrauterine life also in relation to the mode of birth
Delivery room management of the healthy newborn. Monitoring of vital signs.
Temperature control
Classification of the newborn
Ward management and physical examination of the newborn
Neonatal jaundice
Neonatal screening
Discharge and follow-up of the term newborn
Growth and body development
Periodic health examinations of the term newborn
Vaccinations

Theme area 1 Describe how human lactation and breastfeeding works
2. Describe the risks of non-breastfeeding and the importance of breast milk and breastfeeding for the health and well-being of mothers and children.
a. Recommendations regarding: exclusive breastfeeding, complementary nutrition and breastfeeding beyond the first year of life.
Theme area 2
Support mothers in starting and continuing breastfeeding
3. Describe the principles of breastfeeding on demand and explain its importance in relation to the recognition of hunger signs, the need for comfort and the maintenance of lactation.
a. Support for mothers and children in the initial phase of breastfeeding and understanding of mother's and baby's innate reflexes
b. Support mothers and babies to continue breastfeeding for as long as they wish.
c. Importance of the introduction of complementary nutrition at appropriate times and the simultaneous continuation of breastfeeding up to two years of life and beyond.
Teaching methods
The course includes frontal lessons and interactive sessions
Bibliography
Principi di neonatologia per il pediatra. Puericultura e pediatria neonatale di: Vittorio Maglietta - Vico Vecchi - Ed. CEA 2001
La condizione dell'infanzia nel mondo 2012 United Nations Children's Fund (UNICEF) Febbraio 2012 consultabile anche on line www.unicef.it/pubblicazioni
Il libro bianco: la salute dei bambini: stato di salute e qualità dell'assistenza della popolazione in età pediatrica nelle regioni italiane. Maria Avolio, Walter Ricciardi Edito da Società Italiana di Pediatria 2011
Il Percorso Nascita di F. Moccia Osservatorio Civico sul Federalismo in Sanità - Rapporto 2011
Roberton's Textbook of neonatology Edited by Janet M Rennie - Fourth edition 2005
G.V. Zuccotti - Manuale di pediatria. La Pratica Clinica . Ed. Esculapio Medicina II ed. 2016
Ginecologia e ostetricia
Course syllabus
erinatal asphyxia:
- Causes of fetal asphyxia
- Terminology
- Parameters for the definition of asphyxia
- Normal blood gas values on the umbilical cord
- Acidemia and asphyxia
- Acidemia and postpartum
- Brain damage: recognized forms and causes
- Cerebral palsy and fetal / perinatal asphyxia
- Neurological deficit and intra-partum asphyxia
- Methods for controlling fetal well-being
- Fetal extraction interventions: the problem of the times
- Prevention of brain damage
- Prevention of intra-partum brain damage
- Error prevention
Preterm birth:
- Definition
- Incidence
- Risk factors
- multiple gestation
- Perinatal death
- Survival according to gestational age
- Acute morbidity according to gestational age
- Chronic morbidity according to gestational age
- Neurological damage in the preterm born
- Premature rupture of the membranes
Hypertension in pregnancy
- Classification
- Clinical meaning
- Risk factors
- Incidence of hypertension in pregnancy
- Etiopathogenesis
- Immunological factors
- Placental factors
- Endothelial dysfunction
- Fetal compartment
- Management: general considerations, goals of gestation, clinical, preeclampsia
Teaching methods
The course includes frontal lessons and interactive sessions
Bibliography
Bolis G. (2011) Manuale di Ginecologia e Ostetricia. EDISES
Scienze infermieristiche generali cliniche e pediatriche
Course syllabus
Nursing care for the healthy newborn after childbirth
- Skin-to-skin procedure
The first day of life: looking after transition period.

Standard plan of this phase: needings of nursing care in the newborn in the period of adaptation to extrauterine life (safe environment, breathing, maintaining cardiocirculatory function)

Needings of nursing care of physiological newborn:
Need to breathe
Data collection
Nursing intervention to guarantee breathing
Need to maintain cardio-circulatory function
Data collection
Nursing interventions to guarantee cardio-circulatory function
Nursing interventions to guarantee assistance in no complex clinical situations:
- Hypothermia and hyperthermia and possible causes
Need to urine and defecation
Data collection
Nursing interventions to guarantee assistance in no complex clinical situations:
- Gaseous colic: general concepts of prevention and nursing interventions
Need of hygiene
Data collection
Nursing interventions to guarantee assistance in no complex clinical situations:
- Hygiene in the physiological newborn, care of the umbilical stump and clothing

Need to have a safe environment
Data collection
Nursing interventions to guarantee assistance in no complex clinical situations:
(newborn identity, noise, microclimate, falls, nosocomial infections, transport)
Ensure the safety of the newborn at home in the first month of life; educational role of the nurse - SIDS prevention
Need of moving
Data collection
Nursing interventions to guarantee assistance in no complex clinical situations:
Postures ( Kangaroo, nest), handling and holdling
Need to rest and sleep
Data collection
Nursing interventions to guarantee assistance in no complex clinical situations:
- Sleep-waking rhythm of the newborn
- Role of the nurse in respecting the sleep-waking rhythm of the newborn
Need of nutrition and hydration
Data collection
Nursing interventions to guarantee assistance in no complex clinical situations:
- Collection of anthropometric parameters
- Notes on breastfeeding and formulafeeding
- Nursing care in the event of pathological weight loss, regurgitation
Need for communication
Data collection
Nursing interventions to guarantee assistance in no complex clinical situations
(crying, infant massage)
Nursing care for family education in ensuring the satisfaction of the needs of the newborn
Need to perform therapeutic procedures
Nursing assistance to the newborn treated with phototherapy
Theme Area 1 Describe how human lactation and breastfeeding works
2. Describe the risks of non-breastfeeding and the importance of breast milk and breastfeeding for the health and well-being of mothers and children.
b. Applying theory to practice
Theme Area 2Support mothers in starting and continuing breastfeeding
2. Describe the importance for mothers to keep close their children, to respond to their signs.
a. Skin to skin for all mothers (irrespective of feeding type) including Kangaroo Mother Care.
b. How to facilitate this good practice for a good start of mother-child relationship and an adeguate start to breastfeeding.
3. Describe the principles of breastfeeding on demand and explain its importance in relation to the recognition of hunger signs, the need for comfort and the maintenance of lactation.
a. Responsive breastfeeding and how mothers and babies develop a reciprocal relationship when they remain close.
b. Principles and mechanisms of attachment, positioning and breast sucking, promoting and facilitating the expression of child innate skills.
c. Signs of effective feeding.
d. Milk production and transfer assessment's.
e. Support for mothers and children in the initial phase of breastfeeding and understanding of mother's and baby's innate reflexes.
4. Be able to apply their knowledge and understanding of the physiology of lactation to support women to get breastfeeding off to a good start
5. Support mothers and babies to continue breastfeeding for as long as they wish
a. Supporting breastfeeding mothers to maximise the amount of breastmilk their baby receives in case of complementary supply.
Teaching methods
The course includes frontal lessons and interactive sessions, Video clips
Bibliography
Badon Pierluigi - Cesaro Simone Assistenza Infermieristica in Pediatria , ed. CEA 2015
Badon Pierluigi - Zampieron Alessandra Procedure infermieristiche pediatriche , ed. CEA 2010
Roberton's Textbook of neonatology Edited by Janet M Rennie - Fourth edition 2005
Marisa Cantarelli Il modello delle prestazioni infermieristiche Masson 2018
Gruppo di lavoro della Società Italiana di Medicina perinatale - Early-life Nutrition: l'importanza di una corretta nutrizione dal concepimento al bambino - prima edizione 2015
OMS - UNICEF Strategia globale per l'alimentazione dei neonati e dei bambini - 2005

Badon Pierluigi - Cesaro Simone Assistenza Infermieristica in Pediatria , ed. CEA 2015
Badon Pierluigi - Zampieron Alessandra Procedure infermieristiche pediatriche , ed. CEA 2010
Laboratorio professionale 1
Course syllabus
- RESPIRATORY RATE
- PULSE OXIMETRY
- HEART RATE
- BLOOD PRESSURE
- BODY TEMPERATURE
- ANTHROPOMETRIC MEASUREMENTS (weight, length, head circumference)
- HAND EXPRESSION BREAST MILK
- BREASTFEEDING
- MANUAL AND / OR ELECTRIC BREAST PUMP USE
- FORMULA FEEDING
- DEVICES USE / ALTERNATIVE FEEDING METHOD THAT ALLOWS TO RECEIVE BREAST MILK
- UMBILICAL CORD CARE
- CAPILLARY PUNCTURE
- URINE TEST
- URINE CULTURE (sterile urine box, sterile adhesive bag suit, urinary catheter)
- COLLECTING AND STORING STOOL SAMPLES
- ENEMA
- COMPLETE AND PARTIAL BED BATH
- SOCIAL HAND WASHING / ANTISEPTIC HAND WASHING
- USE OF PERSONAL PROTECTIVE EQUIPMENT
- NASAL IRRIGATION
- COLTURAL SWABS (pharyngeal, rectal, auricular, ocular)
- TO CHANGE SHEETS IN AN OCCUPIED BED
- TRANSFERRING A CHILD / TEENAGER FROM BED TO WHEELCHAIR AND FROM WHEELCHAIR TO BED

Training about care planning related to course year

Theme Area 3 Manage the challenges that may arise during breastfeeding
1. Describe particularly situations which have impact on breastfeeding and on lactation and support mothers to overcome these difficulties.
a. Manage common breastfeeding challenges for both mother and baby: sore nipples, engorgement, mastitis,thrush, insufficient milk supply
b. Be able to apply their knowledge of the physiology of lactation and infant feeding to support effective management of challenges which may arise at any time during breastfeeding
c. Expression of breastmilk to include hand and pump expression technique.
Teaching methods
The course includes frontal lessons and interactive sessions
Bibliography
Badon Pierluigi - Cesaro Simone Assistenza Infermieristica in Pediatria , ed. CEA 2015
Badon Pierluigi - Zampieron Alessandra Procedure infermieristiche pediatriche , ed. CEA 2010
Scienze infermieristiche ostetrico-ginecologiche
Course syllabus
The Program introduces to:
1. fertilization and physiological pregnancy
2. the birth process
3. the physiological newborn immediately after birth and assistance from the midwife
4. the dystocic delivery practiced by the gynecologist
5. the mother's health. In particular, introduction to puerperium breast changes. Assistance for nipple trauma, breast engorgement, mastitis, others breast infections.
6. methods to induce lactation
7. additional power supply;
8. drugs during labor, childbirth, puerperium and breastfeeding
9. feeding during pregnancy and puerperium
10. health education processes for women, children and adolescents
11. process "Baby Friendly Hospital Initiative (BFHI)" and "Mother-friendly care"

Theme Area 2 Support mothers in starting and continuing breastfeeding
Describe potential impact that some practices carried out during labor and delivery can have on well-being of mother and child and particularly on starting breastfeeding.
a. Mother's friendly care during labor and delivery.
b. Describe overview of infant feeding culture, including influencing factors women's decisions about food choices for their children.
c. Breastfeeding overview and what has influenced changing breastfeeding rates in Italy and worldwide.
d. Knowledge of health diet principles for pregnant and breastfeeding women.
Teaching methods
The course includes frontal lessons and interactive sessions
Bibliography
Agenzia Italiana del Farmaco (2017) - Via del Tritone, 181 - 00187 Roma - tel. 06 5978401
http://www.farmaciegravidanza.gov.it/
Artico M., Castano P. (2005) Anatomia umana - Principi. Ermes
Bettinelli M.E., Giusti A.(2011-2012) Allattamento al seno tra arte scienza e natura.Dossier
http://www.fofi.it/ordinebs/allegati_professione/documento3977307.pdf
Bolis G. (2011) Manuale di Ginecologia e Ostetricia. EDISES
Candiani G.B., Danesino Gastaldi. (1996) La clinica ostetrica e ginecologica 2/ed. ELSEVIER Masson Italia
Costantini W., Calistri D. (2013) Ostetrica PICCIN EDITORE
De Felici M., Boitani C., Bouchè M., Canipari R., Dolfi A., Filippini A. (2009) Embriologia Umana - Morfogenesi -
Processi Molecolari - Aspetti Clinici. PICCIN EDITORE
Mauri P.A., (2017) Appunti prodotti per lezioni al CLIP. Stampa di digitale
Ministero della Salute (2015) Relazione del ministro della salute sulla attuazione della legge contenente norme per la
tutela sociale della maternità e per l'interruzione volontaria di gravidanza (legge 194/78) (dati preliminari 2014 - dati
definitivi 2013) http://www.salute.gov.it/imgs/C_17_pubblicazioni_2428_allegato.pdf
Peyron L., (1995) Pediatria pratica Minerva Medica
Pescetto G., De Cecco G., Pecorari D., Ragni N. (2009) Ginecologia e Ostetricia Voll. 1/2 4/ed. SEU SocietEditrice
Universo
Unicef (2015) Insieme per l'allattamento Ospedali&Comunità Amici dei Bambini uniti per la protezione, promozione e
sostegno dell'allattamento materno Standard per le Buone Pratiche per gli Ospedali
https://www.unicef.it/Allegati/Standard_BFHI_2015_1.pdf
Scienze tecniche dietetiche applicate alla professione
Course syllabus
Aspects of Nutritional physiology
Proteins, Carbohydrates and Lipids: digestion, absorption and metabolism
Micronutrients: trace elements and vitamins
Energy requirements
Growth and body composition
Healthy child feeding: from birth to adolescence
Artificial nutrition
1. Parenteral nutrition
2. Enteral nutrition
Practical aspects
1. Food storage
2. Drug and nutrient interaction

Theme area 1
Describe how human lactation and breastfeeding works 1. Describe anatomy of the breast and physiology of lactation and support mothers in starting and continuing breastfeeding.
c. Constituents of colostrum and breastmilk (protective and developmental).
d. Constituent differences between human milk and infant formula.
Teaching methods
The course includes frontal lessons and interactive sessions
Bibliography
V. Zuccotti - Manuale di pediatria. La Pratica Clinica . Ed. Esculapio Medicina II 2016
Ginecologia e ostetricia
MED/40 - OBSTETRICS AND GYNAECOLOGY - University credits: 1
Lessons: 15 hours
Professor: Bianchi Stefano
Laboratorio professionale 1
MED/45 - NURSING - University credits: 1
Lessons: 15 hours
Professor: Rampini Serena
Pediatria generale e specialistica
MED/38 - PAEDIATRICS - University credits: 1
Lessons: 15 hours
Scienze infermieristiche generali cliniche e pediatriche
MED/45 - NURSING - University credits: 2
Lessons: 30 hours
Scienze infermieristiche ostetrico-ginecologiche
MED/47 - MIDWIFERY - University credits: 1
Lessons: 15 hours
Professor: Mauri Paola Agnese
Scienze tecniche dietetiche applicate alla professione
MED/49 - FOOD AND DIETETIC SCIENCES - University credits: 1
Lessons: 15 hours