Neonatal Care

It is very important to keep babies warm and identify problems early.
A baby begins to lose heat immediately after birth. Heat loss can be prevented by the following steps:
          1. Baby should be dried immediately after birth and towels or clothing should be removed.
          2. Baby should be placed between breasts.
         3. Baby and mother should be covered with a clean, dry cloth or blanket. Baby’s head should be                covered with a cap, and both hands and feet with socks.
        4. Delivery room temperature should be maintained between 25℃/77℉ to 28℃/82.4℉.
Skin-to-skin care should begin at birth and should continue for at least two hours. During the first two hours, skin-to-skin care should be interrupted only for essential care, such as weighing, and should resume as soon as possible. Interruptions should be as brief as possible, and only areas necessary for care should be uncovered.
Rapid breathing after birth often occurs while normal lung fluid is being absorbed. Rapid breathing usually resolves by one or two hours after birth. However, rapid breathing that continues may be caused by a more serious problem that required advanced care. All babies should be monitored every 15 minutes for rapid breathing (>60 breaths/min) and chest in-drawing until the time of the first two hours after birth. This can be done by observation alone without handling if the baby appears normal.

Starting breastfeeding soon after birth helps mothers to provide enough milk later and establishes successful and exclusive breastfeeding. Early breastfeeding encourages bonding between mother and baby and it helps the uterus contract and reduces maternal bleeding. Breast milk, especially colostrum contains antibodies that protect babies against infection. It also provides nutrition, and is easily digestible.
Babies should receive only breast milk for the first 6 months (180 days). Babies who receive other food or liquids before six months of age are more likely to develop diarrhea, ARI and malnutrition. Counsel expectant mothers and family members about breastfeeding during antenatal visits and discuss it again before delivery.
care, such as weighing, and should resume as soon as possible. Interruptions should be as brief as possible, and only areas necessary for care should be uncovered.
Rapid breathing after birth often occurs while normal lung fluid is being absorbed. Rapid breathing usually resolves by one or two hours after birth. However, rapid breathing that continues may be caused by a more serious problem that required advanced care. All babies should be monitored every 15 minutes for rapid breathing (>60 breaths/min) and chest in-drawing until the time of the first two hours after birth. This can be done by observation alone without handling if the baby appears normal.To encourage early breastfeeding, mother and babies need to be kept together. Babies are often alert immediately after birth and will move towards the mother’s breasts but may not suck.

Provide Cord Care
Application of 7.1% Chlorhexidine on recently cut umbilical cord is a part of the essential newborn care package. It is a proven intervention to reduce newborn morbidity and mortality. Single application should be followed by dry cord care. No other antiseptic or other substance should be used after application of 7.1% Chlorhexidine.
Application of 7.1% Chlorhexidine on the newborn umbilical cord is application for all newborn irrespective of the place of delivery. If not applied immediately, it should be applied within 48 hours of birth.

Examine The Baby

Newborns will be examined within 90 minutes of birth to assess the wellbeing and detect any anomaly. The history and examination should include the following components:

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• Breathing should be checked every 15 minutes, noting especially chest in-drawing, grunting, and a slow or rapid rate of breathing after birth
• Temperature should be checked: hand, feet and abdomen should be felt for warmth if the baby feels cold to touch
• Feeding should be checked and breastfeeding should be observed
• Cord stump should be observed
• Skin color should be checked
• Activity and body movement should be checked
• Body weight should be measured
• Heart murmurs, jaundice and oral thrush should be checked
• The following areas should be checked for abnormalities in a systemic way: head, face, mouth and palate, chest, abdomen, genitalia, anus, limbs, back and skin
• Should be asked for frequency of passing urine and meconium

Criteria of a Normal Newborn:

• Respiratory Rate: 30-59 breaths/min
• Heart Rate: 100-160 beats/min
• Temperature: 36.5℃-37.5℃/97.5℉-99.5℉ (axillary, recorded over 3 minutes)
• Birth Weight: 2500 gm to 4000 gm
• Color: Pink but slight peripheral cyanosis for a few hours after birth
• Movement: Spontaneous, equal, arms and legs are flexed
• Cord Stump: No bleeding or drainage
• Feeding: Able to breastfeed soon after birth
• No apparent congenital malformation
• No birth trauma
• Passes meconium with 24 hours of birth
• Passes urine within 48 hours of birth