Essential Newborn Care

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Essential Newborn Care

• MARY ANNE L. ILAO, M.D.,FPPS,DPSNbM
• 2010

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III. Care of the Newborn Prior to Discharge
(after the first 90 minutes)MARY ANNE
L.ILAO,MD,FPPS,DPSNbM
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After the 90 minutes of age, but prior to
discharge

• Support unrestricted, per demand breastfeeding,
  day and night
• Ensure warmth of the baby
• Washing and bathing (Hygiene)
• Sleeping
• Examine the newborn baby

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Look for Danger Signs

• Signs of serious illness
• Convulsion
• Difficulty feeding
• Temperature of 37.5ºC or lt35.5ºC
• Movement only when stimulated
• Respiratory rate of 60 breaths per minute or more
• Severe chest in-drawing
• Jaundice

Young Infant Child Study II Lancet 2008
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If Danger Signs?

• Sign of POSSIBLE SERIOUS ILLNESS
• TREAT AND ADVISE
• Give first dose of 2 IM antibiotics
• Refer baby urgently to hospital

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Look for signs of jaundice and local infection

• Look at the skin. Is it yellow?
• Refer urgently to hospital, if jaundice present
  
• - on face of lt24 hour old newborn
• - on palms and soles of 24 hour old infant

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Look for signs of jaundice and local infection

• Look at the eyes
• Are they swollen and draining pus?
• If present, consider gonococcal eye infection.
• Give single dose of appropriate antibiotic for
  eye
• infection.
• Teach mother to treat eyes.
• Follow-up in two days.
• If no improvement or worse, refer urgently to
  hospital.
• Assess and treat mother and her partner for
  possible
• gonorrhea.

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Cord Care

• Explain to the mother that she should seek care
  if the umbilicus is red or draining pus.
• Teach the mother to treat local umbilical
  infection three times a day .
• - Wash hands with clean water and soap.
• - Gently wash off pus and crusts with
  boiled and cooled water and soap.
• - Dry the area with clean cloth.
• - Paint with gentian violet
• - Wash hands.
• If no improvement in 2 days, or if worse, refer
  urgently to the hospital

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Discharge Instructions

• Advise the mother to return or go to the
  hospital if
• with danger signs
• Routine check-up
• Additional follow up visits appropriate to the
  babys problem.
• Advise for newborn screening

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• Postnatal visit 48 72 hours of life or
• 7 days of life
• Immunization visit at 6 weeks old

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Discharge Instructions

• Schedule Routine Visits as follows

Postnatal visit Within the 1st week preferably within 2-3 days
Immunization visit (if BCG and HB-1 given in the 1st week of life At age 6 weeks
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IV. Care after discharge to 7 days

• Support unrestricted, per demand exclusive
  breastfeeding, day and night
• Ensure warmth for your baby
• Look for danger signs and seek care appropriately

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V. Additional Care
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A. Newborn Resuscitation

1. Start resuscitation if the newborn is not
   breathing or is gasping after 30 seconds of
   drying or before 30 seconds if the baby is
   completely floppy and not breathing.
2. Clamp and cut the cord immediaetely.
3. Call for help.
4. Transfer the newborn to a dry, clean and warm
   surface.
5. Inform the mother that the newborn needs help to
   breathe
6. Perform NB resuscitation.

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B. Additional Care of A Small Baby or Twin

• If the newborn is delivered 1 month early of
  is visibly small (1501 2499g
• Area Of Concern
• Warmth
• Feeding Support
• Kangaroo Mother Care
• Discharge planning

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C. Dealing with Feeding Problems

• Area of Concern Mother and Infant Separation
• Action use alternative feeding methods
• Teach the mother hand expression of breastmilk
• Feeding by cup

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VI. Enabling the Environment

• Prepare workplace for deliveries
• Restock delivery area
• Practice General standard precautions and
  cleanliness
• Processing Instruments and Other Items

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Essential Newborn Care

• Essential interventions in the first 90 minutes
  of life and up to 7 days of life
• Emphasizes a core sequence of actions, performed
  methodically, step-by-step
• Some time-bound but doable even by a single
  health worker caring for both mother and newborn

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Immediate Newborn Care

• Call out time of birth.
• Deliver the baby prone on the mothers abdomen
• Dry the newborn thoroughly. Check breathing while
  drying.
• Remove wet cloth.
• Position the newborn on the mothers abdomen in
  skin-to-skin contact. Cover the back with a dry
  blanket.

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Examine page 5 of DOH Newborn Care Protocol
Phil. ENCC
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Immediate Newborn Care

• Remove first set of gloves.
• Clamp and cut the cord when pulsations have
  stopped ( 1-3 minutes)
• Place the newborn on the mothers chest in
  skin-to-skin contact
• Cover the babys head with a hat. Cover the
  mother and baby with a warm cloth.
• Initiate breastfeeding while maintaining
  skin-to-skin contact.
• Place identification band on ankle.

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Examine page 5 of DOH Newborn Care Protocol
Phil. ENCC
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• Together, we can DoH it
• before 2015

2015
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HAVE A NICE DAY