ESSENTIAL NEWBORN CARE

Sindhu sebastian Lecturer FMCON

DEFINITION Essential newborn care is a comprehensive strategy to reduce the death of newborn through cost effective interventions before conception, during pregnancy, immediately after birth and postnatal period

PURPOSES 1. To make sure baby is thriving 2. Early detection of problems or danger

signs 3. Helping the mother to meet the baby’s

basic needs –warmth, feeding, infection prevention

4. Baby breast feed within 1st hour 5. Advising and encouraging mother rot

breast feed exclusively 6. Advising mother and family Members about

danger signs and baby care 7. Treatment of key problems such as

asphyxia and sepsis 8. Making plans for continuing care

immunizations and growth monitoring

COMPONENTS 1. Prepare for baby’s birth 2. Immediate newborn care 3. Newborn care during the

first day4. Newborn history and

physical examination 5. Care of newborn during the

first 28 days 6. Teach and counsel mother

and family about the newborn care

1.PREPARE FOR BABY’S BIRTH

a. Prevent infection WHO-32% newborn death due to infection Wash hands Personal contact infection Use the three infection prevention steps

before the baby is born-equipment, supplies and linen and surface

Decontamination Cleaning High level of disinfection and sterilization

CONTD…Wear gloves Protect yourself from splashes or spills of

blood amniotic fluids –wear eye protection, shoes ,face mask and apron

b. Prepare the birth roomMake sure that the room is Clean Warm Light Private

CONTD…

C. Keep records Newborn record cards Immunization cards Mothers records of AN, labor and

delivery

d. Collect the equipment supplies medicines for the birth room and immediate postnatal care

2.IMMEDIATE NEWBORN CARE

Immediate newborn care is based on the knowledge of midwife of his transitional requirement and capabilities.

CONTD… Chance of heat loss by convection ,conduction radiation and evaporation- so optimal thermal environment in delivery room.eg switch of the fan –convection

Closing curtains-radiation

CONTD..A. INITIAL CARE As the baby ‘s head is born wipe

or suction out the excess mucus from the nose /mouth

Note the time of birth and sex of the baby

CONTD..b. clearing the airway Hold the baby’s head lower than the body and turn to side for drainage

Wipe off baby’s face and fluids from the nose and mouth

Suction the nasal and oral passage with soft rubber bulb syringe or mucus sucker

If necessary mechanical suction

CONTD…c. Decide if baby needs resuscitation

A baby who is not breathing ,breathing is less than 30 breaths per minutes or is gasping needs resuscitation

Quickly clamp and tie and cut the cord leaving stump at least 10 cm long

Put baby on flat warm surface and start resuscitation

CONTD…

d. Clamping and cutting the cord Tie the cord securely on two place Tie the first one 2 fingers away from the baby’s

abdomen and second one from 4 fingers away from the baby’s abdomen

Use a small gauze piece to cover the part of the cord to prevent splashing of blood while cutting the cord

Cut the cord between the ties

Do not put anything on the cord stump

CONTD…e.dry and stimulate the baby Rub up and down the baby’s back using clean

warm cloth

f. Assess the baby’s breathing and colour

Face and chest –pink not gray or blue –pink indicate good sign of adequate breathing and circulation

Blue colour of tongue, lips and trunk –sign of lack of oxygen in blood

Bluish colour only on hands and feet –present for 1-2 days after the birth normal

CONTD…

g. Preventing infection Aseptic technique

h. Maintaining the body temperature

Keep the baby's body warm Wipe of dry the baby Bodily contact with mother Radiant warmer -200 watt bulb Warmed blankets

CONTD…Prevention of heat loss Remove the wet towel and cover

with warm blankets Skin to skin contact with mother Keep the baby mothers chest as

soon the baby is born Breast feeding with in the first

hour

CONTD…

i. Preventing the injuryHandle gently

j. Assessing the baby’s condition

APGAR

k. Weight l. Clothing m. Eye care

CONTD…

n. Identification Name bands Remain until gets dischargeSkin to skin contact with the mother

Have the mother to start breast feeding

CONTD….

Close observation at least for 4-8 hours

Any excess mucus from mouthAny bleeding from umbilical cord

Hourly temperature until it stabilize and remain above 36 degree

CONTD…

o. Administer inj. vit k

3.NEWBORN CARE DURING THE FIRST DAYa. Assess the baby b. Breathing c. Warmth d. Colour e. Bleeding f. Give normal newborn care Keep warm Support breast feeding Eye cre cord care ,skin care ,

g. other care for any problems or needs

Newborn physical examination

Common newborn problemsh. Immunizations BCG and polio

4.NEWBORN HISTORY AND PHYSICAL EXAMINATION

a. Take history b. Objectives of physical examination

To detect congenital anomalies To detect illness and birth injuries To record body measurement and vital signs

c. Identify needs or problems

5.DAILY ASSSEEMENT AND CARE OF THE BABY DURING 28 DAYS

Observation General care Warmth Sleep Vital signs check Loving care Weight

CONTD…

Protection from infection

Skin care The head The mouth Eye care Care of umbilical cord

CONTD….

Genital care Bath Early and exclusive

breast feeding Elimination Stool

CONTD…

Immunization Safety and security Newborn danger

signs Plan for follow up

visits

6.TEACH AND COUNSEL MOTHER AND FAMILY ABOUT NEWBORN CARE