THE NEWBORN

BABY

THE CARE OF
NEWBORN BABY
 INTRODUCTION
Before birth a baby leads a somewhat sheltered
life but from the moment h s born, a new phase
in his development starts. He has to adjust to a
completely new environment. Some things like
breathing, for example, he can do
instantaneously without any help but in many
other ways he is entirely helpless and
dependent on his mother’s assistance.
BABY’S ADAPTATION
OUTSIDE THE WOMB
 FIRST BREATHS - As soon as the baby’s head
emerges and while the rest of the body is still
undelivered, the baby may begin to cry and take
his first breaths of air of his own.

 A CHANGE OF TEMPERATURE - In the womb, a

baby is the same extent protected from extremes
of temperature because of the warm amniotic
fluid (water) which surrounds him. In fact, he is 1
˚C warmer than his mother.
 PROTECTION FROM INFECTION - As pregnancy
advances, special proteins, called “antibodies”
build up in baby’s blood and as a result, his white
blood cells become skilled at mopping up any
dangerous germs that dare to invade his territory.

 FIRST FEEDS - All baby’s nutritional needs are

met from the mother’s blood stream. At birth,
when the umbilical cord is cut, this important
source of nutrition is also severed.
WHAT A NORMAL NEWBORN
LOOKS LIKE
 SPOTS AND BLEMISHES
A lot of tiny spots over the
baby’s nose and perhaps,
cheeks and forehead are
caused by temporary
blockage of glands in the
skin and disappear in a
few weeks.
 THE BABY’S HEAD - It is built to withstand the
pressure of being squeeze through the birth canal.
The skull of a young baby is made up of light
bones which are not yet fused into one and during
birth.
Anterior fontanelle - is a diamond shaped area located on the top of the head, towards the front
Cephalhematoma - is caused by a little bleeding
around the skull bones and is harmless
 THE BABY’S MOUTH - White patches on the
tongue are usually caused by milk staining, but
are sometimes confused with a fairly common
mouth infection called “thrush”.
 THE BABY’S BREASTS - Baby boys and girls often
have slightly swollen breasts which discharge a
little milk for several weeks after birth.
 HEART AND LUNGS - Babies breathe more quickly
than adults. Heart murmurs are quite commonly
heard in newborn babies and do not necessary
mean that there is something wrong with the heart.

 THE UMBILICAL CORD

It usually takes about a
week for the stump of
the umbilical cord to
come off.
 TUMMY CHEEKS
A baby’s tummy
usually looks rather
large.
 THE BABY’S BOWELS
During the first few
days a baby passes a
green-black, sticky
substances called
meconium.
 THE NAPPY AREAS - In boys, the opening at the
tip of the penis (urethral meatus) is usually tiny
and sometimes cannot be seen at all as it is
covered by the foreskin (prepuce).
Baby girls often have a vaginal discharge
between 5 and 10 days old, there may also be a
little bleeding caused by temporary hormonal
changes.
 SPINE, HIPS AND FEET
A skin dimple or tiny pit
at the base of the spine,
just where the buttocks
begin, is common and
quite harmless.
Sometimes a baby’s feet
tend to “turn in” or “turn
out” a little after birth.
NATURAL ABILITIES OF THE NEWBORN

 Respiratory reflexes
 Breathing
 Cough or Sneeze
 Yawn
• Nursing or feeding reflexes

– Crying
– Rooting
– Sucking
– Swallowing

 Defense Mechanism
 Crying
 Blinking his eyes
 Shivering
 Resist forcibly
 Crede’s prophylaxis
 As the baby’s head is born eyes are
swabbed using sterile swab; one swab per
wipe, inwards to outwards and discarded
to prevent transmission of infections like
gonorrhoea (ophthalmia neonotorum).
Erythromycin or tetracycline Ophthalmic
Ointment
 To prevent infection prophylactic eye
treatment against gonorrhea conjunctivitis,
may be passed on the fetus from the
vaginal canal during delivery
 Do not put anything else in baby’s eyes
 vastus lateralis

 Give vitamin K prophylaxis 1 mg IM

Vitamin K is also administered to prevent
haemorrhagic disease of the newborn
because newborn has a sterile intestine at
birth, hence, the newborn does not possess
the intestinal bacteria that manufactures
vitamin K which is necessary for the
formation of clotting factors.
 Inject hepatitis B Vaccine IM 0.5 ml
 BCG (Bacille Calmette-Guerin) 0.05 ml
vaccination ID
 Other Nursing Responsibilities
 Newborn Identification
 Birth Registration
 Birth Record Documentation
PHYSICAL NEEDS OF
NEWBORN
A. THE BABY’S NUTRITIONAL NEEDS
 Food for the baby is one of his first demands
and therefore, should be one of the first
concerns of the parents.
a. BREASTFEEDING
b. BOTTLE FEEDING
c. A COMBINATION OF BREAST AND
FORMULA FEEDING
 Preparation of formula for feeding
Equipment needed should be:
1. Assembled for convenience and ease in
preparing the feeding.
2. Wash thoroughly with friction in hot water
and detergent.
3. Rinse thoroughly
The formula may be prepared in either of the
following Method I- Terminal sterilization
procedures:

1. Clean the bottles and rubber nipples.

2. Mix milk, sugar, water in a pan.
3. Pour mixture into nursing bottles.
4. Set bottles on kettle rack to boil (boil
actively 25 minutes by the clock)
5. After the bottles cool, put them in a
refrigerator or tightly covered kettle
1. Sterilizing the equipment technique
Boil the bottles for five minutes and the
nipples also for 5 minutes.
2. Preparing the formula
 Wash your hands very well.
 Pour appropriate number of ounces of
boiled drinking water (cooled) into the
sterilized feeding bottle.
 Add corresponding amount of milk.
 Cover and shake well.
 Test temperature before giving to the
baby.
Cleaning the feeding bottle
 Rinse soiled bottles with cool

water to prevent particles from

sticking to the sides of bottles,
wash with hot water and
detergent using bottle brush; rinse
thoroughly.
 Rinse nipple with cool water, wash with
hot water and detergent and rinse turning
nipple inside and with a blunt article, for
example, the eraser end of pencil.
Placing a nipple or a nipple cap on a bottle

 Hold nipple by outer lower edge to keep

the tip clean and untouched.
 Cup index finger firmly around nipple on
far side of bottle to hold securely; with
other hand pull forward and over rim of
bottle using a rotary pulling motion.
 Place a clean cover over nipple for
protection such as glass, aluminum cup, or
oiled paper
HOLDING THE BABY FOR FEEDING

 Wash hands before feeding. If breastfeeding,

keep breast clean with mild soap and water.
 Sit in a comfortable chair.
 Support baby’s head and
back in the hand of the
arms and elevate the
baby’s head slightly in
case of swallowing.
 Give the baby breathing space when
breastfeeding, pressing the breast away
from baby’s face, if necessary placing a
finger at either edge of the nipple.
 Allow baby to nurse from the breast or bottle
for 10-15 minutes; longer may moan
dawdling and poor training, feeding time
should not be hurried.
BURPING THE BABY
 Burping is done to help release air that the
baby may have swallowed and is usually done
several times during a feeding
 Place clean cloth over
shoulder to protect baby
and clothing.
 Support baby’s hip, head,

and shoulders and hold

baby at shoulder so that he
can breathe easily.
 Stroke baby’s back gently

to aid the release of air

bubbles.
 B. BOWEL
ELIMINATION
 During its first few
days, the new baby
may have 3-4 stools
daily of a brownish-
green tart like
substance
(meconium). The
colostrum the baby
first nurses helps it
eliminate the
meconium.
Caring for diapers:
 Dispose of stool and rinse diaper before
putting in pail. A filler (soft cloth or tissue
placed in center of diaper) aids in easy and
effective disposal of stool.
 Wash diaper daily in hot mild soap or
detergent solution.
 Rinse about 4 times in clear warm
water to remove all soap and to
prevent any irritation to the baby’s
skin.
 Dry in the sun if possible for
cleanliness and appearance.
 When dry, smooth out and fold for use
to save mother’s time and effort.
 Many person like to boil diapers once
or twice weekly for cleanliness and
appearance especially if they cannot
hang them in the sun.
C. SUPPORTING AND HOLDING THE BABY

 From birth the baby

squirms and moves his
arms and legs. There is a
little or no coordination
in his movements.
However, a new baby
does have sufficient
muscular control to hold
his head erect for a
moment or two when
lying on his abdomen.
PICKING UP THE BABY
 Grasp the baby’s foot at the ankles, with your
fingers between them to prevent rubbing and
lift his buttocks slightly.
 Slip your free hand under his buttocks and up
along his back and with your fingers spread
support his head and shoulders.
 Shift your hand from his ankles to support his
buttocks with your palms crooking your
elbow over the far side of the baby.
 Raise the baby gently into your arms avoiding
any sudden motion that may cause fright.
Shifting baby to the total football hold so that one
hand will be free:
 Continue to support his head, back and
buttocks
 Swing the baby to your side so that his hip
rests on your hip on the same side as the hand
that continues to support his head and that
clasps him securely
Transfer Hold – passing a baby from one
person to another.
Hold the baby crosswise in
both arms, using cradle
positions and have
“receiver” hold arms
forward, slightly bent to
make a “cradle”. Place the
baby in the bend arms of
the receiver providing a
double cradle before the
arms of the person
passing the baby are
removed. The double
cradle pass is safe and
gives the baby a feeling of
security.
D. PROTECTION AGAINST INFECTION
 The newborn baby has not had time to
develop resistance to infection. Since it
takes time it is important to:

1. Keep the baby away from persons who may be

sick. If the mother becomes ill, the doctor will
recommend what specific precautions to take
in order to protect the baby.
2. See that everything used for the baby is clean.
Who ever gives care to the baby should have
clean hands and clothes especially during the first
weeks and months.
3. The baby himself should be kept clean always.
1. BATHING THE BABY
 When the baby’s umbilicus (navel) is
healed, usually after ten days, the baby
may be given tub baths. The mother
should talk to the baby, smile and be
pleasant, making this a sociable occasion.
1.1 Preparing for the bath – time, room and
equipment
1. Have a time planned.
2. Have the room ready.
3. Have that table and equipment ready.
 Newspapers or other protective
covering for furniture and newspaper
for soiled clothing
 Bath pad
 Toilet trays with jars open
 Tub of warm water
  Towel (1 over pad, 1 over baby)
 Pitchers of hot water handy to heat bath
water if necessary.
 Clean clothing, wrapping blanket, folded
diaper, and shirt,
4. Wash your hands.
1.2 How to bathe the baby
 Sudden movements, loud noises, or withdrawal of
support can frighten the baby: the bath should be
gentle and pleasant, and there should be
comfortable support for the baby’s back, neck, and
head.
 At bath times the mother has an opportunity to
observe the baby’s entire body. She should
especially observe its skin and eyes and report any
unusual condition to the doctor. Get temperature
first to check if he has fever. Tub bath may be
deferred or postponed if baby is sick.
1. Lift the baby
2. Use the football hold
3. Place the baby on the bath pad.
4. Remove his blanket and outer clothing
5. Clean the baby’s nostril
6. Test the temperature of the water
7. Wash the baby’s face; Dry his face gently
8. Wash ears
9. Wash hands
10. Rinse head
11. Remove diaper
12. Cleanse buttocks
13. Remove shirt
14. Wash, rinse, and dry the baby’s body
15. Wash genitals
16. Apply oil and liquid powder if desired
TUB BATH
1.3 DRESSING THE BABY
1. Put on shirt
2. Put on diaper
3. Wrap in blanket
“Lock-blanket”
4. Returning the baby to bed
1.4 GIVING CARE TO THE BABY’S NAILS
A baby’s nails grow rapidly requiring frequent
care. They can be cut and cleansed most
easily and safely while the baby sleeps, for he
is at least likely to make the quick movement
that makes injury possible.
REST AND SLEEP
Promoting rest and sleep for the baby

1. Avoid disturbing the baby in sleep.

2. Keep his room well ventilated but avoid drafts.
3. Promote comfort in sleep. Support his back
with a firm mattress when he lies on his back;
and with a pillow when he lies on his side.
4. Immediately change wet diapers.
5. If he cries at night, he may need a change of
position; or some gentle but reassuring patting
or cuddling.
While the baby is awake and resting

1. Turn baby from one

side to the other,
from lying down to
lying on his back.

2. Attention should
also be given to his
need to move his
joints without
restriction.
PSYCHOLOGICAL NEEDS
OF A NEWBORN
A. SENSE OF TRUST

The baby already

starts to develop one
of the components of
a healthy personality
in the process of
growing up. One of
the first and most
important of this is
the sense of trust,
usually starting to
develop in the first
year of life.
 The parents and family are encouraged
to meet his essential needs like:
1. Basic needs
a. Relieve his hunger
b. Cloth him well
2. The infant is usually observed to be
wanting to put everything into his
mouth
3. Need for warmth and comfort
4. The infant is usually frighten and made
insecure by action changes
1. Need for love and security
2. Need for sucking pleasure
3. The baby also learns to bite
4. Need to be comfortable
5. Need for companion
6. Need to socialize and communicate
B. WHEN NEEDS ARE FRUSTRATED
1. If the child’s need for food during infancy is not
pleasantly and satisfactorily met, he may grow
up to exhibit anxiety about eating as shown by
overeating or not eating enough.
2. If his need for love and security is not met, he
may grow up doubting his own ability to
influence his environment and become
insecure in his personal world.
3. If he does not develop the sense of trust well in
his infancy, he may not learn to trust others
until he grows up. He may not be able to hold
friends, nor even make ones, for his mistrust
them as he learned to mistrust those who cared
for him during his infancy.
C. TRANSITION

 The successful adjustment of the infant depends

less on he QUANTITY of time his mother now
spends with them than on the QUALITY of their
relations during his first six months while the
crisis was being resolved.
BABIES WHO NEED….

SPECIAL CARE
 Care of the premature infant

 The smaller the premature baby, the greater

his handicaps and the more he will need
immediate attention and special care.
 He will need to be kept warm
 He may need oxygen
 He may need to nod more frequently
 JAUNDICED BABIES

 Many normal babies develop a slight yellow

discoloration of the skin, particularly on the
face, between the third and fifth days of life.
This is caused by a pigment in the blood
known as bilirubin which is formed from the
normal breakdown of red blood cells.
 Phototherapy - “light” treatment is
generally reserved for babies with deep
jaundice.
 BREASTFEEDING
BEST FOR THE BABY
 INTRODUCTION

The worldwide trend away from

breastfeeding has led to an alarming
increase in the rate of illness, malnutrition
and death among small children, because of
the popular use of bottle feeding or artificial
feeding by most mothers.
1. THE HUMAN BREAST
 At puberty, around ten to fourteen years old, the
breast enlarges and grows into their adult size and
shape. The size is very dependent on the amount of
fatty tissues in the breast. Embedded in these fatty
tissues is milk secreting glands. The size and
shape of the nipple is of great importance to the
success of breastfeeding. Ideally, the nipple should
be long and erect enough to reach to the back of
the roof of the baby’s mouth. The nipple itself is
surrounded by a darker area of specialized tissue,
known as the areola. The pressure of the baby’s
lips on this areola squeezes the milk into his mouth
from the lactiferous ducts just under the areola.
 PHYSIOLOGY OF BREASTFEEDING

Delivery of the placenta

↓Estrogen MILK

↑Prolactin Acinar cells

 When an infant sucks at
the breast, the action
releases oxytocin. It
causes the collecting
tubules of the mammary
glands to contract, forcing
milk forward and making
it rapidly available for the
baby.
2. WHY BREAST MILK?
 Breast milk is the
perfect food for babies
and it is the only food
your baby needs from
birth until around 6
months of age.
ADVANTAGES FOR THE BABY
 It is much easier for the baby to digest than
formulas made from cow’s milk.
 It has just the right balance of nutrients to
help your baby grow strong.
 It provides the baby with antibodies that help defend
him against infections. Compared with bottle fed
babies, breast fed babies suffer loss from diarrhea
and common illnesses.
 Breast fed babies are not allergic to their mother’s
milk and breast milk helps protect the baby from
allergies.
 Breast milk is always safe for your baby. It is clean
and will not spoil in the breast.
 Breast feeding is convenient for mother and baby.
Breast milk comes at the right temperature
whenever the baby needs it.
 The baby’s sucking at the breast helps to form his
teeth and palate and to develop his jaws.
ADVANTAGES FOR THE MOTHER

 The breast feeding mother does not need

to buy formulas or to sterilize bottles and
heat milk for each feeding.
 Night feeding for the breast feeding
mother consist merely picking the baby
up and putting him to the breast. The
mother can lie down and rest while the
baby nurses.
The baby’s suckling
stimulates the uterus to
contract and prevent
post- delivery bleeding.
The uterus also returns
more quickly to it normal
size.
Breastfeeding may help
in natural child spacing
during the breastfeeding,
and menstruation has
not yet occurred.
3. PREPARATION FOR BREASTFEEDING
 good health
 an adequate diet
 plenty of fluids
 sunshine and fresh air
 adequate rest
 freedom from worry and anxiety
3.1. PREPARING BREAST FOR FEEDING
 During the last 6 weeks of pregnancy, gently pull the
nipples in all direction to toughen them.
 Rub them gently with a towel.
 Roll them by gently grasping each nipple at the base
with 2 fingers, pulling it out, and rolling it back and
forth. Lubricant may be used such as baby oil,
coconut milk or coconut oil.
 Expose the nipples to the air, or wear loose clothing.
 Massage the breast gently.
 If you seem to have flat or inverted nipples, you
should begin remedial massage during the 3 months
of pregnancy by stretching an inverted nipple.
3.2. TECHNIQUE
 Breast feeding should begin as soon as both the
mother and the baby can nurse, preferably after
birth. It should be started preferably within 30
minutes (1/2 hours) after a live birth.

HOLDING THE BABY

 Mother should hold their babies in various
positions while they are nursing. They may want
to lie down or sit up with a pillow supporting
their arm and perhaps one at the back for
comfort.
POSITIONING THE BABY TO SUCK
 Tickle the lips of the baby lightly with the nipple
and he will open his mouth. If he grasps your
nipple and then loses it turns his head away,
stroke his cheeks that is closest to the breast
with your nipple or finger he will turn towards it
and open his mouth. Be sure not to press his
other cheeks or both cheeks as he may become
confused.
TAKING THE BABY OFF THE BREAST
 When the baby finishes feeding but is still
holding the nipple, do not pull off the breast.
Instead use your finger to press breast away
from the corner of the baby’s mouth or gently
pull back on his cheek near the corner of his
mouth. Then gradually remove your nipple
from his mouth. If your fingers are clean you
can also break the suction by placing one
finger in the corner of the baby’s mouth.
SCHEDULE FOR BREASTFEEDING

 Each baby has his

own schedule. Feed
the baby whenever
he is hungry. A
breast feeding baby
feeds 8 to 12 times
each day.
COMMON PROBLEMS DURING
BREAST FEEDING
A. FLAT OR INVERTED NIPPLES
• Nipples in these conditions, when squeezed
at the base, do not come out but seem to
sink into the breast.

Protrudes normally Flat nipple

Remedy:
1. Daily pull and stretch the nipples in all
directions during the last 3 months of
pregnancy.
2. Place your thumbs on either side
of the nipple. Press in firmly
against the breast tissue and at
the same time push the thumbs
away from each other. This
stretches the nipple out.
3. Use a breast shield in the last
few months of pregnancy.
4. Use a breast pump before you
nurse to pull the nipple out.
5. While nursing, held the areola to
help the baby to hold of the
nipple. Try different positions for
this. After some time the baby’s
sucking will pull the nipple out
naturally.
B. CRACKED OR SORE NIPPLES
• Caused by friction due to strong sucking on
the not yet conditioned nipples; improper
positioning and sucking by the baby.
Remedy:
1. Check the baby’s position and sucking.
2. Nurse for less time, but more often.
3. Start feeding on the less painful breast.
4. Pick the baby up to nurse before he is very
hungry so he won’t suck so hard.
5. Alternate your position for each feeding.
6. Check to make sure the baby has both the
nipple and areola in his mouth.
7. With water, wash the residue of the baby’s
saliva from the breast after a feeding.
8. With water, wash the residue of the baby’s
saliva from the breast after a feeding.
9. Between feeding, expose your nipples to the
air or wear a loose blouse that allows the air
to circulate.
10. Wear cotton bras and clothes as they help t
he nipples dry.
11. Apply warm coconut oil, or Vitamin E oil, to
dry nipples.
12. Avoid using strong detergents on bras or
clothing that comes in contact with the
nipples.
C. BREAST ENGORGEMENT
• This swelling is due to an overproduction of
milk and an accumulation of blood in the
capillaries. It may be uncomfortable and
painful, and there may be fever.
Remedy:
1. Rest
2. Let the baby suck more often.
3. Don’t let the baby miss a feeding.
4. If the baby finds it hard to grasp the nipple,
express a little milk to make the nipple easier
for the baby to suck.
5. Soak a cloth in hot water, wring it out and put
it over the breast.
6. Let the baby begin nursing on the fuller
breast first.
D. CLOGGED MILK DUCT
• A clogged duct appears as a lump in one
area of the breast which may be red, sore,
and tender.

Cause:
1. Milk ducts are not being properly emptied
2. Tight bras or clothing may prevent milk
from moving out of the ducts.
3. Sleeping on your stomach may constrict
milk flow.
4. Secretions may have dried on the nipple.
Remedy:
1. Rest
2. Always start the baby sucking on the affected
side.
3. Gently massage the area from the armpit
down towards the nipple, especially while the
baby is sucking.
4. Empty the affected breast at each feeding.
5. Alternate your position at each feeding .
6. Soak any dried secretions on the nipple with
a washcloth.
7. Apply warm compresses between feedings.
8. Soak the breast in warm water for 20 minutes
before each feeding.
E. BREAST INFECTION
• This is recognize as a painful or swollen
lump or area of the breast which is
accompanied by fever and “flu-like”
symptoms.

Cause:
1. A clogged duct which has not been
treated and becomes infected.
2. A cracked nipple which allows entry of
infection.
Remedy:
1. Begin remedies for clogged milk duct.
2. Don’t delay and see your doctor. Remind him
that you are breast feeding in case he
prescribes medication.

• If your doctor advises you not to breastfeed

while you have the infection, continue
nursing on the unaffected side, and express
milk at regular feeding times from the
affected side.
F. BREAST ABCESS
• This is localized infection which requires
incision and drainage, but occurs rarely. It
will be painful if treatment is delayed.

Cause:
 A breast infection which has not been
treated.
Remedy:
1. Seek medical attention
2. Incision and drainage may be done, and
the mother may be advised to temporary
discontinue nursing on the affected side .
3. To maintain the milk supply, express milk
from the affected side at regular feeding
time.
4. Keep nursing on the unaffected side.
G. DIMINISHING MILK SUPPLY
• The breast milk does not seem adequate and
the baby fusses or is dissatisfied with
feedings.

Cause:
1. Fatigue
2. Inadequate fluid intake.
3. The baby misses some feeding.
4. Supplementary bottles of formula are
being given.
5. The mother has lost confidence in her
ability to nurse, and is tense and anxious.
Remedy:
1. Rest
2. Make sure you are drinking enough fluids.
3. Cut back on tiring outside activities.
4. Gradually discontinue supplementary bottles.
5. Nurse the baby more often – every hour if
necessary.
H. POOR LET – DOWN REFLEX
• The breast milk does not “let – down” with
each feeding.

Cause:
 The mother is tense or upset while
breastfeeding and these interferes with
the milk “letting down”.
Remedy:
 Follow the remedy for “diminishing milk
supply”, and also do the following:
1. Develop a routine to condition the breasts to
let-down the milk.
2. Pick up the baby for a feeding just as he
wakes up, before he can begin crying from
hunger.
3. Keep him sucking at the breast so the “let
down” will be stimulated; console him by
cuddling and/or singing to him.
4. Call up an experienced breastfeeding mother.
MANUAL EXPRESSION
OF BREASTMILK
I. Purpose:
 It helps all the lacteal ducts to open and
protects the lacteal gland by maintaining
elasticity of breast tissue so, lactation is
facilitated.

II. Term:
1. Start first day after delivery.
2. Massage once a day in the morning.
3. All patients are to have a breast massage
III. Necessary Items:
1. Towel for massage
2. Bath towel (2), small towel (2)
3. thermos bottle with hot water
IV. Technique:
1. Place the patient supine
2. Stand by right side of the patient
3. Place dry towels around breasts
4. Place hot, wet towel on patient’s breast, give
the massage while the towel is still warm.
5. There are eight steps for one complete
massage, this should take one minute, give
the massage for 15-20 minutes.
First day after delivery – 1-8 technique once
Second day after delivery – 1-8 technique once
When patient can by herself explain 5-6
technique
(8 Procedures)
1. Put your fingers on around the patient’s
2. Breast
3. then push it up
4. Push breast down toward the umbilicus
5. Make a half circle from right to left then left to
right. (when you stand on the right of the
patient, start from right to left)
6. Pull breast toward you
7. Make a circle from left to right (clock wise)
8. Milking
Advantages:
 Some mechanical pumps cause discomforts and
ineffective
 Many mothers are more comfortable with manual
expression of breast milk because it is more natural.
 Skin- to- skin contact is more stimulating than the
feel of a plastic shield. So manual expression usually
allows for easier let-down.
 It’s convenient.
 It’s ecologically superior
 It’s portable. How can a mother forget her hands?
 Best of all, it’s free.
HOW TO STORE EXPRESSED MILK

 Breast milk may be stored in glass or plastic

bottles or containers that have been sterilized
by being boiled for 20 minutes. Be sure every
container or items that come in contact with the
milk is sterilized.
HOW TO FREEZE EXPRESSED MILK

 If you use a 4 ounce baby bottle, put about 3 ½

ounces of milk in it, that is slightly less the size of
two containers. When the milk is frozen it will
expand and fill the container. Date and number
each bottle. Always chill newly expressed milk for a
few hours before adding it to previously frozen milk.
HOW TO THAW EXPRESSED MILK

 To thaw the milk, run cold water vapor to

container. If you wish warm the milk container
in hot water, but do not boil the milk, as boiling
destroys the nutritive and immunological
properties of milk. It is not advisable to re-
freeze thawed milk.
Expressed milk lasts:
 Up to 6 hours at room temperature
 Up to 24 hours in the refrigerator or in an
ice pack and this include thawed milk.
 Up to 3 months in a refrigerator freezer
 Up to 6 months in the freezer at 0°
Fahrenheit (10° Centigrade), that is, in a
separate freezer with its own temperature
control
 Several years in ilk bank centers

(Discard any milk that has been kept longer

Brown-outs:
If there are brown-outs in your area, check
after each brown out to see if the milk had
thawed out. To delay the thawing process,
put the bottle/s in plastic bag with ice, so
that the additional layer of ice would have to
thaw out before the milk. If milk thaws out,
keep it refrigerated and give it to the baby
within 24 hours, or discard any milk that is
not consumed in the time period.
DO NOT REFREEZE.
RELACTATION
Increasing Breastfeeding

Use this method if:

 you want to purely breastfeed, and you are
currently supplementing breastfeeding with
formula or foods such as lugaw or cereal:
 you have discontinued breastfeeding.
Method:
Feed the baby on demand, always
breastfeeding on both breast before giving
the supplement (formula or cereal).
Decrease the supplement by ¼ to ½ ounce at
each feeding, until you are purely
breastfeeding.
Restarting breastfeeding, or beginning
breastfeeding
Follow this procedure if:
 your baby is less than 6 weeks old, and
you have not breastfed her.
 You have breastfed before and stopped
and now have no milk.
Method:
Start expressing milk as soon as possible and
feed it to the baby by spoon. Also try to have the
baby suck at the breast as soon as possible. If she
refuses the breast, try putting a few drops your milk,
formula, or sugar water on the nipple to entice her to
suck.
SUPPLEMENTARY FEEDING
• Breastfeeding alone during the first 4 – 6
months is enough to meet the daily
requirements of an infant. As long as the
growth of the child is being monitored, and
the child is growing according to his normal
growth pattern, breastfeeding alone will
suffice for 6 months.
WEANING
Solid food is usually introduced into the baby’s
diet at around 6 months, while breastfeeding
continues. Nutritious food prepared at home is
preferable to commercially prepared food.

Up to 9 months, breast milk is still the most

important food in your baby’s diet, and you
should offer it to him as a part of each meal, as
well as whenever he demands it.
 THE CONCEPT AND IMPORTANCE OF
VACCINATION
 Immunization- is the process by which
vaccines are introduced into the body before
infection sets in.
 Vaccines reacts in the immune system that
produces antibodies to fight infection.
 Vaccinations promote health and protect
children from diseases – causing agents.
 Children needs to be vaccinated as early as
indicated because they belong to vulnerable
age group, and susceptible to childhood
illnesses.
 Expanded Program on Immunization:
 Every Wednesday is designated as
immunization day and is adopted in all parts
of the country.
 Baranggay – it is done monthly
 Far Flung Areas – Quarterly.
 A child is immunized to provide maximum
immunity against the seven vaccine
preventable diseases.
1. Bacillus Calmette Guerin (BCG) –
 Given at birth or any time after birth
 given 1 dose
 This is given to the child the earliest date
possible to prevent acquiring TB Meningitis &
Other Tb infections in which infants are prone.
2. Diptheria
Pertussis,
Tetanus (DPT)
 given after weeks of
life
 It has 3 doses and is
given with a
 4-weeks interval • cutaneous diphtheria caused by poor hygiene
Antitoxin —An antibody against an exotoxin, usually derived from horse
serum.
 An early start of DPT Bacillus —A rod-shaped bacterium, such as the diphtheria bacterium.
Carrier —A person who possesses a gene for an abnormal trait without

reduces the chance of

showing signs of the disorder. The person may pass the abnormal gene
on to offspring. Also refers to a person who has a particular disease
agent present within his/her body, and can pass this agent on to others,

severe pertussis but who displays no symptoms of infection.

Cutaneous —Pertaining to the skin
3. Oral Polio Vaccine
 It is given 6 weeks after birth
 Three doses
 4 weeks interval
 It is very effective, the earlier
OPV is given, keeps the
Philippines polio-free.
4. Hepatitis B
 Given at birth
 3 doses
 6 weeks interval from
the 1st dose to 2nd dose,
and 8 weeks interval
from 2nd dose to 3rd dose.
 It reduces the chance of
being infected and
becoming a carrier of
the disease. – It prevents
liver cirrhosis and liver
cancer.
5. Measles

•Given at 9
months after birth
•Only 1 dose EXANTHEM
•At least 85 % of
measles can be
prevented by
immunizations
this age