Early Essential Newborn Care

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Early Essential Newborn Care

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Objectives

• Immediate Newborn Care
• The First 90 minutes
• Essential Newborn Care
• From 90 min to 6 hours
• Care Prior to Discharge
• After the first 90 minutes
• 4. Care After Discharge
• Discharge to 7 days
• Additional Care
• Newborn Resuscitation

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Case study Baby Musonda

• Mrs Musonda is about to give birth to a term baby
  in a remote clinic. Her pregnancy and labour
  have been uncomplicated.
• The next video is about preparation
• How will you prepare for the babys arrival?
• What basic equipment will you need?

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Immediate Newborn Care

• Clean cloths, towels, blanket, cord ties and
  blades
• Wash hands
• Check resuscitation equipment

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Immediate Newborn Care

• Clean cloths, towels, blanket, cord ties and
  blades
• (ref p37)
• Wash hands with soap and water
• Check resuscitation equipment
• Check room temperature
• (ref p1-3)

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Immediate Newborn Care

• Baby of Musonda is born, appears a normal size
  for gestation. Which intervention should you do
  in the first 30 seconds?
• Slap, blow, pour cold water on the baby
• Hold the baby upside down
• Suctioning of the mouth and nose of the baby
  routinely
• Heavy suctioning of the back of the throat of
  baby
• Dry baby with clean cloth, keep warm and check
  baby
• (ref p1)

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Immediate Newborn Care
Dry baby with a clean cloth, keep warm, examine.
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• Immediate Newborn Care

• What do you look for?
• Breathing or crying YES
  
• Good muscle tone YES
• Colour pink YES
• Breathing or crying NO
• Good muscle tone NO
• Colour pink NO

Skin to skin contact
Neonatal Resuscitation
Ref. p2
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Routine Care of the Newborn
Baby of Musonda is crying and active. There are
some nasal secretions but the baby is
comfortable. The midwife is attending to the
mother and asks you when to cut the umbilical
cord. How long should you wait before
cutting the cord? How would you care for the
cord?
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Cord Care

• Wait 3 minutes or until the cord stops pulsating
  before cutting the cord. (Ref. p4)
• Wash hands
• Put nothing on the cord stump keep it dry
• Fold the nappy (diaper) below the level of the
  stump
• Keep cord stump loosely covered
• If the stump is soiled, wash with clean water
  and soap.
• (Ref. p8)

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Immediate Newborn Care
Properly timed cord clamping
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Routine Care of the Newborn
The baby is now 2 minutes of age pink, crying and
active. A warm cloth is placed over the baby on
mother. It is cold outside. How will you
keep this baby warm? What may happen if the baby
becomes cold?
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Routine Care of the Newborn

• Which of the following should you do?
• Keep baby with mother
• Wash baby within 6hrs
• Put newborn on cold/wet surface
• Wipe off vernix
• Footprinting

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Immediate Newborn Care
Skin to skin contact
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Provide Support for Breastfeeding
The newborn is having skin to skin contact and
starts to show feeding cues. How will you
support this mother?
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Immediate Newborn Care
Initiate breastfeeding
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Immediate Newborn Care

• Practice immediate newborn care.
• the first 90 mins in turns as a group of three
  
• 1) Health worker
• 2) Mother
• 3) Observer

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Summary Early Essential Newborn Care

• Dry baby with a clean cloth, keep warm, examine
• Properly time cord clamping
• Wait for up to 3 mins or until pulsations stop.
  Keep umbilical cord clean and dry.
• Maintain skin-to-skin contact
• Give the baby to mother as soon as possible,
  place on chest or abdomen
• Cover the baby to prevent heat loss
• Breastfeeding
• Initiate within the first hour

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Summary Early Essential Newborn Care

• Further Management after the first hour of life
• Give vitamin K (phytomenadione), according to
  national guidelines 1 ampoule IM once
• Apply antiseptic ointment or antibiotic eye drops
  (e.g. tetracycline) to both eyes once
  (prophylaxis), according to national guidelines
• There is no need to bathe baby immediately after
  birth
• (Ref. p. 46, p. 50)