Four hours after birth, a primiparous woman refuses to feed, stating she is too tired and wants to sleep. What should the nurse do?

• A. Tell the woman she can rest after she feeds her baby.
• B. Recognize this as taking-hold stage.
• C. Record the behavior as ineffective maternal-newborn attachment.
• D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time.

Answer: (D)

The situation tests how to handle fatigue in the immediate postpartum period. In the first hours after birth, the mother is typically in a taking-in phase, focused on rest and basic needs. Rest helps her recover physically and mentally, stabilize mood, and supports eventual successful feeding and bonding.

Because she is too tired to feed, the priority is to protect both mother and infant by allowing the mother to rest while ensuring the newborn is cared for and monitored. Taking the baby to the nursery keeps the infant safe and under supervision, gives the mother an opportunity to sleep, and sets the stage for feeding to occur later when she is rested. The nurse can then reassess the mother’s readiness to feed and provide assistance or support, such as positioning, latch help, or expressed milk if appropriate.

Telling her she can rest after feeding would pressure her to feed before she’s ready and could further exhaust her. Labeling this as an ineffective maternal-newborn attachment is not warranted after just a single instance of fatigue, and recognizing a taking-hold phase isn’t accurate this early in the postpartum period.