EINC

Essential Intrapartum Newborn Care

 WHAT IS EINC?

Evidenced- Timebound Doable

based
ESSENTIAL INTRAPARTUM
NEWBORN CARE
A care provided to
every newborn. This is
applied immediately
after baby is born and
continued for the next
days after birth.
 UNANG YAKAP
Campaign for all
practitioners and
health facilities to
adopt and embrace the
safe and quality care of
EINC.
 TIME BOUND
Procedures
PROCEDURES
• Immediate and thorough drying
that are done • Skin to skin contact
routinely • Properly timed cord clamping and cutting
FIRST • Nonseparation of Newborn from Mother
for Early Breastfeeding
NON-TIME BOUND

• Immunizations Can be done after

immediate
• Eye Care
procedures are done.
• Vit. K administration
• Anthropometrics
IMMEDIATE DRYING

• TIME BAND: within the 1st 30 seconds

• Dry the baby and provide warmth. Check the baby if
breathing while drying.
• Stimulates the newborn to breathe normally
• Minimizes heat loss
• DO NOT REMOVE THE VERNIX CASEOSA
• DO NOT VENTILATE BABY; NO SUCTIONING
skiN TO sKiN cONTACT

• TIME BAND: 30 seconds after drying

• Provide warmth
• Improves bonding
• Provides protection from infection by exposure of
the baby to good bacteria of the mother
• Increases the blood sugar of the baby
• Contributes to the overall success of breastfeeding
 EFFECT on IMMunoprotection

Stimulation of the
mucosa-
Colonization with associated
Ingestion
maternal skin flora lymphoid tissue
system colostrum
 HYPOTHERMIA
Delayed fetal
to newborn
Infection circulatory Brain
adjustment hemorrhage
UMBILICAL CORD CLAMPING
• TIME BAND: 1-3 minutes
• Reduces the risk of anemia
Properly timed clamping
• Protection against brain hemorrhage in premature
of the umbilical cord
benefits:
newborn
• Put ties tightly 2cm and 5 cm from newborn
abdomen
• After cord is cut, give oxytocin 10 IU IM.
 BREASTFEEDING
Provide breastfeeding
support for initiation • Maintain uninterrupted skin to skin contact
of breastfeeding for at least 90 minutes after birth and until
the first thorough breastfeed is complete
 MONITORING

Record findings
and procedures
Never leave the
Monitor baby for
woman and the
breathing and
newborn alone
warmth
 BREASTFEEDING
Rest period of the baby
SIGNS OF READINESS TO BREASTFEED
may take from few
minutes to 30 minutes or • Opening of the mouth, tonguing, licking,
40 before the baby rooting
shows feeding cues.
Do not give any formula for the baby, no bottles. Do not
throw away colostrum. If mother is HIV positive counsel
her for breastfeeding.
 GOOD LATCH

• chin is touching the breast and

can breathe through nose
• mouth is wide open and is
fully placed on the areola
• latch does not hurt
• short sucks then slow and
deeply
 EYE CARE

Protect newborn from Erythromycin

ointment
getting bacterial eye
• Do not wash the
infections which causes
oinment
serious eye problems
including blindness.
 VACCINATIONS

• VITAMIN K - prevents • Vitamin K

bleeding • Hepatitis B
• HEP B - prevents infection • BCG vaccines
• BCG - prevents TB
ANTHROPOMETRICS
• Head circumference (33-35 cm)
• Chest circumference (30-33 cm)
• Abdomen (27-30 cm)
• Arm
• Thigh
• Length (47-50 cm)
• Weight (2,500 - 4,000 grams)
APGAR Scoring
• 7-10 supportive care
• 4-6 moderate depression
• <4 aggressive resuscitation
It has been 5 minutes since your patient
delivered her baby. The infant is crying
weakly and is curling his arms and legs. He
is pink all over with a pulse of 90 and weak
respirations. What is his APGAR score
You just delivered a baby boy. His body is
pink, but his hands and feet are blue. Vital
signs are P110, R rapid and irregular. He
has a weak cry when stimulated and resists
attempts to straighten his legs. His APGAR
score is
One minute after birth, your newborn
patient is actively crying in response to your
bulb syringe. His body is pink, and he is
moving his extremities which are blue. His
heart rate is 110. What is the newborns
APGAR score
BALLARD
QUESTIONS??
RETURN DEMO
• Lay-out material in a linear 2. Wears sterile glove. (double
manner. gloving)
• 2 sets of gloves 3. Supports the perineum.
• dry cloth 4. Calls out time of birth and sex of the
• blanket baby.
• bonnet 5. Dries thoroughly the baby for full
• oxytocin
30 seconds using the 1st towel
• syringe
5.1 Follows an organized sequence:
• plastic cord clamp
wipe eyes, face, head, front and back,
• instruments clamp
• arms and leg.
scissors
• kidney basin 5.2 Wipes gently, do not wipe off the
• cotton balls vernix.
• vaccinations 5.3 Removes the wet cloth, replace
with dry one.
6. Performs rapid assessment of the
baby’s breathing.
7. Initiate immediate skin to skin
contact.
7.1 Position the newborn prone on
mother’s abdomen or chest
7.2 Cover the newborn’s back with a
dry blanket.
7.3 Cover the head of the newborn
with bonnet.
8. Remove the first of gloves prior to
cord cutting and clamping.
9. Clamps and cuts properly the cord
timely, between 1-3 minutes.
10. Inject Oxytocin 10 IU IM to the
mother’s deltoid.
11. Check the mother’s condition and
deliver the placenta.
11.1 Check how heavy her bleeding is
and examine the perineum, vulva and
vagina for tears.
11.2 Clean the mother and keep her
comfortable
11.3 Check the perineum of the mother
and assess for bleeding and tears.
12. Initiate breastfeeding for the 1st 14. Performs anthropometric
30-60 minutes measurements
12.1 Encourage the mother to latch her • Head circumference
newborn towards her breast • Chest circumference
12.2 Counsel on proper attachment and • Abdomen
positioning. • Arm
13. Administer eye ointment, Vitamin • Thigh
K, Hepatitis B, and BCG after baby • Length
completes breastfeeding. • Weight
QUESTIONS??