Essential newborn care

1. ESSENTIAL NEWBORN CARE
MANISHA PRAHARAJ
SUM NURSING COLLEGE

2. MEANING OF NEWBORN CARE
NEW BORN CARE IS A COMPREHENSIVE
STRATEGY DESIGNED TO IMPROVE THE HEALTH
OF NEWBORNS THROUGH INTERVENTIONS JUST
SOON AFTER BIRTH, IN POST NATAL WARD &
UP TO 28 DAYS.

3. PURPOSE
• Early detection of problems & danger signs.
• To help mother to meet the basic needs of
baby: breast feeding, warmth, prevention of
infection
• To initiate the breast feeding within 1 hour
of birth.
• To encourage & educate the mother to give
exclusive breast feeding and care of baby.

4. • To treat the problems such as asphyxia & sepsis.
• To advice mother and family members for
continuing care, immunizations and growth
monitoring.

5. COMPONENTS
• PREPARE THE LABOUR ROOM FOR BIRTH OF
BABY.
• IMMEDIATE NEW BORN CARE.
• NEW BORN CARE ON FIRST DAY.
• NEW BORN PHYSICAL EXAMINATION.
• CARE OF NEW BORN DURING THE FIRST 28 DAYS
• EDUCATE THE MOTHER AND FAMILY MEMBERS
ABOUT THE NEW BORN CARE.

6. HEALTHY NEWBORN
• A HEALTHY INFANT BORN AT TERM BETWEEN 38-42 WKS, SHOULD
HAVE AVERAGE BIRTH WEIGHT, CRIES IMMEDIATELY FOLLOWING
BIRTH, ESTABLISHES INDEPENDENT RHYTHMIC RESPIRATION
& QUICKLY ADAPTS TO CHANGED
ENVIRONMENT.

7. IMMEDIATE BASIC CARE
1. DRY THE BABY
2. REPLACE THE WET TOWEL.
3. POSITION THE BABY.
4. ESTABLISHMENT OF OPEN AIRWAY.
5. MAINTENANCE OF TEMPERATURE
6. INITIATE BREASTFEEDING WITHIN A HOUR OF BIRTH.
7. IDENTIFICATION OF NEWBORN
8. ADMINISTER INJ. VITAMIN K

8. DRY THE BABY & REPLACE THE
WET TOWEL
• IMMEDIATELY AFTER DELIVERY, THE BABY SHOULD BE
DRIED WITH A WARM, SOFT TOWEL.
• REMOVE THE WET TOWEL AND REPLACE WITH A DRY
TOWEL, WILL HELP TO REDUCE HEAT LOSS.

9. MECHANISM OF HEAT LOSS
• THE NEW BORN CAN LOSS HEAT BY:
1. CONVECTION: E.G. BY AIR IN ROOM
2. RADIATION: BY COLD WINDOWS/WALLS
3. EVAPORATION: BY BABY BATH
4. CONDUCTION: BY COLD HANDS OR STETHOSCOPE OR
INSTRUMENTS.

10. MAINTENANCE OF TEMPERATURE
• IMMEDIATELY DRY THE BABY UNDER A RADIANT
WARMER.
• SKIN TO SKIN CONTACT WITH MOTHER
• COVER THE NEONATE WITH WARM TOWEL.
THE HEAD AND EXTREMITIES
SHOULD BE COVERED
PROPERLY.
• ROOMING IN

11. ESTABLISHMENT OF OPEN AIRWAY
• MAJORITY OF BABIES CRY AT BIRTH & TAKE SPONTANEOUS
RESPIRATION.
• IMMEDIATELY SUCTION THE SECRETIONS, WIPE MUCUS
FROM FACE, MOUTH AND NOSE.

12. APGAR SCORING

13. • TOTAL SCORE = 10
 NO DEPRESSION: 7 – 10
MILD DEPRESSION: 4 – 6
SEVERE DEPRESSION: 0 - 3

14. NEWBORN IDENTIFICATION
•NEWBORN IDENTIFICATION
BEFORE A BABY LEAVES THE
DELIVERY AREA, IDENTIFICATION
BAND WITH IDENTICAL NUMBERS
ARE PLACED ON THE BABY AND
MOTHER.

15. VITAMIN K
• VITAMIN K PREVENT NEONATAL
HEMORRHAGE DURING FIRST FEW
DAYS OF LIFE BEFORE INFANT IS ABLE
TO PRODUCE VITAMIN K
ADMINISTRATION.
• TERM INFANTS (1MG) – IM
• PRETERM INFANTS (0.5MG) - IM

16. ALTERNATIVE ROUTE:
•ORAL DOSE: 2MG ORALLY AT
BIRTH
•REPEAT DOSE (2MG) AT 3 – 5
DAYS AND AT 4- 6 WEEKS OF
AGE.

17. INITIATION OF BREAST
FEEDING
•BABIES CAN BE BREAST FED AS
SOON AS POSSIBLE WITH IN ONE
HOUR OF BIRTH OR AS SOON AS
THE AIRWAY IS CLEARED AND
THEY ARE BREATHING
NORMALLY.

18. DAILY ROUTINE CARE OF
NEONATES
• THE MAJORITY OF COMPLICATION OF
THE NORMAL NEWBORN MAY OCCUR
DURING FIRST 24 HOURS OR WITHIN 7
DAYS. SO CLOSE OBSERVATION AND
DAILY ESSENTIAL ROUTINE CARE IS
IMPORTANT FOR HEALTH AND
SURVIVAL OF THE NEWBORN BABY.

19. MAJOR GOALS
• ESTABLISH AND MAINTAIN HOMEOSTASIS
• STABILITY OF NORMAL PHYSIOLOGICAL STATUS.

20. DAILY ROUTINE CARE OF
NEONATES ARE:1. WARMTH
2. BREAST FEEDING
3. SKIN CARE & BABY BATH
4. CARE OF UMBILICAL CORD
5. CARE OF EYES
6. CLOTHING OF BABY
7. GENERAL CARE
8. TAKING ANTHROPOMETRIC MEASUREMENTS

21. 9. Protection from infection
10. Observation
11. Immunization
12. Follow up

22. WARMTH:
• WARMTH IS PROVIDED BY KEEPING THE
BABY DRY & WRAPPING THE BABY WITH
ADEQUATE CLOTHING IN TWO LAYERS,
ENSURING HEAD & EXTREMITIES ARE
WELL COVERED. BABY SHOULD KEPT BY
THE SIDE OF THE MOTHER.

23. BREAST FEEDING:
• THE 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 LABOR.
• THE ENERGY REQUIREMENT INITIALLY IS
55CAL/KG/DAY AND INCREASE TO ABOUT
120CAL/KG/DAY AT 1ST WEEK OF AGE.

24. • THE NEONATE LOSES ABOUT 7 TO 8% OF BODY WEIGHT
DURING 1ST WEEK AND REGAINS BODY WEIGHT FROM 10TH
DAY AND THEN CONTINUE TO GAIN WEIGHT.

25. SKIN CARE & BABY BATH:
• THE SKIN SHOULD BE CLEANED OFF BY GENTLE WIPING BEFORE
PRESENTED TO THE MOTHER. BABY BATH CA BE GIVEN AT
HOSPITAL OR HOME BY USING WARM WATER IN A WARM ROOM
GENTLY & QUICKLY.

26. CARE OF UMBILICAL CORD:
• KEEP THE CORD STUMP CLEAN & DRY.
• TOPICAL APPLICATION OF ANTISEPTICS IS USUALLY NOT
NECESSARY UNLESS THE BABY IS LIVING IN A HIGHLY
CONTAMINATED AREA.

27. CARE OF 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.

28. DAILY OBSERVATION OF
NEONATES
THE NEONATES SHOULD BE MONITORED FOR DANGER SIGNS.
THE DANGER SIGNS ARE:
1. POOR FEEDING, SUCKING AND SWALLOWING REFLEX
2. COLD TO TOUCH OR HAVING RISE IN BODY TEMP.
3. POOR ACTIVITY OR POOR RESPONSE TO STIMULATION
4. EXCESSIVE CRYING & IRRITABILITY
5. RAPID RESPIRATION, MORE THAN 60/MIN AND PRESENCE
OF CHEST RETRACTION.

29. 6. CENTRAL CYANOSIS
7. DROOLING OF SALIVA OR CHOCKING DURING FEEDING
8. LABORED RESPIRATION OR ABSENCE OF RESPIRATION
9. JAUNDICE APPEARS WITHIN 24 HOURS
10. NO URINE WITHIN 48 HOURS OR MECONIUM WITHIN 24
HOURS
11. CONVULSION
12. BLEEDING OR UMBILICAL DISCHARGE
13. DIARRHEA, VOMITING AND ABDOMINAL DISTENTION
14. INFECTION

30. THANK YOU