ESSENTIALNEWBORN CARE

SHEBA SUSAN BENNY

CONTENTS OF THIS SECTION• Introduction

• Definition

• Elements in essential newborn care

• Components in essential newborn care

• Early care and later care of newborn

• Care of newborn with problems

INTRODUCTIONIn India,

2/3 under 5 deaths (66%) happens in 1st

year of life2/3 infant deaths happens in 1st month /

neonatal period¾ neonatal deaths happens in 1st day of life

• Birth asphyxia• Infection• Hypothermia• Feeding problems

ELEMENTS• BASIC PREVENTIVE NEWBORN CARE

– Care before and during pregnancy

– Clean delivery practices

– Temperature maintenance

– Eye & cord care

– Early & exclusive breast feeding

• Early detection of problems and appropriate referral

• Treatment of key problems such as sepsis and birth asphyxia

COMPONENTS

PHASES

Before conception

Antenatal period

During birth &

Immediate postnatal

Postnatal period

1. Before conception

• Adequate care of a girl child, including nutrition, education & health care

• Immunization, including TT

• Folate supplementation

• Birth spacing

• Prevention of STD’s

• Avoidance of drug & substance abuse

2. Antenatal period

• At least 4 antenatal visits

• TT injection

• Iron & folic acid supplements

• Adequate nutrition intake

• Adequate rest

• Iodized salt consumption

• Delivery preparations

• Identification of problems in mother & treatment

3. During birth & early newborn period

• Clean delivery practices & skilled birth attendant

• Early newborn care– Respiratory system care

– Temperature regulation

– Proper breastfeeding technique

– Prevention of infection

• Detection of danger signs &

appropriate treatment

Early newborn carePrevention of infectionClean handsClean perineumNothing unclean introduced vaginallyClean delivery surfaceCleanliness in cord clamping & cutting Cleanliness in cord careEye careHand hygiene before & after handling

baby

Breathing initiation & respiratory care

If baby is crying

• Receive baby in a dry, clean, warm towel

• Dry the baby, but don’t wipe off vernix

• Replace wet towel with clean, dry, warm towel

• Cut cord within 1-3 minutes

If baby is not crying

• Look for meconium1. If meconium absent

o Dry the baby- drying up by warm clean cloth stimulates & helps in initiation of breathing, baby starts crying

2. If meconium presento Gentle suction to remove mucus and meconium

from mouth & nose

If baby still not crying

• Cut the cord

• Place on a flat, firm warm surface

• Position baby with neck slightly extended

• Suction mouth & then nose

• Stimulate and reposition

……………… If baby still not crying

Contd…..

• Resuscitate the baby to prevent hypoxemia, brain damage & death

Temperature regulation

• Deliver in a warm room

• Dry baby thoroughly & wrap in a warm, clean cloth.

• Wrap head & body completely

• Give to mother as soon as possible

• Check warmth by feeling newborn’s feet every 15 minutes

• Bathe only after 24hrs

• Maintain temp of 36.5-37.5 degree C

Feeding technique & exclusive breastfeeding

• Early contact between mother & newborn enables breastfeeding

• Best practices are:

– No prelacteal feeds

– Colostrum is very important

– Give first feed within 1 hour of life

– Correct position to enable good attachment

– On demand feeds

Danger signs of newborn• Poor sucking/not sucking• Lethargy• Fever / hypothermia• Respiratory distress• Convulsions• Vomiting• Severe umbilical infection• Abdominal distension• Jaundice reaching palms & soles• Swollen eyelid with pus discharge• Extensive pustules or skin infection

Other care during 1st 6 hours

Other care contd….

4.Postnatal period (after 6hrs)

• Consultation with mother & baby within day 3

• Continue essential preventive newborn care

• Bathe

• Immunization

• Appropriate monitoring

• Detect danger signs

CARE OF NEWBORN WITH PROBLEMS

• Low birth weight & preterm babies are at increased risk of hypothermia, hypoglycemia, & poor growth

• Main principles while caring them are:– Warmth

– Feeding

– Detection & management of complication

• Babies with any other condition needs neonatal centre care

SUMMARY

Essential newborn care is a comprehensive strategy, designed to improve the health of newborns through interventions before conception, during pregnancy, at & soon after birth & in postnatal period

REFERENCE

• WHO ‘PRACTICAL GUIDE FOR CARE IN NORMAL BIRTH’, GENEVA

• USAID, ‘BEST PRACTICES IN MATERNAL & NEWBORN CARE-A LEARNING RESOURCE PACKAGE’, 2008, BALTIMORE

• INDIRA NARAYANAN & MANDY ROSS ‘THE COMPONENTS OF ESSENTIAL NEWBORN CARE’, USAID