Question: 322 CHAPTER 19 Caring For Mothers And Infants Knowing No Trouble Changing Him, Bathing Him, Or When To Bring Him To His Doctor For Weekly Visits. Supporting Leslie And On Your Visit Today, Leslie Greets You At The Door, Milton: Knowing Whom Carrying Milton In One Arm And Holding A Cigarette To Turn To For Answers In Her Other Hand. She Looks As If She …

322 CHAPTER 19 Caring for Mothers and Infants knowing no trouble changing him, bathing him, or when to bring him to his doctor for weekly visits. Supporting Leslie and On your visit today, Leslie greets you at the door, Milton: Knowing whom carrying Milton in one arm and holding a cigarette to Turn to for Answers in her other hand. She looks as if she has been Leslie, 17, mother of 2-week-old Milton, is a single crying. Milton is crying, wet, and obviously needs a diaper change. Leslie says that she thinks that he mother who is new to your community. Milton’s father left Leslie during her pregnancy while they decision to keep Milton was a wrong one and that were both in drug rehab, and she does not have any she wants to spend more time with her friends. contact with her family. You are the support worker While you watch Leslie change Milton’s diaper, you assigned to Leslie after a public health nurse notice her hands are shaking. Leslie then says that reported that Leslie had troubles bathing and she has been feeling very lonely and sad lately and feeding Milton and adjusting to her new role as a asks if smoking a “joint” (i.e., marijuana cigarette) mother. You are to report any concerns to your to help her relax will be harmful to Milton. supervisor. Leslie is currently breastfeeding Milton. Milton weighed 3.6 kg (8 lb.) at birth and, accord- You are unsure how to answer Leslie’s question ing to his pediatrician, has grown and gained weight What should you do? What can you say well. On the two last visits, Leslie seemed to have her? Who can she turn to for help in your community? TO BOX 19–1 Signs and Symptoms of Postpartum Complications • Fever of 38°C (100.4°F) or higher • Chills, poor appetite, fatigue, nausea, or vomiting • Lochia that soaks a sanitary pad within 1 hour of application Foul-smelling lochia • Large number of clots in the lochia • Painful, burning, or difficult urination • Severe abdominal or perineal pain • Bleeding, redness, swelling, or drainage from a Caesarean-section incision (see next page) Leg pain, tenderness, or swelling • Breast pain, tenderness, or swelling (see BOX 19-2) Feelings of depression (see BOX 19-3, on p. 326, BOX 19-3 BOX 19-2 Signs and Symptoms of Mastitis Signs and Symptoms or Postpartum Depression Pain, heat, tenderness, red streaks, or swelling in a breast • Tender lump or hardened area in the breast • Fever: 38°C (100.4°F) or higher • Chills Fatigue • General body ache • Cracked nipples or cracked skin around the nipples Crying Feelings of sadness, hopelessness, or guilt Difficulties sleeping Inability to cope with everyday problems Avoiding visiting with others Feelings of anger toward the baby Fatigue Extreme anxiety Delusions or hallucinations Thoughts of harming the baby or self