CARE OF

NORMAL
NEW
BORN
BABY

Pushpa Gupta
 HEALTHY NEW BORN BABY
Born at term – 38 -42 weeks
Cries immediately
Establish independent rethymic respiration
Quickly adopts with extra-uterine environment
Having average weight
No congenital anomalies

Neonatal - 0-28 days

Early neonatal period - 1st week of life
Late neonatal period - 7 -28 days of life
Basic needs of a baby at birth

 Warmth
 Normal breathing
 Mother’s milk
 Protection from
infection
 Call out the time of birth. IMMEDIATE CARE
Deliver the baby onto a warm, clean and dry towel or cloth and keep
n mother's
hest (between the breasts).
Clamp and cut the umbilical cord.
Immediately dry the baby with a warm clean towel or piece of cloth;
pe the eyes.
Assess the baby's breathing while drying.*
Wipe both the eyes separately with sterile gauze
Leave the baby between the mother's breasts to start skin-to-skin
re.
Place an identity label/band on the baby.
Cover the baby's head with a cap. Cover the mother and baby with a
arm cloth.
0. Encourage mother to initiate breastfeeding (within half an hour of
rth).
Examination of new born
Weight General examination
Skin colour / rashes
Lenth
Head : fontanelle , caput
Head cicumfrances succedenum,cephalohemot
oma , moulding
Chest circumfrances
Face and mouth
Vital sign Eyes abdoman
Chest genitalia
Heart anus/ rectum
reflexes
Warm chain
At delivery
Ensure the delivery room is warm
(25° C), with no draughts
l Dry the baby immediately;
remove the wet cloth
l Wrap the baby with clean dry
cloth
l Keep the baby close to the
mother (ideally skin-to-skin)
l Postpone bathing/sponging for
24 hours
After delivery
 Keep the baby clothed and wrapped
with the head covered
 Minimize bathing especially in cool
weather or for small babies
 Keep the baby close to the mother
 Use kangaroo care for stable LBW
babies and for re-warming stable bigger
babies
 Show the mother how to avoid
hypothermia, how to recognize it, and
how to
 re-warm a cold baby. The mother should
aim to ensure that the baby's feet are
 warm to touch
Routine care of neonates
 Warm chain
 Eye care
 Cord care
 Breast feeding
 Dresses for
infant
 Hygiene
 Look for any
danger sign
 immunization
 THERMAL
PROTECTION

CONDUCTION

CONVECTION
Evaporation: if baby is not
dry and not covered
adequately.
Conduction: direct contact with
cooler object or surface [ cold table
,mackintosh, towel, tray, hands,
weighing scale, etc.
Convection: when the baby is
placed in the cooler air and air
movement is present there e.g.
open window , fans
Radiation: colder the object and
closer it to neonate
Prevent heat loss by evaporation:
Drying the infant as quickly as possible after birth.
Drying the infant immediately after bathing.

prevent heat loss by conduction:

Warming the objects that will touch an infant.
Placing an infant against the mother's skin helps
prevent conductive heat loss.

prevent heat loss by convection:

Keeping the new born out of drafts.
Maintaining warm environmental temperature.
Keeping a preterm neonate in an incubator.

prevent heat loss by radiation:

Incubators must have double walls.
Cribs and incubators should be placed away from
the walls and windows.
EYE CARE
Cleaned eye daily with sterile cotton swab socked in
normal saline.
Each eye should be cleaned using a separate swab.

Don’t apply kajal

Observed for redness, sticky discharge or excessive
tearing for early detection of problems.
CARE OF
UMBLICAL CORD
• Cut the cord with aseptic technique.
• Keep dry and clean with alcoholic swab daily.
• It falls off after 5 to 10 days if it takes longer time may be
cause of infection and useful marker of
immunodeficiency state.

Delaying cord clamping allows blood flow between the placenta and
neonate to continue, which may improve iron status in the infant for
up to six months after birth. This may be particularly relevant for
infants living in low-resource settings with less access to iron-rich
foods.
Breast feeding
Within an hour
Whenever the baby
wants
Avoid supplementary
feeds and bottle
feeding
Breast milk
Creates bonding
Highly nutritive
Anti infective
 Good attachment sign

The baby’s Usually the

The baby’s The baby’s
lower lip is lower portion
mouth is wide chin touches
curled of the areola
open the breast
outward is not visible
 Signs that a baby is attached well at the
breast
lower lip is curled outward baby’s mouth is wide open

chin touches lower portion

the breast of the areola is
not visible

Teaching Aids: NNF NF-17

 WHAT IS KMC
 A special way of caring for Low birth weight
(LBW) babies
 It promotes
 Effective thermal control
 Breast feeding
 Prevention of infection
 Parental bonding
Component of KMC

Skin-to-skin contact
Early, continuous and
prolonged skin-to-
skin contact

Exclusive breast feeding

Promotes lactation
and facilitates
feeding
 Pre-requisites of KMC

1. Support to the mother

In hospital &
At home

2. Post-discharge follow up
 Benefits of KMC

 Breast feeding
 Increased breast feeding rates
 Increased duration of breast
feeding

 Thermal control
 Effective thermal control
 Equivalent to conventional
incubator care
 Early discharge Other benefits
 Better weight
gain Early
 Less stress to
discharge
the infant
 Lesser morbidity  Stronger
 Regular bonding
breathing
 Deep
 Decreased
episodes of satisfaction for
apnea mother
 Protection  More
from nosocomial
confident
infections
parents
 Preparing for KMC

 Counseling
 Demonstrate procedure
 Ensure family support
 KMC support group
 Mother’s clothing
 Front-open, light dress as per the local
culture
 Baby’s clothing
 Cap, socks, nappy and front-open sleeveless
shirt or ‘jhabala’
 PROCEDURE
 Place baby between the mother’s
breasts in an upright position
 Head turned to one side and slightly
extended
 Hips flexed and abducted in a “frog”
position; arms flexed
 Baby’s abdomen at mother’s
epigastrium
 Support baby’s bottom
 KMC procedure:
Kangaroo positioning (cont..)

Head turned
Baby between to one side
mother’s breasts

Frog-leg
Support baby’s position
bottom
Any family member can do it !

Grandmother

Father

Father & other family members can

also provide skin-to-skin care
 Jaundice
Yellow coloring of an infants skin
Common and is caused by the natural breakdown of RBCs in the infant after
birth
Is never considered normal in the first 24 hours.

Physiological jaundice
Most jaundice in newborns is physiologic
It peaks between 48-72 hours
Usually disappears within a week
Usually benign
Can become elevated to a point of concern for the baby
Care of Infant on Phototherapy
Risk of injury to eyes
Risk of injury to gonads
Risk of impaired skin integrity
Risk for fluid volume deficiency
Risk for hyperthermia or hypothermia
Risk of neurological injury
Imbalance nutrition
Parental anxiety
Ten steps to successful breastfeeding
Every facility providing maternity services and care for
newborn infants should

1. Have a written breastfeeding policy that is routinely

communicated to all health care staff
2. Train all health care staff in skills necessary to
implement this policy
3. Inform all pregnant women about the benefits and
management of breastfeeding
Ten steps to successful breastfeeding
(contd….)
4. Help mothers initiate breastfeeding within half
hour of birth
5. Show mothers how to breastfeed, and how to
maintain lactation even if they are separated
from their infants
6. Give no food or drink, unless medically indicated
7. Practice rooming-in : allow mothers and infants
to remain together 24 hrs a day
 Ten steps to successful breastfeeding
(contd….)
8. Encourage breastfeeding on demand
9. Give no artificial teats or pacifiers (also
called dummies or soothers) to
breastfeeding infants
10. Foster the establishment of breastfeeding
support groups and refer mothers to them
on discharge from the hospital.