Essential Intrapartum Newborn Care
Make sure the newborn is facing the breast, with
- The EINC is a package of evidence-based
practices recommended by the Department of
Health (DOH), Philippine Health Insurance
Corporation (PhilHealth), and the World Health
Organization (WHO) as the standard of care in
all births by skilled attendants in all government
and private settings.
- Standards for safe and quality care of birthing
mothers and their newborns, within the 48 hours
of intrapartum period (labor and delivery) and a
week of life for the newborn
- A series of time bound, chronologically-
ordered, standard procedures that a baby
receives at birth.
- Can prevent at least half of newborn death
without additional cost to both families and
hospitals.
At the Heart of the Protocol are Four Time-Bound
Interventions:
1. Immediate Drying
- Immediate and thorough drying for 30
sec. to one-minute warms the newborn
and stimulate breathing.
- Use a clean, dry cloth thoroughly dry the
baby by wiping the face, eyes, head,
front and back, arms and legs.
2. Skin-to-skin contact
- If a baby is crying and breathing
normally, avoid manipulation, such as
routine suctioning, that may cause
trauma or introduce infection.
- Place the newborn’s back with a blanket
and head with a bonnet.
This prevents:
 Hypothermia
 Infection
 Hypoglycemia
3. Proper cord and clamping and cutting
- Clamp and cut the cord pulsations have
stopped (typically at 1-3 minutes).
- Put ties tightly around the cord at 2
centimeters and 5 centimeters from the
newborn’s abdomen.
- Cut between ties with sterile instrument.
- Observe for oozing blood.
- Do not milk the cord towards the
newborn.
- After cord clamping, ensure oxytocin 10
IU IM is given to the mother.
4. Non-separation of baby from mother and
breastfeeding initiation
- Time bound: within 90 minutes of age.
- Continuous nonseparation for early
breastfeeding which protects the infants
from infection.
- Observe the newborn. Only when the
newborn feeding cues, make verbal
suggestions to the mother to encourage
her newborn to move toward the breast.
- Counsel on positioning and attachment.
When the baby is ready, advise the mother to:
a. Make sure the newborn’s neck is neither flexed
nor twisted.
b.
the newborn’s nose opposite her nipple and chin
touching the breast.
c. Hold the newborn’s body close to her body.
d. Support the newborn’s whole body, not just the
neck and shoulders.
e. Wait until her newborn’s mouth is opened wide.
f. Move her newborn onto her breast, aiming the
infant’s lower lip well below the nipple.
g. Looking the signs of good attachment and
suckling:
- Mouth wide open
- Lower lip turned outward
- Baby’s chin touching breast
- Suckling is slow, deep with some pauses
- If the attachment or suckling is not
good, try again and reassess.
Essential newborn care from 90 mins to 60 hours of
life
 Intervention: Give Vitamin K prophylaxis
 Action: Wash hands. Inject a single dose of
Vitamin K 1mg IM.
 Intervention: Inject hepatitis B and BCG
vaccinations at birth.
 Action: Inject hepatitis B vaccine
intramuscularly and BCG intradermally.
 Record.
 Intervention: Examine the baby
 Action: Thoroughly examine the baby. Weigh
the baby and record.
 Intervention: Check for birth injuries,
malformations or defects.
• Action: Look for possible birth injury.
: Look for malformations
Care Prior to Discharge
 Time Band: After the 90 minutes of age, but
prior to discharge.
 Intervention: Support unrestricted, per demand
breastfeeding, day and night.
 Action: Keep the newborn in the room with
his/her mother, in her bed or within easy reach.
Do Not separate them (rooming-in). Support
exclusive breastfeeding on demand day and
night.
 Intervention: Ensure warmth of the baby.
 Action: Ensure the room is warm. Explain to the
mother that keeping baby warm is important for
the baby to remain healthy.
 Keep the baby in skin-to-skin contact with the
mother as much as possible. Dress the baby or
wrap in soft dry clean cloth. Cover the head with
a cap for the first few days, especially if baby is
small.
 Intervention: Washing and Bathing (Hygiene).
 Action: Wash your hands. Wipe the face, neck
and underarms with a damp cloth daily. Wash
the buttocks when soiled. Dry thoroughly. Bathe
when necessary, ensuring that the room is warm
and draft-free, using warm water for bathing and
thoroughly drying the baby, then dressing and
covering after the bath. If the baby is small,
ensure that the room is warmer when changing,
wiping or bathing.
Notes:
 - Health workers should not touch the newborn
unless there is a medical indication.
- Do not give sugar water, formula or other
prelacteal.
- Do not give bottles or pacifiers
- Do not throw away colostrum
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