Name: Hiyan Jade R.

Del Castillo

The essential newborn protocol is a series of time bound and chronologically ordered care that a baby
receives at birth and it has standardized effective procedural steps. Diana is from a small community
where she and her family are farmers. She is 18 years old and this is her first baby. Diana gave birth to a
healthy term baby three days ago in the hospital. The baby is nursing well and is warm.

The baby has passed stool and urine. Diana feels well. Now the OPD nurse teaches Diana how to give her
baby a bath and other concerns about taking care of a baby. The umbilical cord has not yet fallen off.

1. What are the important things that the nurse should explain and demonstrate to Diana?

The nurse should explain and demonstrate the vital concepts surrounding newborn care, and especially
cord care practices. The nurse should take the time to properly explain the rationale and importance
behind each newborn care steps that the mother should perform. It would also be beneficial for the
nurse to explain to the mother to always seek care when the umbilicus is red or draining pus.

Other important things to explain and teach include:

Cleanliness is vital

- Demonstrate and teach how to clean it with cotton or wet cloth followed by soft dry tissue. Do
not use alcohol or soap for cleaning.

Keep it dry

- Teach the mother on that the stump should remain dry at all times for natural healing. Make
sure the diaper does not enclose the area.

Sponge bath

- Teach the mother on how to perform a sponge bath instead of a tub bath since it makes sure
that the navel does not remain underwater for a long time.

Clothing the baby sensibly

- Dress the baby in loose-fitting cotton clothing so that the stump remains unobstructed which
helps more air-circulation

Allow natural healing

- Teach the mother to never pull the cord manually, especially when it is hanging by a tiny weak
thread. Advise the mother to let it fall and heal naturally.
2. What are the ways to cord care?

There are various ways to cord care but the key ways to do this are:

- Put nothing on the stump

- Fold diaper below the stump. Keep cord stump loosely covered with clean clothes
- If stump is soiled, wash it with clean water and soap. Dry it thoroughly with clean cloth
- Explain to the mother that she should seek care if the umbilicus is red or draining pus
- Teach the mother to treat local umbilical infection three times a day
- Wash hands with clean water and soap
- Gently wash off pus and crusts with boiled and cooled water and soap
- Dry the area with clean cloth
- Paint with gentian violet
- Wash hands
- If pus or redness worsens or does not improve, seek care.

3. What are the four (4) time bound interventions involved in essential newborn care?

The four times bound interventions involved in essential newborn care in the first 90 minutes include:

1. Immediate and thorough drying of the baby

2. Early skin-to-skin contact
3. Properly timed clamping and cutting of the cord after 1 to 3 minutes
4. Non-separation of the newborn from the mother for early breastfeeding initiation and rooming-
in

These are recommended by the department of health and are coined as the unang-yakap principles.

4. What is the importance of keeping the mother and baby in uninterrupted skin-to-skin contact?

 The importance of keeping the baby and the mother in uninterrupted skin-to-skin contact lies in
the fact that it prevents hypothermia, hypoglycemia and sepsis. In addition, it also increases the
colonization with protective bacterial flora and improves breastfeeding initiation and exclusivity.

5. What newborn care practices in the delivery room should no longer be continued?

There are several newborn care practices in the delivery room that are found to be outdated and are
deemed to be no longer recommended for use in the delivery room and these include:

a. Manipulation such as routine suctioning of secretions if the baby is crying and breathing
normally. Doing so may cause trauma or infection.
b. Putting the newborn on a cold or wet surface
c. Wiping or removal of vernix caseosa if present
d. Foot printing
e. Bathing earlier than 6 hours of life
f. Unnecessary separation of the newborn for weighing, anthropometric measurements,
intramuscular administration of vitamin K, hepatitis B vaccine and BCG vaccine
g. Transferring of the newborn to the nursery neonatal intensive care unit without any indicators