A new mother is concerned because her 1-day-old infant spits up a small amount after feeding.

She asks the nurse how to prevent this.
Which instruction should the nurse provide?

Choice A rationale

While a toddler may seem quieter or more clingy, clinical depression and total withdrawal are not the typical or expected developmental responses to a new sibling. Toddlers are more likely to express their frustration through outward behaviors or shifts in their routine rather than a deep, persistent depressive state. If a child becomes completely non-responsive, it may indicate a different psychological issue rather than a standard reaction to a new family member.

Choice B rationale

Toddlers lack the cognitive maturity to grasp complex concepts like family roles or social hierarchies. Their world is centered on their immediate needs and their relationship with their primary caregivers. They do not fear a change in the abstract family structure; instead, they react to the tangible loss of undivided attention and the disruption of their established daily routines. Their anxiety is rooted in the present moment rather than future roles.

Choice C rationale

Toddlers are developmentally in a stage where they are still very dependent on parents for emotional security. The arrival of a new baby often triggers jealousy as the toddler competes for attention. Regression is a common coping mechanism where the child may return to earlier behaviors, such as wanting a bottle or having toileting accidents. This is a normal way for the child to seek the same care the newborn receives.

Choice D rationale

Although some toddlers might show brief interest in a new baby, they generally lack the empathy and fine motor skills to truly help with newborn care. Expecting a 2-year-old to be excited about a sibling is often unrealistic, as they primarily view the infant as a competitor for their parents' time. Their limited impulse control makes it difficult for them to consistently interact with a newborn in a helpful or gentle manner.

Choice A rationale

Flatulence and constipation are common occurrences in the early postpartum period due to the effects of progesterone on GI motility, decreased abdominal muscle tone, and potential side effects of pain medications. While uncomfortable for the patient, these symptoms are expected and do not typically require immediate notification of a physician. Nursing interventions like encouraging ambulation, increasing fluid intake, and providing stool softeners are usually sufficient to manage these issues.

Choice B rationale

Extreme hunger and thirst are normal physiological responses following the intense physical exertion of labor and delivery. The body requires additional energy and hydration to begin the recovery process and to support the initiation of lactation. This is an expected finding as the body shifts from the stress of childbirth to a state of replenishment. It does not indicate a medical emergency or a complication requiring a physician's intervention.

Choice C rationale

Lochia follows a specific chronological progression: rubra (red) for 1 to 3 days, serosa (pinkish-brown) for 4 to 10 days, and alba (white-yellow) after 10 days. A direct change from rubra to alba, skipping the serosa stage, is physiologically abnormal and may indicate an underlying issue with the healing of the placental site. Any regression or deviation from the expected color sequence warrants assessment and notification of the healthcare provider to rule out complications.

Choice D rationale

The presence of yellowish fluid from the nipples, known as colostrum, is a normal and expected finding in the early postpartum period before the transition to mature breast milk. Colostrum is rich in antibodies and nutrients, serving as the first milk for the newborn. This signifies that the hormonal transition and lactation process are beginning as intended. It is a healthy sign of postpartum physiological adaptation and does not require physician notification.