1. ESSENTIAL NEWBORN CARE

2. 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.

3. 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.

4. 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

5. Contd.. Clamp and cut the umbilical cord
Immediately dry the baby with a warm clean towel or piece of cloth

6. Contd.. Assess the baby’s breathing while drying
Wipe both the eyes with sterile gauze
Leave the baby between the mother’s breasts to start skin-to-skin care
Place an identity label on the baby

7. Contd..
Cover the baby’s head with a cap; cover the mother and baby with a warm cloth
Encourage mother to initiate exclusive breastfeeding

8. IMMEDIATE BASIC CARE Establishment of open airway & circulation
Maintenance of temperature
Identification of newborn
Vitamin K injection
Initiation of breastfeeding.

9. 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.

10. 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.

11. APGAR SCORING TOTAL SCORE = 10 No depression: 7-10
CRITERIA 1 2
Respiration
Absent
Slow, irregular
Good, crying
Heart rate
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: 7-10
Mild depression: 4-6
Severe depression: 0-3

12. 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

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

14. DAILY ROUTINE CARE OF NEONATES
Thermoregulation
Breastfeeding
Skin care & baby bath
Care of umbilical cord
Care of the eyes

15. Clothing of the baby
General care
Observation
Taking anthropometric measurement
Immunization
Follow up & advice

16. 1. THERMOREGULATION Mechanisms of heat loss Convection Evaporation
Radiation
Conduction

17. 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.

18. WARM ENVIRONMENT

19. BATH

20. CLOTH EFFECTIVELY

21. PRE WARM

22. DURING PROCEDURES AND TRANSPORTS

23. SKIN TO SKIN CONTACT-"Kangarooing"

24. APPLICATION OF OIL /PARAFFIN

25. Temperature recording
Axillary temperature
Rectal temperature
Skin temperature

26. 2. 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 labour.

27. 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.

28. 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.

29. 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.

30. 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.

31. 7. GENERAL CARE
Rooming –in
gentle approach
Aseptic technique
sensory stimulation
tender& loving care

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

33. 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

34. 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

35. 9. ANTHROPOMETRIC MEASUREMENT
Measure weight
Length
Head circumference
Chest circumference

36. 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.

37. 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.

38. PREVENTION OF INFECTIONS
CLEAN CHAIN
BREAST FEEDING
IMMUNIZATION
CARE OF SKIN, EYE AND CORD

39. ‘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

40. 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

41. NURSING DIAGNOSES
Ineffective airway clearance
Ineffective thermoregulation
Risk for injury
Risk for infection

42. Thank you