3 Objectives Demonstrate evidencebased daily care of the

3

Objectives Demonstrate evidence-based daily care of the newborn baby Counsel the mother how to look after her baby and to identify the danger signs Teaching Aids: ENC NC- 2

Routine care after birth Four major domains 1. Postnatal environment 2. Every day care of the baby 3. Looking for danger signs and giving treatment 4. Preparation for discharge Teaching Aids: ENC NC- 3

Postnatal environment Keep the room warm Ensure that the mother and baby are in a warm room (>250 C) Keep a radiant warmer or another heating device ready, if necessary Teaching Aids: ENC NC- 4

Postnatal environment Rooming-in Keep the baby in the same room with the mother, ideally in her bed Teaching Aids: ENC NC- 5

Every day care Four key elements 1. Breastfeeding 2. Ensure warmth 3. Cord care 4. Hygiene Teaching Aids: ENC NC- 6

Every day care 1. Breastfeeding Support exclusive breastfeeding on demand day and night Help mothers with breastfeeding difficulty; explain key points of attachment and positioning Assess breastfeeding before planning to discharge DO NOT discharge the baby if breastfeeding is not established Teaching Aids: ENC NC- 7

Every day care 2. Ensuring warmth The first day and later Dress the baby Wrap in soft dry clean cloth, cover head with cap Assess warmth every 4 hours by touching baby’s feet: If feet are cold, provide skin-to-skin contact and extra blanket; reassess Keep the room warm; if room not warm cover baby with a blanket or use skin-to-skin Teaching Aids: ENC NC- 8

Every day care 2. Ensuring warmth At home One more layer of clothes than older children / adults Keep room warm for baby During the day, dress or wrap baby At night, let baby sleep with mother Teaching Aids: ENC NC- 9

Every day care 3. Cord care Wash hands before and after cord care Put nothing on the stump Fold diaper below stump If the stump is soiled, wash with clean water and soap Ask mother to visit health facility, if umbilicus is red or draining pus / blood or adjoining skin is red Teaching Aids: ENC NC- 10

Every day care 4. Hygiene Wipe the face, neck, underarms DAILY Wipe the buttocks when soiled Give bath when necessary: Use lukewarm water for bathing Dry the baby thoroughly; dress and cover after bath Use cloth diaper on baby’s bottom to collect stool; wash hands after disposing DO NOT put anything in baby’s eyes or ears Teaching Aids: ENC NC- 11

Danger signs Early recognition and treatment Not feeding well Less active than before Fast breathing (>60/ min) Moderate or severe chest indrawing Grunting Convulsions Teaching Aids: ENC Floppy or stiff Temperature >37. 50 C or <35. 50 C Umbilicus draining pus or umbilical redness extending to skin. >10 skin pustules Bleeding from umbil. Stump NC- 12

Preparing for discharge Ensure immunization as per National schedule Age Vaccine Optional 0 -7 days BCG, OPV, Hep B 6 Weeks OPV, DPT, Hep B Hib 10 Weeks OPV, DPT, Hep B Hib 14 Weeks OPV, DPT, Hep B Hib 9 months Measles 15 months MMR 18 months DPT, OPV 5 years DT, OPV Teaching Aids: ENC Hib NC- 13

Preparing for discharge Feeding well suckling effectively 8 times in 24 hours, day and night No danger signs Mother confident of taking care of the baby Teaching Aids: ENC NC- 14

Follow up visit Assessment of growth & development Ensure immunization Early diagnosis and management of illness Health education Exclusive breastfeeding for 6 months Complementary Spacing Teaching Aids: ENC feeds after 6 months of family NC- 15

Summary: Care of normal neonates Four major domains 1. Postnatal environment 2. Every day care of the baby Breastfeeding Ensure warmth Cord care Hygiene 3. Looking for danger signs 4. Preparation for discharge Teaching Aids: ENC NC- 16