Nursing Care Guidelines for Congenital
Disorders in Pediatrics (CET518)
, Chapter 27 Nursing Care of the Child Born With a Physical or Developmental Difference
What causes birth defects?
Some causes are known, but others are unknown. Here's what we do know:
Things that help prevent some birth defects:
• Taking folic acid before and during early pregnancy → prevents neural tube defects (like spina bifida).
• Avoiding tobacco, alcohol, and certain medications → prevents issues like:
o Fetal alcohol syndrome
o Cleft palate/lip
Risk factors that increase birth defect chances:
• Obesity and diabetes in the birthing parent can increase the risk — especially for heart defects.
Treatment outcomes vary:
• Some birth defects can be corrected with surgery → the baby may go on to live a healthy life.
• Others may require long-term medical care, even after surgery.
How are birth defects detected?
1. Newborn Metabolic Screening Test (done shortly after birth in the U.S.)
• Checks for many congenital conditions
• Goal: Catch problems early so treatment can start quickly and improve outcomes.
2. Prenatal ultrasound (sonogram)
• Sometimes defects are found before birth.
3. Physical exam after birth
• Some issues are only noticed after delivery.
Nursing Care at Birth: What Should You Do?
When a baby is born with a difference:
• Doctors (pediatrician/neonatologist) give the medical diagnosis and explain the baby’s health to the parents.
• Nurses provide:
o Emotional support
o Education
o Communication between family and healthcare team
Important nurse actions:
, • Explain the baby’s condition in simple language
• Describe what medical equipment is for (parents might feel scared seeing tubes or machines)
• Give parents time to ask questions
• Help them spend time with and interact with their newborn
• Use the baby’s name to help the family bond
Cultural Considerations – Box 27.2
• Many parents come from different cultural backgrounds, and may have beliefs or myths about what causes birth defects.
• Examples of cultural myths:
o Evil eye ("mal de ojo") caused the problem
o Eating raisins caused brown marks
o Eating strawberries caused red birthmarks
• Parents may blame themselves — it’s important to educate them and relieve guilt.
Your job as the nurse:
• Respect their beliefs.
• Provide accurate information.
• Help parents feel confident and involved in their baby’s care.
What should you say as a nurse?
Example:
“When your doctor placed your baby on your abdomen, you might have noticed that your baby’s spinal cord isn’t completely formed; this is
called a meningocele. I will bring the baby’s isolette over to you. Notice how bright-eyed and alert the baby is for just being born.”
• Point out normal baby behaviors (like being alert) to help parents connect.
• Be honest, but also gentle and encouraging.
What if the parents are upset or don’t want to care for the baby? (What If. . .27.1)
Imagine this:
• One parent is so upset they don’t want to feed or hold the baby, even talking about adoption.
• The other parent is asking questions and showing interest.
• No family members are coming to visit.
What should the nurse do?
• Start with emotional support:
o Sit with them, allow them to talk.
o Normalize their feelings — it’s okay to feel shocked, sad, or overwhelmed.
• Encourage bonding:
o Offer skin-to-skin time (if appropriate).
o Talk positively about the baby’s behaviors.
o Involve them in simple care (touching, talking, holding).
• Provide information gently and clearly
• Offer social work or counseling support if needed.
• Respect their choices while continuing to advocate for the baby’s well-being.
Disorders in Pediatrics (CET518)
, Chapter 27 Nursing Care of the Child Born With a Physical or Developmental Difference
What causes birth defects?
Some causes are known, but others are unknown. Here's what we do know:
Things that help prevent some birth defects:
• Taking folic acid before and during early pregnancy → prevents neural tube defects (like spina bifida).
• Avoiding tobacco, alcohol, and certain medications → prevents issues like:
o Fetal alcohol syndrome
o Cleft palate/lip
Risk factors that increase birth defect chances:
• Obesity and diabetes in the birthing parent can increase the risk — especially for heart defects.
Treatment outcomes vary:
• Some birth defects can be corrected with surgery → the baby may go on to live a healthy life.
• Others may require long-term medical care, even after surgery.
How are birth defects detected?
1. Newborn Metabolic Screening Test (done shortly after birth in the U.S.)
• Checks for many congenital conditions
• Goal: Catch problems early so treatment can start quickly and improve outcomes.
2. Prenatal ultrasound (sonogram)
• Sometimes defects are found before birth.
3. Physical exam after birth
• Some issues are only noticed after delivery.
Nursing Care at Birth: What Should You Do?
When a baby is born with a difference:
• Doctors (pediatrician/neonatologist) give the medical diagnosis and explain the baby’s health to the parents.
• Nurses provide:
o Emotional support
o Education
o Communication between family and healthcare team
Important nurse actions:
, • Explain the baby’s condition in simple language
• Describe what medical equipment is for (parents might feel scared seeing tubes or machines)
• Give parents time to ask questions
• Help them spend time with and interact with their newborn
• Use the baby’s name to help the family bond
Cultural Considerations – Box 27.2
• Many parents come from different cultural backgrounds, and may have beliefs or myths about what causes birth defects.
• Examples of cultural myths:
o Evil eye ("mal de ojo") caused the problem
o Eating raisins caused brown marks
o Eating strawberries caused red birthmarks
• Parents may blame themselves — it’s important to educate them and relieve guilt.
Your job as the nurse:
• Respect their beliefs.
• Provide accurate information.
• Help parents feel confident and involved in their baby’s care.
What should you say as a nurse?
Example:
“When your doctor placed your baby on your abdomen, you might have noticed that your baby’s spinal cord isn’t completely formed; this is
called a meningocele. I will bring the baby’s isolette over to you. Notice how bright-eyed and alert the baby is for just being born.”
• Point out normal baby behaviors (like being alert) to help parents connect.
• Be honest, but also gentle and encouraging.
What if the parents are upset or don’t want to care for the baby? (What If. . .27.1)
Imagine this:
• One parent is so upset they don’t want to feed or hold the baby, even talking about adoption.
• The other parent is asking questions and showing interest.
• No family members are coming to visit.
What should the nurse do?
• Start with emotional support:
o Sit with them, allow them to talk.
o Normalize their feelings — it’s okay to feel shocked, sad, or overwhelmed.
• Encourage bonding:
o Offer skin-to-skin time (if appropriate).
o Talk positively about the baby’s behaviors.
o Involve them in simple care (touching, talking, holding).
• Provide information gently and clearly
• Offer social work or counseling support if needed.
• Respect their choices while continuing to advocate for the baby’s well-being.
