Care of Normal Newborn:

A) Care at birth:
• Clear air way ( suction mouth and pharynx)
• Temperature control ( dry and wrap with dry cloth)
• clamping the cord immediately after the birth of baby app. 2.5 cm from abdomen
• provide appropriate eye care to prevent Ophthalmia Neonatorum( TTC eye ointment)
• Identification of newborn with mothers name
• Vitamin K injection to prevent hemorrhagic disease of the newborn
• Measurement (Weight, Height, Head circumference)
• Encourage rooming-in immediately after delivery

Assessment of APGAR score:

• 7-10 well adjusted
• 5-7 mild asphyxia
• 3-4 moderate asphyxia
• < 3 severe asphyxia

B) Care in the Postnatal Ward:

• Handle the baby gentle
• Avoid infection (hand washing)
• Keep the baby warm
• Encourage and initiate exclusive breast feeding -4 months of age
• Encourage care of umbilical stump
• Give immunization ( BCG & OPV0) C)
Assessment of the newborn before discharge:
• Take vital sign
• Check for sign infections (eye , cord ,skin)
Check for birth trauma (cephalohematoma, fracture..)
• Check for anomalies ( spina-bifda, imporforate anus, club foot…)
• Carryout systematic examinations ( head to foot)
D) Classification of the newborn:
Newborns are classified based on their gestational age and birth weight.
Gestational age defined as:
 Preterm defined as gestational age below 37 complete weeks
 Term defined as gestational age above 37-42 weeks
 post term defined as gestational age above 42 weeks
 Classification of Newborn by birth weight:
 Low birth weight (LBW- is defined as birth weight < 2.5 kg , they may be
Preterm or small for gestational age (SGA)
 Very LBW - birth weight < 1500gm
 Large for gestational age (LGA)- birth weight above 90th percentile.
 Appropriate for gestational age (AGA)- birth weight between and 10th
and 90th percentile
 Small for gestational age-(SGA) – birth weight below 10th percentile

4.2 Causes of Low Birth Weight (LBW):

Fetal:
1. Fetal distress
2. Multiple pregnancies
3. Erythroblastosis fetalis
Placental:
i. Premature separation
ii. Placenta previa
Uterine: Incompetent cervix
Maternal:
1. Pre-eclampsia
2. Chronic illness
3. Infection
4. PROM (prematurerapture ofmembrane)
5. Poly hydrominous >1500ml
6. Nutrition status of the mother
A) Management of low birth weight:
Clean air way
Initiate breathing
Establish circulation
Keep Warm
Administer Vit. K
Administer Silver nitrate or TTC ointment to the eyes
Apply gentian Violet to the cord
 Feeding- Breast feeding
NGT feeding
Parental feeding
Treat anticipated problems (infection)
Hypothermia (cold injury). If Rectal temperature is < 350C
Hyperthermia temperature >38.50C
Normal temperature:

Rectal 36.5 - 37.20C

Axillary 36.5 - 370C
Hyperthermia caused by

 Excessive environmental temperature

 Infection
 Dehydration (loss of ECF, Evaporation)
Immediate Newborn care:
• Drying, wrapping, close contact with mother
• Immediate breast feeding
• Prophylactic eye care, where appropriate
Routine Newborn Care:
• Exclusive breast feeding, counseling for problems
• Maintenance of body temperature
• Clean cord care
• Early postpartum visit for mother and baby (within 3 days)
• Recognition of danger signs; treatment and referral as needed
• Immunization
Special Newborn Care:
• Special care for the sick children
• Recognition and management of birth asphyxia
• Recognition and management of infection
• Special care for the LBW infant
• Skin – to- skin / kangaroo mother care
• Close surveillance for signs of infections and feeding difficulties