CARE OF NEW BORN

BASIC CARE OF NORMAL NEONATES

After checking the vitals the following should be attended to:

WARMTH:
The baby should continue to be kept under warmer. Many a time, after initial
resuscitation, the baby may be left outside the warmer & the baby may become
hypothermic due to fans, air conditioners & improper covering. RAPID
GESTATIONAL AGE ASSESSMENT
A quick assessment of the gestational age should be made as soon as the baby is
comfortable & can be done using BALLARD SCORE
Detailed gestational age assessment can be done in the postnatal ward or nursery
at around 24 hours of age.

IDENTIFICATION:
Two identical bands carrying details of mothers name, hospital number,
neonatal sex, date & time of birth should be prepared.
One tag should be tied around the infant’s wrist & other around the wrist of
the mother.
At this point, the mother should be asked to verify the information on the
baby’s band. If she is anesthetized, some other responsible family member
should verify the same.
The labor room register should be updated & these details must be verified
once again before the baby leaves the labor room.
CORD CARE:
The cord & its base should be thoroughly cleaned with povidine- iodine
solution before tying the ligature or applying a cord clamp
The clamp should be applied at least 3 cm above the skin margin
After cutting the cord with sterile scissors, the raw surface should be inspected
for bleeds & the presence of two arteries & one vein.
The cord should be examined once again for bleeding before the baby leaves
the labor room.
 EYE CARE:
Both eyes should be wiped clean, from the medial to the lateral side, with two
separate sterile cotton balls.
Need for prophylaxis & the drops used; depend upon the prevalent local
infections.
SKIN CARE
The baby should be cleaned off all blood, amniotic fluid & meconium before
presenting to the mother.
No attempt should be made to remove the vernix as it will fall off
spontaneously in a day.
The baby should not be given bath in the labor room.
VITAMIN K
All babies should receive 1 mg of vitamin K, intramuscularly, at birth. This should be
given within a No.26 needle at the anterolateral aspect of the thigh.
MEASUREMENT:
Birth weight should be taken immediately the average head circumference is
33-35 cm.
Length can be taken with infantometer. The average length at birth is 50cm.
BONDING:
As the baby is usually alert in the 30-60 minutes after birth, he should be
handed over to the mother as soon as possible.
At this point, every attempt should be made to suckle the baby at the mother’s
breast.
2. TRANSFER FROM LABOR ROOM
The baby’s vital signs should be checked & recorded.
The baby should be covered well, including the head.
Identification should be crosschecked with the postnatal ward sister, before handing
over the baby.

CARE OF BABY ON RADIANT WARMER

DEFINITION:

Radiant warmers are used to keep babies in a thermoneutral zone.

PURPOSE

To maintain body temperature.

To assist in baby’s procedure (i.e.) portable x-ray, ventilator, ICD,
resuscitation, intubation.
To change position.
For continuous observation.
To assess the child
frequently.
To detect any deviation from normal.
SCOPE

Babies who are under radiant warmers for care.

EQUIPMENTS NECESSARY

Open care radian warmer.

Assembled with connections of oxygen flow, suction apparatus, oxygen hood,
and pulse-oximeter and skin temperature probe, atmospheric temperature
probe.
Stethoscope, Digital Thermometer

ESSENTIAL STEPS IN PROCEDURE

Sl. No PROCEDURE RATIONALE

1 Wash hands. To prevent from cross infection.

2 Assemble the equipments. To minimize time, material and

energy.
3 Switch on the warmer and warm up the sheets to To prevent from hypothermia.
receive the baby.

4 Receive the baby and fix the temperature probe To know the accurate temperature
on abdomen or thigh. of the baby.

5 Stabilize the baby and keep the warmer in servo There is no set temperature in the
mode and monitor the temperature of the baby. manual mode.

6 Respond to the alarm immediately and continues To see what is wrong immediately
monitoring is essential. and to carry out the necessary
intervention.

7 Provide skin care and change the placement of To maintain skin integrity.
the probe every q6h

8 Turn the position of the baby every q2h. Aids in observation.

9 Record all the activities in the case file. To maintain the record
appropriately.

10 Report any untoward sign of the child To aid in the early recovery of the
immediately to doctor. child.