IMMEDIATE NEWBORN CARE

Prepared by:
Nona Shakya,
Narayani Gautam
MN First Year
 Objectives
At the end of this session, the participants will
be able to:
 Define the essential newborn care.

 Introduce the immediate newborn care.

 State the purpose of immediate care of newborn.

 State the principle of immediate newborn care.

 List the equipments required for immediate newborn

care.
 Describe the steps of immediate newborn care.

 Explain about injection vitamin K.

 Essential Newborn Care

The basic care is called Essential Newborn

Care and includes:

• Immediate care at birth

• Care during first day
• Care up to 28 days
 Immediate Care of Newborn

• Most babies breathe and cry at birth with no

help.
• The immediate care of newborn is simple but
important.
• Care should be gentle.
• Keep the baby warm.
 Heat Loss in Babies

Evaporation
Convection

Radiation

Conduction
Immediate care of the newborns include:

1. Dry, stimulate and wrap baby

2. Assess breathing and color
3. Decide if the baby needs resuscitation
4. Tie and cut the cord
5. Give the baby to the mother to keep
warm
6. Put identification tag to baby
7. Have the mother start breastfeeding
8. Give eye care and weigh the baby
 Purpose

•To establish respirations.

•To provide warmth and prevent hypothermia.
•To ensure safety, prevent injury and infection.
•To identify actual or potential problems that
may require immediate attention.
 Principles
 Hand washing should be done before touching the
baby.
 Maintain the warm environment (>25˚c) and draft

free.
 Maintain adequate lightening.

 Maintain aseptic technique.

 Prepare the resuscitation table for every newborn

baby.
 Equipment must be checked daily and well before a

delivery takes place.

 Equipment and supplies for immediate Newborn care

•2 clothes or towels
1 to dry baby
1 to wrap baby
•Warm clothes or blanket for covering the
Newborn
•Clean baby clothes and cap/ topi
•A flat surface if resuscitation is needed with 2
clothes: 1 to roll and put under the baby’s
shoulder, 1 to laid over the flat surface
 Contd……….
•Protective clothing likes gloves( can be clean
or sterile) apron, glasses (if available)
•Supplies to tie and cut the cord
3 cord ties or 2 instrument or 1 cord clamp
and 1 instrument
New or boiled razor blade or sterile scissors
•Weigh scale
•Equipment and supplies for newborn
resuscitation
•Newborn record form and birth certificate
 Equipment And Supplies for Newborn
Resuscitation

 Ambu bag with mask / tube mask / 2 gauge

pieces for mouth to mouth respiration
 Oxygen with flow meter and tubing

 Suction equipment:

 Electrical or manual suction, suction catheter

or
 Mucus extractors

 Radiant warmer for making the room warm /

bulb
 Contd…………..
 Place for resuscitation : clean, dry, well lit,
flat and firm surface
 4 clothes to dry, wrap, put under the baby’s

shoulder, laid over flat and firm surface.

 Gloves

 Watch

 Stethoscope

 Medicine: epinephrine, soda bicarbonate, etc

 Steps of Immediate Care at Birth
Step 1: Dry and stimulate the baby
 Dry the baby.
 Rub up and down on baby's back, using a
clean, warm cloth.
 Don’t remove the vernix.
 Discard the wet cloth.
 Wrap the baby in a clean, dry cloth
covering head.
Drying The Newborn

• Stimulates the newborn to breathe normally.

• Minimizes heat loss.
Step 2: Assess the Baby's breathing and color:

While drying the baby, watch breathing

pattern and color of baby.

 Check baby’s breathing (breathing, having

trouble breathing or not breathing).
 Assess the baby’s colour (pink, gray, blue,
pale).
 Step 3: Decide if the Baby needs
Resuscitation
• If the baby is not breathing, is breathing less
than 30 breath /minute, or gasping baby
needs resuscitation.
• In that case, quickly clamp or tie and cut the
cord leaving a stump at least 10cm long.
• Put the baby on a flat surface and start
resuscitation quickly.
• If the baby does not need resuscitation, go on
to next steps.
Note: Steps 1-3 all happen at almost
the same time
 Step 4: Tie and cut the cord

Keep baby wrapped. Only expose cord area.

If clamp available, clamp 3 fingers from the cord.
If using cord tie: Tie the cord securely in three
places:
Tie 1: tie two fingers away from the baby's
abdomen.
Tie2: tie three fingers away from the baby's
abdomen.
Tie 3: tie four fingers away from the baby's
abdomen.
 Cut the cord between the ties:
• Use new razor blade or sterile scissors
• Use a small piece of cloth or gauge to cover
the part of the cord to prevent blood splashes.
• Cut cord between ties 2 and 3.
• Be careful not to cut or injuries the baby.

 Do not put anything on the cord stump.

 Step 5: Place the baby in skin -to skin contact with the mother

• Put the baby on mother's chest for skin to

skin contact.
• Cover both mother and baby together with
a warm cloth or blanket.
• Cover the baby's head.
• Explain to the mother how important it is
to keep the baby warm.
Immediate skin-to-skin contact
 Advantages of Skin to skin contact

• Keeps the baby warm. ( conduction )

• Increase bonding.
• Helps to initiate early breastfeeding.
Step 6: Put identification tag on the baby
 Step 7: Have The Mother Start Breast Feeding

If everything is normal:
Do not separate the mother and baby
until after the baby has breastfeed.
Help the mother begin breastfeeding
within the first hour of birth.
• Make sure the baby has a good
position, attachment, and suck.
• Do not limit the time the baby feeds.
 Step 8: Give eye care

Give eye care within 1 hour after the

birth.
Use normal saline or cool boiled water.
If baby’s eyes are infected apply
antimicrobial medication (Silver nitrate,
erythromycin and tetracycline ophthalmic
ointments as prescribed by doctor) .
 Weigh the baby
 Take weight of baby.
 While taking the weight, be ensure to

keep warm cloth over the weighing pan.

 Record it.
Weight Measurement
 Vitamin K

• The newborn has a sterile intestine at birth,

hence, the newborn does not possess the
intestinal bacteria that manufactures vitamin
K.
• Vitamin K is necessary for the formation of
clotting factors. This makes the newborn
prone to bleeding.
• As a preventive measure, 0.5 mg (preterm)
and 1 mg (full term) Vitamin K is injected IM.
 Recording

•Write records of immediate newborn care.

•Report to an appropriate person.
Any Question?

?
 References
 Diana Beck, F. G. (2004). Care of the Newborn.
washington, DC: Bill & Melinda Gates Foundation.
 Save the children. (2009). Newborn Care Training
Package for Nursing Programme.
 Shrestha, T. (2012). Essential Child Health Nursing.
kathmandu: Medhavi Publication.
Thank you