(Until 1 hour after birth). Objectives To describe evidence-based routine care of a newborn baby at...
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Transcript of (Until 1 hour after birth). Objectives To describe evidence-based routine care of a newborn baby at...
(Until 1 hour after birth)
ObjectivesObjectivesTo describe evidence-based routine care of a newborn baby at and soon
after birth
NC- 2Teaching Aids: ENC
FOUR basic needs at birth:
• Thermal protection• Normal breathing• Mother’s milk• Protection from infection
Basic needs of a baby at birthBasic needs of a baby at birth
NC- 3Teaching Aids: ENC
Care of normal baby at birth Care of normal baby at birth
The birth of Meghna
NC- 4Teaching Aids: ENC
Care at birth Care at birth
1. Call out time of birth
2. Receive the baby onto a warm clean towel and place on
mother’s chest
3. Clamp and cut the umbilical cord
4. Dry the baby with a warm, clean towel or piece of cloth
5. Assess baby’s breathing while drying
NC- 5Teaching Aids: ENC
Steps
Dry the baby Dry the baby immediately after immediately after birthbirth
Care at birth… Care at birth…
NC- 6Teaching Aids: ENC
Care at birth… Care at birth…
6. Wipe both eyes (separately) with sterile gauze pieces
7. Put the baby between mother’s breasts for skin-to-
skin contact
8. Place an identity label on the baby
9. Cover mother and baby with warm cloth; put a cap on
the baby’s head
10. Initiate breastfeeding
NC- 7Teaching Aids: ENC
Care at birth… Care at birth…
Immediate Immediate skin-to-skin skin-to-skin contact & contact & breastfeedingbreastfeeding
NC- 8Teaching Aids: ENC
Ensuring warmth at the time of Ensuring warmth at the time of delivery: ‘Warm chain’delivery: ‘Warm chain’
NC- 9Teaching Aids: ENC
‘‘Warm chain’: At deliveryWarm chain’: At delivery
At delivery: 1. Ensure the delivery room is warm (25° C), with no
draughts.
2. Dry the baby immediately; remove wet cloth
3. Wrap the baby with clean dry cloth
4. Keep the baby skin-to-skin with mother
NC- 10Teaching Aids: ENC
Assess baby’s breathing at the time of drying: If the baby is crying vigorously or
breathing adequately, then no intervention is needed
if the baby is not breathing or gasping, then skilled care in the form of positive pressure ventilation etc. (i.e. RESUSCITATION) would be required
Helping the baby breatheHelping the baby breathe
NC- 11Teaching Aids: ENC
1. Keep the baby clothed and wrapped; cover the head
2. Postpone bathing particularly for small babies
3. Keep baby close to the mother4. Use kangaroo care for stable LBW
babies5. Show mother how to avoid
hypothermia and to recognize6. Initiate breastfeeding
NC- 12Teaching Aids: ENC
‘‘Warm chain’: After deliveryWarm chain’: After delivery
Keep the baby in skin-to-skin contact between mother’s breasts immediately after drying
Help the mother in her first few attempts to breastfeed
Make her and the baby comfortable Explain and show her proper positioning
and attachment
Initiating breastfeedingInitiating breastfeeding
NC- 13Teaching Aids: ENC
Ensure skin to skin contact after birth
NC- 14Teaching Aids: ENC
Baby shows feeding cues…
NC- 15Teaching Aids: ENC
..and is ready for breastfeeding
NC- 16Teaching Aids: ENC
Prevention of infections: ‘Clean Prevention of infections: ‘Clean chain’chain’
At delivery: WHO five cleans Clean
1. Hands of attendants (washed with soap)
2. Surface for delivery
3. Cutting instrument for cord(i.e. razor, blade)
4. String to tie cord
5. Cloth to wrap baby and mother
NC- 17Teaching Aids: ENC
‘‘Five cleans’ to prevent infectionFive cleans’ to prevent infection
Prevention of infections: ‘Clean Prevention of infections: ‘Clean chain’chain’
After delivery1. Hand washing before handling the baby
2. Exclusive breastfeeding
3. Keep the cord clean and dry; do not apply anything
4. Use a clean cloth as a diaper/napkin
5. Hand wash after changing diaper/napkin
NC- 19Teaching Aids: ENC
Apply a sterile tie tightly around cord at 2 cm and 5 cm from the abdomen
Cut between the ties with a sterile instrument
Observe for oozing blood every 15 minutes; if blood oozes, place a second tie
Do not apply any substance to the stumpDO NOT bind or bandage stumpLeave stump uncovered
Cord careCord care
NC- 20Teaching Aids: ENC
Clean eyes immediately after birth with swab soaked in sterile water
Use separate swabs for each eye; clean from medial to lateral side
Give prophylactic eye drops within 1 hour of birth (as per hospital policy)
Do not put anything else in baby’s eyes
Eye careEye care
NC- 21Teaching Aids: ENC
Do not leave the mother and baby alone in the first hour after birth
Monitor three parameters every 15 minutes: Breathing: Grunting, chest in-drawing, fast
breathing (>60/min)
Warmth: Check if the baby’s feet are cold (by using your hands)
Color: Evaluate the color of trunk and extremities
Monitoring the babyMonitoring the baby
NC- 22Teaching Aids: ENC
Special situationsSpecial situations
Mother has HIV/AIDS1. Follow universal precautions as with any other delivery2. Baby can have immediate skin-to-skin contact as any
other mother and baby3. Breastfeeding can begin when the baby is ready*4. If mother chooses replacement feeding, prepare
formula for the first few feeds5. All other care (including cord care and eye care)
remain the same
NC- 23Teaching Aids: ENC
Key messages Key messages
Four basic needs at birth: warmth, normal breathing, breastfeeding, prevention of infections
Ensure warmth by skin to skin contact with mother’s chest/abdomen
Help the mother to initiate early breastfeeding Follow ‘WHO five cleans’ to prevent infections
NC-Teaching Aids: ENC 24