A nurse is reinforcing teaching about comfort measures for breast engorgement with a client who is postpartum and is bottle-feeding her newborn. Which of the following statements by the client indicates a need for further teaching?

The medical term for the soft spot on a baby's skull is fontanelle (or fontanel). Fontanelles are gaps between the bones of the skull that allow for the baby's brain to grow and accommodate rapid brain development during infancy. There are typically two fontanelles in a newborn's skull: the anterior fontanelle (located at the top/front of the head) and the posterior fontanelle (located at the back of the head). These fontanelles are composed of connective tissue and remain open during the early months of life, gradually closing as the baby's skull bones fuse together over time. Healthcare professionals often assess fontanelles during routine physical exams of infants. The fontanelle's size and tension can provide valuable information about the baby's hydration status, intracranial pressure, and neurological development.

Normally, the fontanelles should feel relatively soft and flat, indicating proper hydration and brain development. If the fontanelles are sunken or overly tense, it may suggest dehydration or increased intracranial pressure, which requires further evaluation and management. The proper examination of fontanelles is an essential part of newborn care, and any abnormalities observed during assessment should be promptly reported to the healthcare provider for appropriate evaluation and intervention.

Back to sleep.

Choice A rationale:

Placing a baby on their back to sleep is the most effective way to prevent flat spots on the back of their head. This sleeping position, recommended by pediatric experts, helps reduce the risk of sudden infant death syndrome (SIDS) while also minimizing pressure on any one part of the baby's head, thus decreasing the likelihood of developing flat spots.

Choice B rationale:

Taking the baby for walks does not directly address the prevention of flat spots on the back of the head. Although it is beneficial for the baby's overall well-being, it does not specifically address the positional issue that leads to flat spots.

Choice C rationale:

Keeping the baby awake most of the day is not a suitable solution, as it may lead to sleep deprivation and hinder the baby's development. Adequate sleep is essential for a baby's growth and development.

Choice D rationale:

Tummy time is a valuable activity to promote the baby's neck and upper body strength. While it can indirectly contribute to preventing flat spots by encouraging different head positions, it is not as effective as placing the baby on their back to sleep.