Neonatal care Neonatal Mortality Rate Causes 1 LBW

Neonatal care

Neonatal Mortality Rate Causes: 1. LBW and prematurity 2. Birth injury and difficult labour 3. Sepsis 4. Congenital anomalies 5. Hemplytic disease of the newborn 6. Condition of placenta and the cord 7. Diarrhea 8. ARI 9. Tetanus

Early neonatal death rate and its percentage share in IMR India and states Early NMR Percentage in IMR Total Rural Urba n India 25 28 15 53. 9 Jammu and Kasmir Madhya Pradesh Rajasthan Kerela Karnataka 30 34 33 5 22 32 17 69. 4 54. 6 49. 6

NMR and percentage share in IMR India and states NMR Total Rural Urba India J&K Madhya Pradesh Uttar Pradesh Karnataka Kerela 33 35 44 42 25 7 36 37 47 45 31 8 19 25 30 14 5 69. 3 82 70 70 66 53 70. 6 61. 9

Priority areas to improve newborn health Before and during pregnancy: • Delayed child bearing • Well timed, well spaced and wanted pregnancies • Free of drug abuse, alcohol and tobacco • TT and rubella • Prevention of HIV transmission

During pregnancy: • Early contact with health system including: - Birth and emergency preparedness - Early detection and tt of maternal complications - Fetal monitoring and timely intervention - Tetenus immunisation - Prevention and tt. Of anemia - HIV counselling and testing and PPTCT

During and soon after delivery: • Safe and clean delivery by skilled attendant • Emergency obstretic care • Early detection and prompt management of delivery and fetal complication • Warmth and cleanliness • Newborn resuscitation • Treatment of complications of the newborn • Exclusive breatfeeding • Special care for premature and small for date • PPTCT, and education on homecare, danger signs

During firdt month of life: • Early post natal contact • Protection, promotion and support of exclusive breastfeeding • Prompt detection and management of diseases • Immunisation • Protection of girl child

Post neonatal mortality: India is 14, Assam has 25 and kerela has 6 Infant Mortality rate India 47(2011) Pakistan 59 Myanmar - 48 China 13 Newzea. LAND , Usa, UK and Japan is 2 -6

MP and odisha , UP, -62 and kerela has 13 Causes: • Diarrhea, • ARI, • CD, • Malnutrition, • congenital anomalies and • accidents

NEONATAL CARE Cardiorespiratory functions Body temp Infection Feeding regimen Congenital abnormalities

Immediate care • • Clearing the airway Apgar score Care of the eyes Care of the skin Care of the cord Maintenance of body temperature Breastfeeding

Immediate care: Apgar Score Sign score 0 1 2 Heart rate Absent Over 100 Respiratory effort Absent Muscle tone Flaccid Reflex response None Slow (<100) Slow, irre gular Some flexion Grimace Colour Blue/pal Body Completely pink, extr pink mity blue Total score Severe depression 0 -3 Mild 4 -6 Good crying Active movement Cry No depression 7 -10

Neonatal examination