Immediate Newborn Care Checklist

Name of Student: _________________________________________ Date: _____________

SECTION: ________________________________________
ID NUMBER ______________________________________
A. At perineal bulging with presenting part visible Done Not done

1. Prepare for delivery (Checks materials needed)

2. Ensure area is draft-free, room temp 26-28C
3. Wash hands
4. Double glove just prior to delivery
B. Within the first 30 seconds
1. Dry and provide warmth
2. Remove wet cloth
3. Do a quick check on newborn’s breathing while drying
C. After 30 seconds of thorough drying, newborn is breathing and crying
1. Place the newborn prone on the mother’s abdomen or chest in
skin-to-skin
2.Cover the newborn’s back with a blanket and head with a bonnet
3. Place ID band on the ankle
D. Within 1-3 minutes, do delayed or non-immediate cord-clamping
1. Remove the first set of gloves
2. Apply cord clamp at 2cm and forceps at 5cm from the newborn’s
abdomen
3. Cut between the cord clamp and the forceps using a sterile instrument
E. Provide Support for initiation of breastfeeding
1. Leave the newborn on the mother’s chest in skin to skin contact
2. Counsel on positioning and attachment
3. Look for signs of good attachment and sucking
4. If the attachment or sucking is not good, try again and reassess

Comments: ____________________________________________________________________

___________________________________
Preceptor Name & Signature
You can ask additional questions?

1. What do you do when after checking, you find that the attachment or latch is not good?

2. What are the signs of good attachment?

 CLASSIFICATION OF NEWBORNS (BOTH SEXES)
BY INTRAUTERINE GROWTH AND GESTATIONAL AGE1,2
NAME ____________________________________________ DATE OF BIRTH ___________________________________ LENGTH _________________________________________

HOSPITAL NO. _____________________________________ SEX _____________________________________________ HEAD CIRC. ______________________________________

RACE ____________________________________________ BIRTH WEIGHT ____________________________________ GESTATIONAL AGE

DATE OF BIRTH ___________________________________

WEIGHT PERCENTILES LENGTH PERCENTILES

4600 54
90
4400 53
4200 52
75
4000 90 51
3800 50 50
75
3600 49
25
3400 50
48
3200 47
25 10
3000 46
2800

Length (cm)
10 45
Weight (g)

2600 44
2400 43
2200 42
2000 41
1800 40
1600 39
1400 38
1200 37
1000 36
800 35
600 34
PRETERM TERM
400 33
0 32
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 PRETERM TERM
Gestational Age (week) 31
0
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Gestational Age (week)
HEAD CIRCUMFERENCE PERCENTILES
38
37 Weight Length Head Circ.
90 CLASSIFICATION OF INFANT*
36
75
35 50 Large for
34 Gestational Age (LGA)
25
Head Circumference (cm)

33 (>90th percentile)
10
32
31 Appropriate for
30
Gestational Age (AGA)
29
(10th to 90th percentile)
28
27
Small for
26
Gestational Age (SGA)
25
(<10th percentile)
24
23
PRETERM TERM *Place an "X" in the appropriate box (LGA), AGA or SGA) for weight, for
22 length and for head circumference.
0
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Gestational Age (week)

References
1. Battaglia FC, Lubchenco LO: A practical classification of newborn infants by weight and gestational age.
J Pediatr 1967; 71:159-163.
2. Lubchenco LO, Hansman C, Boyd E: Intrauterine growth in length and head circumference as estimated
from live births at gestational ages from 26 to 42 weeks. Pediatrics 1966; 37:403-408.
Reprinted by permission from Dr Battaglia, Dr Lubchenco, Journal of Pediatricsand Pediatrics

©2008 Abbott Laboratories Inc. Abbott Nutrition

A5860/OCTOBER 2008 Abbott Laboratories
LITHO IN USA Columbus, Ohio 43219-3034 USA