SYSTEMS PLUS COLLEGE FOUNDATION

MacArthur Highway, Balibago, Angeles City

COLLEGE OF NURSING

JOURNAL REPORT
in

Delivery Room
(Institution/ Area)

In partial Fulfillment of the Requirements

In the Nursing Care Management 107 – RLE

Submitted by:

Nickaela C. Calalang

Submitted to:

Junefaith Elese C. Neo

Clinical Instructor, MSN

November 3, 2020
 I. INTRODUCTION:

This topic is all about the care that we give as a nurse to the new-born babies
Studies have shown that many newborn lives can be saved by the use of interventions that require simple
technology. The majority of these interventions can be effectively provided by a single skilled birth attendant
caring for the mother and the newborn. Care of all newborns includes immediate and thorough drying, skin
to skin contact of the newborn with the mother, cord clamping and cutting after the first minutes after birth,
early initiation of breastfeeding, and exclusive breastfeeding. Newborns who do not start breathing on their
own by one minute after birth should receive positive pressure ventilation with room air by a self-inflating
bag and mask.

After the first hour of life, newborns should receive eye care, vitamin K, and recommended immunizations
(birth dose of OPV and Hepatitis B vaccine). They should be assessed for birth weight, gestational age,
congenital defects and signs of newborn illness. Special care should be provided for sick newborns, those
who are preterm and/or low birth weight, and those who are exposed or infected by HIV or have congenital
syphilis.
 II. JOURNAL / ARTICLE:

Initial Care of the Newborn

By  Deborah M. Consolini   , MD, Sidney Kimmel Medical College of Thomas Jefferson
University

Last full review/revision Sep 2019| Content last modified Sep 2019

The successful transition of a fetus, which is immersed in amniotic fluid and totally
dependent on the placenta for nutrition and oxygen, to a crying, air-breathing baby is a
source of wonder. Healthy newborns (age birth to 1 month) and infants (age 1 month
to 1 year) need good care to ensure their normal development and continued health.

Immediately after the normal delivery of a baby, the doctor or nurse gently clears
mucus and other material from the mouth, nose, and throat with a suction bulb. The
newborn is then able to take a breath. Two clamps are placed on the newborn's
umbilical cord, side by side, and the umbilical cord is then cut between the clamps.
The newborn is dried and laid carefully on the mother's abdomen with skin-to-skin
contact or on a sterile, warm blanket. Not all deliveries follow a standard pattern. For
example, some women need to have a cesarean delivery or have complications of
labor and delivery. In some cases, the newborn requires some special attention by the
medical staff after birth.

Cutting the Umbilical Cord: Soon after a baby is born, two clamps are placed on the
umbilical cord, and the cord is cut between the clamps. The clamp on the cord's stump
is removed within 24 hours after birth. The stump should be kept clean and dry. Doctors
no longer recommend applying alcohol or other antiseptic solutions to the stump. The
stump falls off on its own in a week or two.

The doctor examines the newborn for any obvious abnormalities or signs of distress. A
full physical examination comes later (typically within 24 hours of birth). The newborn's
overall condition is recorded at 1 minute and at 5 minutes after birth using the Apgar
score. A low Apgar score is a sign that the newborn is having difficulty and may need
extra assistance with breathing or blood circulation. Once the newborn is stable, the
nurses obtain the head circumference, weight, and length (see also Physical Growth
of Infants and Children).

Keeping the newborn warm is critical. As soon as possible, the newborn is wrapped in
lightweight clothing (swaddled), and the head is covered to reduce the loss of body
heat. A few drops of an antibiotic, such as erythromycin, tetracycline, or silver
nitrate or, in some countries, povidone iodine, are placed into the eyes to prevent
infection from any harmful organisms that the newborn may have had contact with
during delivery.

Immediately after a normal birth, the parents are encouraged to hold their newborn.
Some experts believe that early physical contact with the newborn helps establish
bonding. However, parents can bond well with their newborn even when the first hours
are not spent together. The mother and newborn usually recover together in the
delivery room. If the delivery is in a birth center, the mother, father or mother's partner,
and newborn remain together in the same room. Mothers who are breastfeeding put
their newborn to their breast within the first 30 minutes after delivery. Breastfeeding
stimulates oxytocin, a hormone that helps the mother's womb to heal and promotes
development of the milk supply. Once transported to the nursery, newborns are placed
on their back in a small crib and kept warm. Because all babies are born with low
levels of vitamin K, a doctor or nurse gives an injection of vitamin K to prevent
bleeding (hemorrhagic disease of the newborn).

About 6 hours or more after birth, newborns are bathed. The nurse tries not to wash
off the whitish greasy material (vernix caseosa) that covers most of the newborn's skin
because this material helps protect against infection.
SUMMARY
This article tackles the initial care for new-born infants. It is believed that for a
new-born to be called as a healthy baby it should be dependent on the placenta
for nutrition and oxygen, a crying and breathing new-born after the delivery.
Immediate care after the normal delivery is also needed to make sure that the
baby would not be affiliated with any infectious disease due to delivery, the
doctor or nurse should be responsible for the care of the new-born once the
baby’s out they should remove any destructive material from the mouth, nose
and the throat of the baby so he will able to breathe. Cutting the umbilical cord is
also important and should be performed carefully with a sterile cord clamp. After
that the nurse will dry the new-born and place it on the mother’s abdomen or also
called Kangaroo care so that the baby will be kept warm and it will support early
breastfeeding. But not all deliveries follow the standard procedure; it has an
exception to the mothers who need to have a cesarean delivery or in a critical
situation. After the delivery the doctor should monitor the newborn for at least 24
hours for any abnormalities or distress. It can be measured using an Apgar score,
low score means immediate action for the medical staff because the baby may
need  assistance in breathing or blood circulation.

In some countries they use povidone iodine as an antibiotic to protect eyes from
infections that they may have contact with during delivery but most of the
countries they use erythromycin, tetracycline, or silver nitrate to be put on a new-
born baby’s eye. Immediately after birth a mother is encouraged to hold their
baby to form a bond between them and to perform breastfeeding, because it can
help to stimulate oxytocin that will promote development of milk supply and a
healing of a mother’s womb. After 6 hours after birth, the newborns are bathed 
but the nurse will try not to wash the vernix caseosa that covers the skin because
it serves as a protection against infection. The care for  the new-born will be
continued and should be monitored until they reach 1 year old to ensure their
normal development.

LEARNING DERIVED
As I’ve read this article I’ve learned a lot on how to attend an initial care to a new-
born and how to handle the situation from the moment the baby was delivered by
the mother and the remaining time that the baby is in the hospital. I know that the
cutting of umbilical cord is one of the responsibility of the nurse and as well as
the caring of the new-born baby so it should be performed carefully and I also
agree in the concept that after birth the baby was placed on the abdomen of the
mother so they can form a bond and to feel the warmth of their bodies. These
practices were very helpful to delivering a baby because it avoids complications
and danger to the baby’s health. By using this procedure the mother and baby
will receive an optimal care. Always remember that as a nurse you should always
give your best to the patient because their life depends on you and the other
medical staff and they trust you to give them the help that they need because it is
your duty to do that.

RECOMMENDATION
 I recommend this to the future nurses to practice smooth delivery and for a
new-born to receive the care that they need.

 I recommend this to the future mothers so that they can build a strong bond
with their child after the delivery and to easily cooperate with the health care
workers.

III. CONCLUSION:
IV. LEARNING DERIVED:

V. RECOMMENDATION/s:

VI. REFERENCE/s:

https://www.merckmanuals.com/home/children-s-health-issues/care-
of-newborns-and-infants/initial-care-of-the-newborn

VII. APPENDICES: