Infant Care: Preventing Spit-up During Diaper Change

What should the nurse do first if the infant begins to spit up during a diaper change?

A. Bubble or burp the infant by patting the infant's back

B. Encourage the mother to avoid overfeeding the infant

C. Turn the newborn and bulb suction the mouth and nose

D. Wipe away the secretions and finish the diaper change

Answer:

To prevent aspiration during a spit-up, the nurse should immediately turn the newborn and bulb suction the mouth and nose.

When an infant begins to spit up during a diaper change, the first action the nurse should implement is to turn the newborn and bulb suction the mouth and nose. This immediate action helps prevent the aspiration of the regurgitated milk into the airway, which could lead to respiratory issues.

During feeding, whether from breastfeeding or bottle-feeding with formula, the infant may swallow air along with the milk, which can cause them to spit up. Burping the infant or 'bubbling' can help to release some trapped air accumulated in the stomach during feeding, thereby reducing the possibility of spitting up.

It is also important for the nurse to guide the mother in best feeding practices such as recognizing signs of satiety in the infant to avoid overfeeding, which can lead to spit-up. However, the immediate concern when an infant starts to spit up is to ensure that the airway is clear to prevent aspirational complications.