LESSON PLAN FORMAT

SECTION I: BACKGROUND INFORMATION

1. Course and unit :

2. Topic : Newborn care
3. Duration : 30mins
4. Date :
5. Objectives :
5.1 Central objective: At the end of the clinical teaching , participants will be able to get adequate knowledge regarding the newborn care

5.2 Behavioural Objectives: At the end of the class, participants will be able to:
I. define the newborn care.
II. state the essential components of newborn care.
III. list the causes of hypothermia.
IV. list the clinical features of hypothermia.
V. explain the management of hypothermia
VI. explain breast feeding
VII. explain benefits of breast feeding
VIII. demonstrate different positions of breast feeding
IX. describe the hygienic needs of newborn
X. explain the immunisation schedule
XI. discuss the cord care
XII. list the danger signs of newborn .
6. List of A.V. Aids
7. Description of learner:
7.1Class
7.2 Number of participants
7.3 Previous knowledge/Experiences
8. Name of the Student Teacher
9. Name of the Supervising teacher
: Flash cards, demonstration.
: postnatal ward OBG IV
: 5-6
: Past experience and previous knowledge about newborn care
: Roshani
: Dr. Judith Noronha
 SECTION II: LESSON DETAILS

Time Behavioural content Teaching Learning A.V. aids

objectives activities activities and
references

Topic introduction: Asking Listening and

1min The participants Asking the question to the participants about their experience of question answering
will be able to - newborn care. Asking about their culture how the infants are taken care about
after birth. newborn care

Defining Listening and Ref 2

define newborn Definition: newborn care is defined as management of neonate during newborn care discussion.
2min the transition to extrauterine life and subsequent period of stabilization.
care Neonatal means relating to the first few days of life of a new born baby.

. Essential components
Stating the
essential
There are striking variations from place to place in the patterns of care
state the components Listening and Flash cards
and interventions that newborn infants receive. In many cases there is a
2min essential of newborn discussion. ref 1,3
lack of knowledge of what is needed for optimal newborn care.the
components of care
essential components of newborn care are,
newborn care
1. Maintain thermoregulation
2. Breast feeding
3. Hygiene and skin care
4. Immunization
5. Umbilical cord care
6. Danger signs

1. Thermal protection: newborns need a warmer environment

than adults. All health care providers need to be alert to the risk of
 hypothermia and hyperthermia. Both are dangerous and may cause the
death of the baby, but are easily prevented, by simple procedures,
without any special equipment.
Hypothermia
Axillary temperature below 36.5 ºC (97.7 0F).
list the causes listing the listening and Flash cards
2min Causes of hypothermia-
for hypothermia causes for discussing Ref 1,3
 Large body surface area relative to the body weight
hypothermia
 Thin and immature skin
 Increased cutaneous blood flow
 Decreased energy store
 Small amount of insulating fat under the skin (Less brown fat)
 Immature brain center that controls their temperature
 Increased exposed area.
 Increased respiratory rate

list the clinical Clinical feature of hypothermia- Listing the Flash cards
2min Listening and
features of 1. Mild hypothermia: clinical Ref.1&3
discussion
hypothermia  Restlessness and excess cry features of
 cold feet, acrocyanosis hypothermia
 Cold extremities and poor feeding.
2. Moderate hypothermia:
 Breathing difficult
 Bradycardia.
 Poor or no feeding
 Lethargy
 Cold to touch
3. Severe hypothermia:
 Breathing difficult
 Poor or no feeding
 Lethargy
  Hardened skin (sclerema)
 Slow, shallow and irregular respiration with bradycardia
 Cold to touch
 Hypoglycemia

explain the Management in postnatal ward

1 min management of  Initiate KMC if not initiated in delivery ward. Explaining listening Flash cards
hypothermia  Encourage breast feeding the Ref 1
management
 Remove soiled clothes immediately
 Keep windows closed
 Encourage 24 hours KMC

2 min describe the How can a hypothermic baby be re-warmed?

1. Make sure the room is warm. Keep the room where the
method of Describing Listening and Ref 1 ,3
newborn stays warm and free from drafts day and night.
rewarming the method discussing
2. Remove cold clothes and replace with warm clothes. Dress the of rewarming
baby in warm clothing (the newborn needs at least 1-2 more
layers than an adult).
3. Keep the baby’s head covered with a hat or cloth.
4. Use loose clothing and covers. Tight clothing and coverings do
not keep the baby as warm.
5. Put the newborn in bed with the mother for warmth and
continue breastfeeding.
6. Keep the newborn skin-to-skin with the mother. Use a warm
cloth or blanket to cover them both together. Be sure not to
cover the baby’s face so he can breathe freely.
7. Monitor the temperature at regular intervals.
8. Assess for infection

explain about 2. Breast feeding-

1 min Early Breastfeeding - Feeding within 1 hour of the baby's birth
breast feeding Explaining Listening and Ref 1& 2
 discussion
1.
Exclusive Breastfeeding
2. Exclusive breastfeeding is defined as "an infant's consumption of
human milk with no supplementation of any type (no water, no juice,
no nonhuman milk, and no foods) except for vitamins, minerals, and
medications. Helps baby live, grow and develop
Duration and frequency of breast feeding:
2min explain the
 The initial feeding should last for 5-10min at each breast. This
duration and Explaining Listening Flash cards
help to let down reflex.
frequency of the duration and Ref 1 &2
breast feeding  Baby is fed one breast completely in each feeding so that baby and discussion
gets both foremilk and hind milk. Then baby is put to other frequency of
breast if required. breast
 Breastfeeding at least every two hours helps to maintain milk feeding
production. .
 Newborn babies may feed 10 to 12 times every 24 hours is
common, and some may even feed 18 times a day.
 Feeding a baby "on demand" means feeding when the baby
shows sign of hunger
explain the Benefits of Breastfeeding-
3 min benefits of To Baby Explaining Listening Flash cards
breast feeding  Perfect nutrient benefit of and Ref 1,3
 Easily digested breast discussion
 Protects against infections feeding
 Protects against allergy
 Acts like 1st immunization
 Helps body and brain develop and grow
 Increases bonding with mother

To Mother
 Helps placental separation
  Helps involution of uterus
 Helps delay another pregnancy
 Protects mothers health so she has less chances of: Carcinoma
breast/uterus and Anemia
 Increases bonding with baby
3.
Different position for breast feeding
2 min demonstrate the 1. Cross-cradle hold: Demonstratin Observing Real
different  The cross-cradle hold is ideal for early breast-feeding. g the demonstrati
positions of different on and
 Sit up straight in a comfortable chair with armrests. Hold
breast feeding positions of flash cards
your baby crosswise in the crook of the arm opposite the
breast Ref 1,3
breast you're feeding from — left arm for right breast, right
feeding
arm for left.
 Support the baby's trunk and head with your forearm and
palm. Place your other hand beneath your breast in a U-
shaped hold and guide the baby's mouth to your breast.
 Don't bend over or lean forward. Instead, cradle your baby
close to your breast.
2.Cradle hold:
 The cradle hold is similar to the cross-cradle hold, but you
support the baby with the arm on the same side as the
nursing breast, rather than the opposite arm.
 As with the cross-cradle hold, sit up straight — preferably in
a chair with armrests.
 Cradle your baby and rest his or her head in the crook of
your elbow while he or she faces your breast. For extra
support, place a pillow on your lap.
3. Football hold:
 Another option is the football hold. This position may be a
good choice if you're recovering from a C-section
 You have large breasts or you're nursing two babies at
 once.
 Hold your baby at your side, with your elbow bent. With
your open hand, support your baby's head and face him or
her toward your breast.
 Your baby's back will rest on your forearm. It may help to
support your breast in a C-shaped hold with your other
hand. For comfort, put a pillow on your lap and use a chair
with broad, low arms.
4. Side-lying hold:
 A lying position may help your baby latch on to your
breast correctly in the early days of breast-feeding,
especially after a C-section.
 It's also a good choice when you're tired — although it's
important to return the baby to his or her own bed to sleep.
 Lie on your side and face your baby toward your breast,
supporting him or her with the hand of the arm you're
resting on. With your other arm and hand, grasp your
breast and then touch your nipple to your baby's lips.
 Once your baby latches on, use the bottom arm to support
your own head and your top hand and arm to help support
the baby.

2 min describe the

3. Hygiene and skin care-
hygienic needs Bathing- Describing Listening and Ref. 1,3
of the newborn Should be delayed until the infants temperature has stabilized (3 the hygienic discussion
readings of T36.5-37.20C at least one hour apart) needs of the
Any blood, meconium or vernix will be wiped off during the newborn
initial drying process. Any remaining vernix is re-absorbed
through the skin in the first few days of life. .
Bathing should not happen until the second or third day of life.
 Nappy care –
Regular diaper checks and changes are a must while taking care of
newborn baby. With each diaper change, the area should be washed
with clear water and dried well to prevent diaper rash. Cotton clothes
should be used to avoid irritation. One should always wash hands after
each diaper change. .

1 min describe the How to prevent a skin infection-

ways of  Always use infection prevention steps for birth and postnatal Describe the Listening and
discussing Refer 1,2,3
preventing skin care. ways of
infection  Do not wash off the vernix (creamy white substance on a preventing
newborn’s skin) after birth; the vernix protects the newborn’s skin infection
skin.
 Always wash your hands before and after handling each
newborn.
 Teach the mother and family to wash their hands before caring
for their newborn.
 Teach the mother and family to keep the baby’s room, covers,
and clothing clean.
 Keep flies away from the newborn.
 Teach the mother how to bathe the baby.
4. Immunizations-
4min explain the Immunizations are given to prevent illnesses that cause serious Explaining Listening and
immunization problems and even death. immunisatio discussing Chart
schedule The timing of immunizations is important. n schedule Refer 1,3
The following immunization schedule has been recommended
by Indian Academy of Pediatrics for children.
Immunization Schedule:
Age of immunization Protection Vaccine
against
(Disease)
AT BIRTH Hepatitis B, Hep B Vaccine – I
Polio, OPV – Zero Dose
Tuberculosi BCG
s
4 -6 WEEKS Hepatitis B Hep B Vaccine – II
6 WEEKS Diphtheria, DPT – I
Pertusis, OPV – I
Tetanus, HiB – I
Polio, H.
influenza
10 WEEKS Diphtheria, DPT – II
Pertusis, OPV – II
Tetanus, HiB-II
Polio, H.
influenza
14 WEEKS Diphtheria, DPT – III
Pertusis, OPV – III
Tetanus, HiB – III
Polio, H.
influenza
6 MONTHS Hepatitis B Hep B Vaccine – III
9 MONTHS Measles and MEASLES VACC
Polio OPV – IV
 12 MONTHS Chicken Varicella Vaccine
Pox
15-18 MONTHS Mumps, MMR – I
Measles and
Rubella
18-24 MONTHS Diphtheria, DPT – Booster I
Pertusis, OPV – V
Tetanus,
Polio
24 MONTHS Typhoid Typhoid(TAB) Vaccine
4 ½ -5 YEARS Diphtheria, DPT – Booster II
Pertusis and OPV – VI
Tetanus, MMR – II – Booster is recommended
Polio,
Mumps,
Measles and
Rubella
Chicken
Pox
4.
5.
2 min Discuss the cord 5.Cord Care- Discussing Answering
care 6. Cord care is an important way to prevent a newborn from getting and asking and discussing
tetanus or sepsis (generalized body infection). Putting certain question Refer 1,2,3
substances on the cord or covering it with dressings can cause serious
cord infections, such as tetanus and septicemia. These infections are
major causes of neonatal death but are preventable.
How to do cord care in home-
  Do not put anything on the cord (no medication or dressing).
 Keep the cord clean and dry.
 Urine or stool should not touch the cord. If they do, wash the
cord with soap and water and dry it with a clean cloth or air-dry
it.
 The cord normally falls off 5-10 days after birth, leaving the
umbilicus to heal.
 Give the baby only sponge baths until the cord falls off and the
umbilicus is healed.
 Look at the cord and umbilicus for signs of infection every day
until it is dry and healed. Signs of infection are: delay in
separation, pus discharge, foul smell and redness and swelling
of the skin around the umbilicus.
 Get medical help right away if you see any of these signs.
Listening
Listing
1min List the danger 6.Newborn Danger Signs-
danger signs
signs of newborn  Skin colour changes Refer 1,3
of newborn
 Projectile vomitting
 Periods of apnea
 Refusal of feeding
 Temperature changes
 Abdominal distension
 Elimination pattern change
 Local signs of bleeding
 Behavioral changes
 SECTION III- SUMMARY
Conclusion : During neonatal period close observation is necessary.
Being aware of cultural variations in newborn care helps to plan care
that is specific and meaningful to individual parents and aid parent –
child bonding.
Evaluation questions -
1. List the essential components of newborn care
2. Demonstrate different positions of breast feeding.
List the danger signs of newborn.

SECTION IV- OTHERS DETAILS

List of references
1. Beck D, Ganges F, Goldman S, Phyllis L.Care of the Newborn,
Reference Manual, saving new born life.Save the Children
2004.
2. Pillitteri A, maternal and child nursing, care of the childbearing
and child rearing family,9th edition.2010
3. Bhatnagar A. Baby Care: How to take care of your Newborn
Baby Available from -http://www.onlymyhealth.com/how-take-
care-your-newborn-baby-1300955160
NEWBORN CARE DURING
POSTNATAL PERIOD