Early Essential Newborn Care Objectives 1 Immediate Newborn

Early Essential Newborn Care

Objectives 1. Immediate Newborn Care • The First 90 minutes 2. Essential Newborn Care • From 90 min to 6 hours 3. Care Prior to Discharge • After the first 90 minutes 4. Care After Discharge • Discharge to 7 days 5. Additional Care • Newborn Resuscitation

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 baby’s arrival? What basic equipment will you need?

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

Immediate Newborn Care • Clean cloths, towels, blanket, cord ties and blades (ref p 37) • Wash hands with soap and water • Check resuscitation equipment • Check room temperature (ref p 1 -3)

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 p 1)

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

Immediate Newborn Care What do you look for? q. Breathing or crying YES q. Good muscle tone YES q. Colour pink YES q. Breathing or crying NO q. Good muscle tone NO q. Colour pink NO Skin to skin contact Neonatal Resuscitation Ref. p 2

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?

Cord Care Wait 3 minutes or until the cord stops pulsating before cutting the cord. (Ref. p 4) • 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. p 8)

Immediate Newborn Care Properly timed cord clamping

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?

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

Immediate Newborn Care Skin to skin contact

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

Immediate Newborn Care Initiate breastfeeding

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

Summary: Early Essential Newborn Care • Dry baby with a clean cloth, keep warm, examine • Properly time cord clamping • Maintain skin-to-skin contact • • Wait for up to 3 mins or until pulsations stop. Keep umbilical cord clean and dry. 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

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)