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STEPS IN ESSENTIAL NEWBORN CARE

Drying and wrapping the newborn baby. Step 1 Deliver the baby onto the mother’s abdomen or a dry warm surface close to the mother. Continue to support and reassure the mother. Tell her the sex of the baby and congratulate her. Step 2 Dry the baby’s body with a dry warm towel as you try to stimulate breathing. Wrap the baby with another dry warm cloth and cover the head. Dry the baby well, including the head, immediately and then discard the wet cloth.

Rub up and down the baby’s back. Thus. both sides of the chest will rise and fall equally at around 30– 60 times per minute. check if the baby is: . Then wrap the baby with another dry cloth and cover the head. if not breathing. gasping or there are less than 30 breaths per minute. then resuscitate. Drying often provides sufficient stimulation for breathing to start in mildly depressed newborn babies. Step 3 Assess breathing and colour. white substance which may be on the skin) as it protects the skin and may help prevent infection.Wipe the baby’s eyes. assess its breathing. As you dry the baby. Do your best not to remove the vernix (the creamy. warm cloth. using a clean. If a baby is breathing normally.  You will remember that you learned how to manage a newborn baby with birth asphyxia in Study Session 7 of the Labor and Delivery Care Module.

Functional resuscitation equipment should always be ready and close to the delivery area since you must start resuscitation within one minute of birth. quickly clamp or tie and cut the cord. leaving a stump at least 10 cm long for now and then start resuscitation immediately. If the baby needs resuscitation. or Not breathing at all. you can assess breathing and colour and take urgent action if necessary. while you are delivering the baby onto the mother’s abdomen and drying the baby. It may sound as if you have a lot to do in one minute. That is. Resuscitation of a baby who is not breathing must start within one minute of birth. .    Breathing normally Having trouble breathing Breathing less than 30 breaths per minute. but the steps described here are ones that you can take simultaneously.

cut the cord immediately. If the baby needs resuscitation.Tying and cutting the cord.2). wait for 7–3 minutes before cutting the cord. Step 4 Tie the cord two fingers’ length from the baby’s abdomen and make another tie two fingers from the first one (Figure 2. Cut the cord between the first and second tie. . If not.

 Tie the second one four fingers away from the baby’s abdomen. 3. 2. or sterile scissors. the thread you use to tie the cord must be clean. Cut the cord between the ties:  Use a new razor blade. Step 5 .  Be careful not to cut or injure the baby. Tie the cord securely in two places:  Tie the first one two fingers away from the baby’s abdomen.1. Do not put anything on the cord stump.  Make sure that tie is well secured.  Use a small piece of cloth or gauze to cover the part of the cord you are cutting so no blood splashes on you or on others. Either cut away from the baby or place your hand between the cutting instrument and the baby. or a boiled one if it has been used before.

table. • Conduction: when the baby is placed naked on a cooler surface. tables. weighing scales.Place the baby in skin-to-skin contact with the mother. The newborn loses heat in four ways (see FIGURE below): • Evaporation: when amniotic fluid evaporates from the skin. • Radiation: when the baby is near cool objects. without actually being in contact with them. cold bed. . cabinets. walls. • Convection: when the baby is exposed to cool surrounding air or to a draught from open doors and windows or a fan. such as the floor. cover with a warm cloth and initiate breastfeeding.

After 24 hours. 3. if the temperature is stabilized. Put the baby on the mother’s chest. Cover both mother and baby together with a warm cloth or blanket. 1.The warmth of the mother passes easily to the baby and helps stabilize the baby’s temperature. Cover the baby’s head. The baby should not be bathed at birth because a bath can cool the baby dangerously. . 2.  The first skin-to-skin contact should last uninterrupted for at least one hour after birth or until after the first breastfeed. for skin-to-skin warmth. the baby can have the first sponge bath. between the breasts.

Make sure the baby has a good position.4).Initiating immediate breastfeeding. nutrition to grow. and antibodies to fight infection. Help the mother begin breastfeeding within the first hour of birth (Figure 2. 2. For optimal breastfeeding you should do the following: 1. Do not limit the length of time the baby feeds. the mother should immediately start breastfeeding. attachment. Help the mother at the first feed. early and unlimited breastfeeding gives the newborn energy to stay warm. and is sucking well. . If everything is normal.

Appropriate clothing/bedding. 8. Mother and baby together. Immediate drying. Warm transportation for a baby that needs referral. 2. Bathing and weighing postponed. Step 6 Give eye care (while the baby is held by its mother). 7. 1. 5. 4. 3. Warm the delivery room. . Skin-to-skin contact at birth. Breastfeeding. 6.The steps to keep the newborn warm are called the warm chain.

and then using tetracycline 1% eye ointment: 1.Putting tetracycline eye ointment into the eyes of the newborn baby. give the newborn eye care with an antimicrobial medication. wash your hands. Eye care protects the baby from serious eye infection which can result in blindness or even death. Hold one eye open and apply a rice grain size of ointment along the inside of the lower . The steps for giving the baby eye care are these: First. Shortly after breastfeeding and within one hour of being born.

You will be learning more about safe injection techniques in your practical skills training sessions. 3. Step 7 Give the baby vitamin K. Make sure not to let the medicine dropper or tube touch the baby’s eye or anything else (see Figure 2. Then press the plunger to inject the medicine. Do not rinse out the eye medication.5).eyelid. with the other hand stretch the skin on either side of the injection site and place the needle straight into the outside of the baby’s upper thigh (perpendicular to the skin). 4. Repeat this step to put medication into the other eye. There is also a study session on routes of injection in the Immunization Module. 1 mg by intramuscular injection (IM) on the outside of the upper thigh (while the baby is held by its mother). After following correct infection prevention steps. Wash your hands again. 2. Step 8 .

500 gm must be referred urgently to a hospital. Weigh the baby an hour after birth or after the first breastfeed. If the baby weighs less than 1. Newborn babies who weigh less than 1.Weigh the baby. .500 gm you must refer the mother and baby urgently.