Care of the Normal Newborn at the time of Birth
(Immediate Care)
1. Call out the time of birth
2. APGAR Scoring
3. Receive baby onto warm, clean and dry towel or cloth.
4. Immediately dry baby with warm towel or piece of clothes.
5. Wipe the eye inner canthus to outer canthus, if amniotic fluid present.
5 . If secretions present suction first then dry (prevent aspiration)
5. Blood or meconium on baby wiped, vernix caseosa not wiped off.
5. Drying itself stimulation for baby to breathe
6. Clamp and cut the umbilical cord
Clamped after 1 minute sterile disposable clamp or sterile tie and cut using sterile blade about 2-3cm away from the skin.
Dry umbilical cord, not apply any solution.
6. Assess the baby breathing while drying
(Time of drying; breathing assess.
Normal Newborn crying; vigorously
Normal respiration rate; 40-60b/m
If baby not breathing well than, basic steps of newborn/ neonatal resuscitation carried out.
7. Leave the baby between mother's breasts to start skin to skin care.
Once cord cut; baby placed mother's breast
8. Place an identity label on the baby (place on wrist or ankle).
9. Cover the baby's head with a cap, cover the mother and baby with a warm clothes.
Delivery room should warm; 25-28 degree Celsius
10. Encourage mother to initiate exclusive breast feeding; early as possible within 30 minutes.
11. Administration of vitamin K injection
(Protect babies from serious bleeding).
Administered vitamin K injection;
Normal birth weight baby; 1.0mg, route IM
<1500grams; 0.5mg, route IM
(Encourage mother to breastfeed their baby during injection for comfort.
12. Transfer
Sick or at risk neonates; transferred to neonates intensive unit (NICU).
13. Ensuring warmth "WARM CHAIN"
Baby's skin temperature falls within seconds of being born.
Baby must be dried immediately after birth and delivered onto warm towel and loosely wrapped before being placed naked between mother's breast or over abdomen.
Baby normal temperature; 36.5-37.5 degree Celsius
Mild hypothermia; 36-36.4 degree Celsius
Cold stress; warm abdomen, cold extremities
Moderate hypothermia; 32-35.9 degree Celsius; cold abdomen, cold extremities
Severe hypothermia; less than 32 degree Celsius, cold abdomen, cold extremities
14. Helping to establish normal breathing
Baby's breathing should be assessed at the time drying.
If baby crying vigorously
Respiration rate; 40 to 60 b/m
If baby not breathing or gasping
Basic resuscitation
15. Prevention of infection, clean chain
Cleanliness at delivery.
Infection can cause neonatal sepsis and tetanus.
16. Cord and eye care
Cord care
Put baby on mother's abdomen or chest or on warm, clean and dry surface close to mother should clamped after 1 minute.
Put ties (sterile tie) tightly around cord at 2cm and 5cm from abdomen.
Cut between ties with sterile blade.
Remove blood or meconium by wiping with clean clothes.
Observe for oozing blood.
If blood oozes, place the second toe between skin and first tie.
Donot apply any substance the stump.
Leave stump exposed and dry.
If stump soild, wash it with clean water and dry with clean clothes.
Eye care
Do's
Clean eye immediately after birth with swab soaked in warm sterile water using separate swabs for each days
Give prophylactic eye drops within 1 hours of birth as per hospital policy. Done after baby has been dried.
Don't
Donot apply anything else in eye.
Baby's eye should wiped as soon as possible after birth.
17. Weight the baby
1. <2500 gram
Required special care to prevent low body temperature.
2. <2000 gram
Receive prolonged skin to skin
3. <1500 gram
Need referral
Examine the baby
A complete examination sould performed with in about 60 minutes after birth.
Count number of breathe during one minutes.
Observe movement of limbs when awake.
Observe skin color
Inspect the following body any Abnormalities;
Head
Face
Mouth
Palate
Chest abdomen
Genetilia
Anus
Limb and
Skin
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