Essential Newborn Care

Essential Newborn Care
Introduction Care of the newborn at birth is primarily aimed at helping the newborn to adapt to the extra-uterine environment. Physiological adaptation includes:

. Initiating respiration and oxygenation of the arterial blood . Temperature adaptation . Initiation of feeding.
Preparing for birth
Ma e sure that the following things are available for the newborn: Two clean and warm towels!cloths for eeping the baby
warm" one for drying and wrapping the baby initially# the other one for covering the newborn to prevent heat loss
The room where the delivery ta es place should be clean# warm# well-lighted and ventilated# but draught-free
$nsure the %five cleans during% delivery have soap# water# new ra&or blade # a clean plastic sheet and
o
' clean piece of thread. . ' clean delivery it for cord care . 'n oral mucus extractor . ' blan et . ' watch to note the time of delivery.
Routine care at birth (ver )*+ of newborns do not re,uire any active resuscitation at birth. $fforts are directed to maintain asepsis and prevent infection of the newborn# prevent hypothermia and eep the airways patent. Asepsis -ash your hands with soap and water when preparing for the birth. .se gloves. /eliver the newborn under aseptic conditions. 0ote the time 1hour and minute2 of birth. Clamping of the cord
The umbilical cord should be clamped 3-4 minutes after the neonate is delivered completely. -ait till the cord has stopped pulsating before clamping and cutting it. This will result in an extra amount of blood being transfused in the neonate and prevent neonatal anaemia.
5owever# early and immediate clamping of the cord is recommended in newborns with severe birth asphyxia# cord around the nec and rhesus iso-immuni&ation. Care of the cord
The umbilical cord must be cut with a pair of sterile scissors!blade 4.6 cm from the abdominal s in surface. 0ote the following: 0othing needs to be applied to the cord .The cord is fre,uently infected because many mothers apply substances which may not be clean. The cord will dry and fall off on its own.
Tell the mother to prevent the cord from getting soiled with the newborn.s urine or faeces.
The mother should wash her hands with soap and water after cleaning the baby every time it passes 7tools.
Inspect the cord for bleeding 3 hours after tying. /o 0(T apply anything on the stump" eep the cord clean and dry.
Inspect for discharge or infection till healing occurs.
Maintaining the body temperature
0ewborns may be hypothermic at birth. 5ypothermia is a body temperature of 849 :C. 5ow to measure body temperature in the newborn The simplest way to measure body temperature in a newborn is by placing a thermometer in the axilla of the child. The thermometer should be ept for at least 6 minutes before ta ing the reading off the thermometer. The normal temperature of the baby is between 49.6;C and 4<;C. 'xillary temperature is comparable to rectal temperature and is safer 1less chances of in=ury and ! or infection2
5ypothermia results in increased oxygen consumption and hypoxaemia# increased glucose consumption# and hypoglycaemia and metabolic acidosis. 5ypoxaemia and hypoglycaemia can result in death of the newborn. 'mong survivors# it can lead to permanent impairment of the brain resulting in developmental handicaps.
5eat loss at birth can be prevented by the following simple interventions:
>eceive the baby in a dry# warm# clean towel. /ry the baby well. -hile drying# ma e sure that the head is in a neutral position# neither too flexed nor too extended. /iscard the wet towel immediately and wrap!cover the baby 1except for the face and upper chest2# in a fresh# clean dry towel. The baby should be ept wrapped during the assessment# and suction ventilation applied 1if re,uired2 to prevent heat loss.
-rap the baby in loose multiple layers of light but warm cloth. ?lood# meconium and some of the vernix will have been wiped off during drying at birth. The remaining vernix does not need to be removed as it is harmless# may reduce
heat loss and is reabsorbed through the s in during the first few days of life.
Place the baby near a source of warmth. ' normal baby# who is crying well after birth# can be placed in s in-to-s in contact with the mother.s abdomen and covered with a dry cloth. The maternal body heat will provide the extra warmth re,uired. It is also an additional assurance to the mother of the baby.s well-being.
In a P5C setting# additional heat can be provided by placing the baby under a source of heat such as a lamp with a 3** -att bulb or under a radiant warmer.
$nsure that during and after the delivery# no fans are running in the delivery room# and no windows are open through which air currents blow into the room.
-hile the baby needs to be ept clean# discourage the mother from giving a bath to the baby on the first day after birth. The mother or the birth attendant can clean the baby by wiping with a soft moist cloth. -hen the baby is given a bath# it should be done ,uic ly in a warm room# using warm water.
Airways and breathing
If the baby is crying and the breathing is normal# then there is no need for resuscitation. Provide normal care and clear the upper airway by wiping the nose and mouth of the baby and removing the secretions
present therein. If the baby is not crying# assess the breathing" if the chest is rising symmetrically and the
respiratory rate is @4*!minute# no immediate action is needed. >emember# occasional gasps are not
considered breathing.
Care of the skin
Clean the blood# mucus and meconium on the baby before presenting it to the mother. ?athing babies soon after birth is not recommended. Postpone the first bath for the next day. $nsure that the baby.s
temperature is normal before giving a bath to the baby.
Care of the eyes
The eyes should be cleaned at birth and once every day using sterile cotton swabs soa ed in sterile water or normal saline. $ach eye should be cleaned using a separate swab. The routine use of local antiseptic
drops for prophylaxis is not recommended.
Feeding
Initiate breastfeeding within half an hour of a normal delivery. $nsure that the baby is suc ling well. If suc ling is poor# ensure correct positioning and attachment of the baby to the breast
Apgar score
The 'pgar score of the baby indicates his!her well-being. It should be calculated at A minute and at 6 minutes after birth. 'n 'pgar score of @< is considered satisfactory.

Essential Newborn Care

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Essential Newborn Care

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Essential Newborn Care

Preparing for birth

Inspect for discharge or infection till healing occurs.

Maintaining the body temperature

5eat loss at birth can be prevented by the following simple interventions:

Airways and breathing

Care of the skin

temperature is normal before giving a bath to the baby.

Care of the eyes

drops for prophylaxis is not recommended.

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