Aberos, Marithe Joi A Group 1 Assignment 1

A. EINC
It is a basic component of DOH’s maternal newborn and child health and nutrition strategy. The EINC
practices for newborn care constitute a series of four (4) time-bound, chronologically ordered, standards
procedures that a baby receives at birth

1. Immediate drying.
- Using a clean, dry cloth, thoroughly dry the baby, 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 any manipulation such as routine suctioning,
that may cause trauma or introduce infection. Place the newborn prone on the mother’s
abdomen or chest skin-to-skin
- Cover newborn’s back with a blanket and head with a bonnet. Place identification band on
ankle.
3. Proper cord clamping and cutting
- Clamp and cut the cord after cord pulsations have stopped (typically 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 to 10 IU IM is given to the mother.
4. Non-separation of baby from mother and breastfeeding initiation
- Observe the newborn. Only when the newborn shows feeding cues )e.g., opening of mouth,
tonguing, licking, rooting), make verbal suggestions to the mother to encourage her newborn to
move toward the breast (e.g., nudging).
- 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. Make sure the newborn is facing the breast, with the newborn’s 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. Look for 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
 Notes
- Health workers should not touch the newborn unless there is a medical indication.
- Do not give sugar water, formula or other prelacteals.
- Do not give bottles or pacifiers.
- Do not throw away colostrum.
B. Ballard’s Scoring (*Physical & neurological maturity of newborn) Tabulate
34-35 weeks

The Ballard score is based on the neonate's physical and neuromuscular maturity and
can be used up to 4 days after birth (in practice, the Ballard score is usually used in the first 24
hours). The neuromuscular components are more consistent over time because the physical
components mature quickly after birth. However, the neuromuscular components can be
 affected by illness and drugs (eg, magnesium sulfate given during labor). Because the Ballard
score is accurate only within plus or minus 2 weeks, it should be used to assign gestational age
only when there is no reliable obstetrical information about the estimated date of confinement
or there is a major discrepancy between the obstetrically defined gestational age and the
findings on physical examination.
https://www.msdmanuals.com/professional/pediatrics/perinatal-problems/gestational-age

C. Newborn reflexes describe & demo

1. Grasp Reflex (palmar and plantar grasp)
- Palmar grasp: when placing a finger or stroking the inside of the infant’s palm, the hand
will close around it. This reflex disappears in 4-6 months of age.
-Plantar grasp: when a finger is placed under the toes will curl. It usually disappears in 9
months – 1 year of age.

2. Moro Reflex (Startle Reflex)

- When the infant hears a sudden loud noise or experiences unexpected movement, the
infant will extend the arms with palms up, and then move the arms back to the body.
Sometimes crying is noted afterwards. It disappears in 6 months of age.

3. Rooting Reflex
- When the infant’s cheek or side of mouth is stroked the head will turn towards it, and the
infant’s mouth will open in an attempt to suck. This helps the baby find the food source
 when feeding. Usually disappears on 4 months of age.

4. Sucking Reflex
- When something touches the top of the infant’s mouth the infant will begin to suck.
Usually disappears on 4 months of age.

5. Babinski Reflex
- When the bottom of the foot is stroked from the heel upward along the outward part of
the foot, the big toe dorsiflexes (bends back) and the other toes fan or spread out. It
disappears about 1 year of age.
6. Crawling Reflex (Bauer Crawling Reflex)
- When the infant is place on the stomach and pressure (such as a hand) is applied to the
sole of the foot, the infant will attempt to push against the hand and move the arms and
legs in a crawling like motion. It disappears on the few weeks to months after birth.

7. Step Reflex
- When holding the infant upright with legs and feet touching a surface, the infant will move
the legs like taking steps or walking.

8. Tonic Neck Reflex (Fencing Reflex)

- When infant’s head is turned to a particular side, the leg and arm on that side will extend,
while the leg and arm on the opposite side will flex. It disappears about 4 months of age.
 D. Apgar Scoring. Tabulate 6/10 and 8/10.

APGAR is an easy and quick assessment tool used to assess the status of a newborn AFTER birth. Usually
done 1 minute, 5 minutes and 10 minutes after birth.

Interventions based on Score= 7-10: routine post-delivery care

4-6: Some resuscitation (oxygen, suction, stimulate baby, rub back)
0-3: Full resuscitation