ESSENTIAL NEWBORN CARE

• Newborn babies struggle a lot when they are adapting to the new environment. The first hour of birth is the most crucial period and how well a baby is cared during this time will determine the future health and wellbeing. Health professionals play an important ole during this adaptation phase. Poor care prevents complications and ensures good survival.

HEALTHY NEWBORN

• A healthy baby born at term should weighs more than 2500 grams, cries immediately following birth establishes independent rhythmic respiration & quickly adapts to the changed environment.

CARE OF NEWBORN AT BIRTH Call out the time of birth

Receive the baby onto a warm, clean and dry towel and place on mother’s chest

Contd.. Clamp and cut the umbilical cordImmediately dry the baby with a warm

clean towel or piece of cloth

Contd..Assess the baby’s breathing while

dryingWipe both the eyes with sterile

gauzeLeave the baby between the

mother’s breasts to start skin-to-skin care

Place an identity label on the baby

Contd.. Cover the baby’s head with a cap; cover the

mother and baby with a warm cloth

Encourage mother to initiate exclusive breastfeeding

IMMEDIATE BASIC CARE

Establishment of open airway & circulation

Maintenance of temperature

Identification of newborn

Vitamin K injection

Initiation of breastfeeding.

ESTABLISHMENT OF OPEN AIRWAY

(Majority of babies cry at birth & take spontaneous Respiration)

When the head is delivered birth attendant immediately suction the secretions, wipe mucus from face and mouth and nose.

Suction the mouth and nose by using bulb syringe

Keep head slightly lower than the body

Position the Baby on their backs or tilted to the side, but not on their stomachs.

APGAR SCORINGCRITERIA 0 1 2

Respiration Absent Slow, irregular Good, crying

Heart rate Absent Slow (Below 100) More than 100

Muscle tone Flaccid Some flexion of extremities

Active body movements

Reflex response No response Grimace Cry

Skin color Blue, pale Body pink, extremities blue

Completely pink

TOTAL SCORE = 10 No depression: 7-10Mild depression: 4-6Severe depression: 0-3

VITAMIN K

Vitamin K Prevent neonatal hemorrhage during first few days of life before infant is able to produce Vitamin K

Term infants (1mg) - IM

Preterm infants (0.5mg) – IM

INITIATION OF BREASTFEEDING 

Babies can be breast-fed as soon as the airway is cleared and they are breathing normally.

 

DAILY ROUTINE CARE OF NEONATES

 

Thermoregulation

Breastfeeding

Skin care & baby bath

Care of umbilical cord

Care of the eyes

Clothing of the baby

General care

Observation

Taking anthropometric

measurement

Immunization

Follow up & advice

Mechanisms of heat loss

1. THERMOREGULATION

Radiation

ConvectionEvaporation

Conduction

WARM CHAIN

• Keep the baby clothed and wrapped with the head covered

• Minimize bathing especially in cool weather or for small babies

• Keep the baby close to the mother• Use kangaroo care for stable LBW babies and for re-

warming stable big babies• Show the mother how to avoid hypothermia, how to

recognize it, and how to re-warm a cold baby. The mother should aim to ensure that the baby's feet are warm to touch.

WARM ENVIRONMENT

BATH

CLOTH EFFECTIVELY

PRE WARM

DURING PROCEDURES AND TRANSPORTS

SKIN TO SKIN CONTACT-"Kangarooing"

APPLICATION OF OIL /PARAFFIN

Temperature recording

• Axillary temperature

• Rectal temperature

• Skin temperature

2. BREAST FEEDINGThe baby should be put to the mother’s breast within half an hour of birth or as soon as possible the mother has recovered from the exertion of labour.

3. SKIN CARE & BABY BATH: 

• The skin should be cleaned off blood, mucus & meconium by gentle wiping before he/she is presented to the mother.

• Baby bath can be given at the hospital or home by using warm water in a warm room gently & quickly.

4. CARE OF THE UMBILICAL CORD

Keep the cord stump clean and dry.

Topical application of antiseptics is usually not necessary unless the baby is living in a highly contaminated area.

5. CARE OF THE EYES

 

Eyes should be clean at birth & once in every day using sterile cotton swabs soaked in sterile water or normal saline.

Separate swabs for each eye.

6. CLOTHING OF THE BABY 

The baby should be dressed with loose, soft & cotton cloths. The frock should be open on the front or back for easy wearing.

Large button, synthetic frock and plastic or nylon napkin should be avoided.

7. GENERAL CARE

Rooming –in

gentle approach

Aseptic technique

sensory stimulation

tender& loving care

8. OBSERVATION 

The baby should be kept in continuous observation twice daily for detection of any abnormalities or danger signs

DANGER SIGNS

• 1. Not feeding well• 2. Less active than before• 3. Fast breathing (more than 60 breaths per

minute)• 4. Moderate or severe chest in-drawing• 5. Grunting / moaning• 6. Convulsions

Contd..

• 7. Floppy or stiff• 8. Temperature >37.50C or <35.50C• 9. Umbilicus draining pus or umbilical redness

extending to skin.• 10. More than 10 skin pustules or bullae, or

swelling, redness, hardness of skin• 11. Bleeding from stump or cut

9. ANTHROPOMETRIC MEASUREMENT

Measure weightLengthHead circumference Chest circumference

10. IMMUNIZATION

Newborn should be immunized with BCG vaccine & ‘0’ dose of ‘OPV’. Hepatitis ‘B’ vaccine can be administered at birth as first dose & other two doses in one month & 6 months of age.

11. Follow up & advice

PREPARATION FOR DISCHARGE– Feeding well - suckling effectively 8 times in 24 hours, day and

night– No danger signs– No need for any medication except vitamins– Mother confident of taking care of the baby

Each infant should be followed up, at least once every month for first 3 months & subsequently 3 month interval till one year of age.

PREVENTION OF INFECTIONS

• CLEAN CHAIN

• BREAST FEEDING

• IMMUNIZATION

• CARE OF SKIN, EYE AND CORD

‘Clean chain’

1. Clean delivery (WHO five cleans):– Clean attendant's hands (washed with soap)

– Clean delivery surface– Clean cord- cutting instrument (i.e. razor, blade)

– Clean string to tie cord– Clean cloth to wrap baby and mother

2. After delivery:– All caregivers should wash hands before handling the baby

– Feed only breast milk– Keep the cord clean and dry; do not apply anything

– Use a clean cloth as a diaper/napkin

– Wash your hands after changing diaper/napkin

NURSING DIAGNOSES

• Ineffective airway clearance

• Ineffective thermoregulation

• Risk for injury

• Risk for infection

Thank you