CARE OF NEWBORN…..

Dr.Roshen Mascarenhas
 Definitions

• Preterm Baby: A baby who is born before 37 weeks (259 days).

• Term baby : between 37 weeks to 41 weeks (259 – 292 days).

• Post term baby: babies born beyond 42 weeks (292 days ).

• Low Birth Weight(LBW): A baby weighing <2.5 kg.

• Very low birth weight : < 1.5 kg.

• Extremely LBW : < 1 kg .

Neonate: A baby who is ≤ 4 weeks or 28 days.

Early Neonatal Period (< 7 days).

Late Neonatal Period (7-28 days).

Infant: A child who is less than 1 year or 365 days.

6 Cleans for baby.
 Every day care

Four key elements

1. Breastfeeding

2. Ensure warmth

3. Cord care

4. Hygiene
 Every day care
1. Breastfeeding

• Support exclusive breastfeeding

on demand day and night.

• Establish proper attachment and

positioning .

-
 Every day care
2. Ensuring warmth

The first day and later

• Wrap in soft dry clean cloth, cover
head with cap.

• Assess warmth every 4 hours by

touching baby’s feet:
– If feet are cold, provide skin-to-
skin contact and extra blanket.

NC- 8
• The baby should be kept away from wet cloth, cold room, cold
walls, cold surface, open windows, draught, revolving fan and
air conditioner.

• Don’t wipe off VERNIX by massage.

• The temperature of newborn should be maintained at 36.5-

37.5 degree C.

• Postpone bathing/sponging for 24 hours.

 How to identify a baby with hypothermia?

• If a newborn is felt cold to touch over its abdomen and feet.

• If a new born becomes lethargic and stops breast feeding.

• If the axillary temperature recorded is less than 36.5 degree C.

 Vernix Caseosa

• Protective cheesy-like, gray-white fatty substance

• FT: skin folds under the arms and in the groin under
the scrotum or in the labia.

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 Every day care
2. Ensuring warmth

At home

• Cover the baby well including the head and the extremities.
• Keep the rooms warm.
• Skin to skin contact / Kangaroo mother care.
• Regular and frequent breast feeds.
 Every day care
3. Cord care

Wash hands before and after cord

care
• Put nothing on the stump
• Fold diaper below stump
• If the stump is soiled, wash with
clean water and soap
• Observe for red or draining pus /
blood or adjoining skin is red.

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 Every day care
4. Hygiene

• Wipe the face, neck, underarms DAILY

• Wipe the buttocks when soiled

• Bathing the baby:

– Use lukewarm water for bathing.
– Use soaps which are not acidic to the skin.
– Dry the baby thoroughly; and cover after bath
• Use cloth diaper on baby’s bottom to collect stool; wash hands after
disposing
• DO NOT put anything in baby’s eyes or ears
 Care of eyes

• Should be cleaned daily with sterile cotton swabs soaked in

clean lukewarm water.( inner to outer canthus, with separate
swabs)

• Don’t apply kajal in the eyes.

 Hair care
While many babies are born with a full head of hair, others are
nearly bald and stay that way for up to a year.

Hair usually does not need to be shampooed daily; twice a week

with a non-tearing product may be sufficient.
 Body massage
• Advantages:
1) improves circulation.
2)Improves tone of the muscles.
3)Reduces stress and helps baby sleep better.
4)Prevents dryness of the skin.

Which oil??
Preferably coconut or olive oil.

AVOIDS VIGAROUS AND PAINFULL OIL MASSAGES ,

RUBBING AND OILLING OF EXTREMITIES OR PUTTING
OIL IN THE EARS AND THE NOSE!!!!!!
 Clothing for the baby
- Loose, soft and preferably made of cotton.

- Open in the front or back for ease of wearing.

- Avoid using large buttons which can hurt them.

- Nappies should be made of thick, soft and absorbent material.

 TRIMMING NAILS

• The baby's nails may be softer and more pliable but very
sharp, and a newborn, who has little control over his flailing
limbs, can easily end up scratching his own face.

• The best time : after recent bath and when baby is sleeping.
-Begin daily mouth-cleaning at birth
before teeth appear.

-Cloth wrapped around your finger, to

brush your baby’s gums just as it they had
teeth.

- Wipe the roof of mouth and insides of

cheeks with a clean soft damp fabric.

-When the first teeth appear, brush them

gently with a small, soft bristled
toothbrush.
Place baby in sitting position. Lean them
forward, supporting their chin and chest
with your hand. Pat their back in an
upward motion. Continue until you hear
the burp of air.
Keep lights on and regular
noise levels.
If you always rock your baby
to sleep, they will come to
expect and rely on it.

AGE SLEEP REQUIRED

1 week old 17 hrs, including 4 naps
1 month 16 hrs, including 3 naps
3 month 15 hrs, including 3 naps
6 month 14.5 hrs, including 2 naps
9 month 14 hrs, including 2 naps
1 yr 13.5 hrs, including 2 naps
 .

.
The stools of the average
newborn are very soft and
yellow, with little or no
offensive odor

For various reasons baby does not always digest all the milk they
eat. This undigested milk shows up in the stools in the form of
curds (much like the curds in cottage cheese).
 Excessive crying:

• Hunger cry
• Cry due to discomfort
 Danger signs
Early recognition and treatment

• Not feeding well • Floppy or stiff

• Less active than before
• Fast breathing (>60/ min)
• Moderate or severe chest
in-drawing
• Grunting
• Convulsions
• Temperature >37.50C or
<35.50C
• Umbilicus draining pus or
umbilical redness
extending to skin.
• >10 skin pustules
• Bleeding from umbilcal
Stump

Teaching Aids: ENC NC- 25

Common neonatal problems
- Plugged sebaceous
glands or oil ducts.
-Located over nose, cheek,
and chin.
-Caused by stimulation
from the mother’s
hormones. .
-Disappear in a week or
two.

DO NOT SQUEEZE!
Milia are NOT pimples,
and squeezing could
result in permanent
scarring.
 Mongolian Spots
• Blue-green or gray
pigmentation
• Lower back, sacrum &
buttocks
• Disappears by 1 years
of age

051104 Neonatal Care 28

 Desquamation
• Dryness/ peeling of the skin.
• Usually occurs after 24-36 hours .
• Marked scaliness & desquamation = signs of postmaturity.

051104 Neonatal Care 29

 Salmon Patches

• AKA:"angel kisses"
(when on the forehead or
eyelids), and "stork bites"
(over the nape of the
neck)

051104 Neonatal Care 30

 Stork bites

051104 Neonatal Care 31

 Mottling

• Bluish mottling or
marbling of skin in
response to chilling, stress
or overstimulation.

051104 Neonatal Care 32

 Erythema toxicum
• Newborn rash
• Small, white, yellow, or
pink to red papular rash
• Trunk, face & extremities
• Within 48 hrs

051104 Neonatal Care 33

 -Swollen breasts or genitals.
-Milky discharge from their
nipples.
- girls :clear or whitish
vaginal discharge/blood
tinged.
Breast
enlargement Cause : maternal hormones
transferred during pregnancy.

Don't try to squeeze any

discharge from the breasts:
can cause mastitis
.
 Constipation occurs when stools become hard and are difficult to pass.

Never use artificial laxatives or stool

softeners without the orders of a physician.
Babies easily become dependent on these
chemicals.

.
 .

Immature digestive system.

Immature nervous system.
Nearly 22% of all babies will
suffer from colic.

The condition seems to intensify toward evening hours.

It may last from 3 weeks up to 3 months, but rarely beyond.
• Congenital teeth
• Tongue tie
• Umbilical hernia
• Watering of eyes
• Physiological jaundice
 K Y O U
T H A N