Counseling Sheet

Agatha M. Thrash, M.D.

Preventive Medicine‍

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Regarding mother, check the following:

• Uterus and umbilicus should be firm.
• Lochia rubra—moderate to slight
• Perineum—Showing good care; no infection or bad odor; edges healing nicely. If mother has a lot of discomfort, recommend a cold or hot sitz bath.
• Hemorrhoids—Suggest foods to keep bowel movements soft; and suggest sitz bath—in very clean tub.
• Breasts—should be still secreting colostrum, if not already milk. Should not be engorged; but if so, hot towels applied for 15-20 minutes should help.
• Nipples—no cracks or fissures. Remind to clean nipples both before and after nursing the baby.
• BP—Confirm as normal.
• Rest—Recommend help for the house and caring for other children.
• Is she in good spirits? You may encourage and have prayer with her before leaving.

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Regarding the baby, check the following:

‍1. Sucking—Is it strong and frequent?

2. Bowel movement and urination—Is it normal in color and frequency?

3. Cord—Is it healing nicely and drying up? Is there an odor?

4. Skin—Check to be sure there is no jaundice or cyanosis.

5. Weight—It should not be less than birth-weight.

6. If a plastic cord clamp was used, cut it with special instrument (don't forget to take it with you).

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Items to take with you: baby scales, blood pressure equipment, thermometer, cord clamp cutter, flashlight.

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If for some reason the birth certificate or application was not completed before mother left place of birth, complete it at this time.