Care of Normal Newborn - gmch.gov.in lectures/Pediatrics/   Teaching Aids: NNF NC- 3 Care of normal

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Text of Care of Normal Newborn - gmch.gov.in lectures/Pediatrics/   Teaching Aids: NNF NC- 3 Care of...

  • Teaching Aids: NNF NC- 1

    Care of Normal Newborn

  • Teaching Aids: NNF NC- 2

    Principles of care at birth

    Establishment of respirationPrevention of hypothermiaEstablishment of breastfeedingPrevention of infectionIdentification of at risk neonates

  • Teaching Aids: NNF NC- 3

    Care of normal newborn

    Preparation before deliveryImmediate care at and after birthEssential postnatal care

  • Teaching Aids: NNF NC- 4

    Contents of clean delivery kit (at home)

    Soap for washing hands; ensure clean and boiled water2 to 3 sterilized cord tiesA new clean blade / boiled at home instrument to cut cordClean sun-dried cloth / sheet, small gauze padsA clean plastic envelope / cloth to keep the kit in

  • Teaching Aids: NNF NC- 5

    Five cleans to prevent infection

  • Teaching Aids: NNF NC- 6

    Physical facilities for resuscitation (at hospital)Resuscitation corner with warmerContents of resuscitation kitSuction catheter 10 Fr, De Lee trap, suction machine Resuscitation bag and masks

  • Teaching Aids: NNF NC- 7

    Physical facilities for resuscitation (at hospital)

    Infant laryngoscope with bladesEndotracheal tubes (2.5, 3.0, 4.0 mm)Medications epinephrine, naloxone, normal saline, sodium bicarbonatePlenty of disposables

  • Teaching Aids: NNF NC- 8

    Newer guidelines

    for neonatal

    resuscitation

  • Teaching Aids: NNF NC- 9

    Concept ofRoutine Care,

    Supportive care and

    Ongoing Care

  • Teaching Aids: NNF NC- 10

  • Teaching Aids: NNF NC- 11

    Immediate care after birth

    Prevent hypothermiaEye, skin, cord careGive injection vitamin K Breastfeed within hour of birthSearch for malformations

  • Teaching Aids: NNF NC- 12

    Increased risk of malformation

    Single umbilical arterySimian creaseDysmorphic featuresAsymmetric cry due to absence of Depressor Angularis Oris Muscle Excessive drooling of saliva

  • Teaching Aids: NNF NC- 13

    Quick screening for malformations

    Screen from top to bottom and in midlineOrifice examination

    Anal openingOesophagus patency*Choanal atresia

    * SFD baby, polyhydramnios, excessive drooling, single umbilical artery

  • Teaching Aids: NNF NC- 14

    Essential postnatal care

    Nurse in thermal comfort(warm to touch, pink soles)Check umbilicus, skin, eyesGood sucking at breast Screen for danger signalsAdvice on immunization

  • Teaching Aids: NNF NC- 15

    Care of umbilical stump

    Inspect 2 to 4 hours after ligation for bleedingDo not apply anything, keep cord clean and dryInspect for discharge or infection till healing occurs

  • Teaching Aids: NNF NC- 16

    Care of the skinDry using soft prewarmed clean clothBathing soon after birth is not recommended Do not make vigorous attempts to remove vernix caseosaInspect for superficial infections

  • Teaching Aids: NNF NC- 17

    Care of the eyes

    Clean at birth and subsequently dailyNo kajal applicationFor sticky eyes use normal saline or appropriate medication Nasolacrimal duct blockage, Massaging helps

  • Teaching Aids: NNF NC- 18

    Summary: care of normal neonates at home

    Protect from cold/ heatKeep umbilical stump clean and dryDont apply anything on cordNo application in eyesExclusive breastfeeding - day and night

    for six months

  • Teaching Aids: NNF NC- 19

    Weight change pattern in term baby

    May loss up to 5-7% during first 3-5 daysRegains birth weight by 7-10 daysGains 30 g/day during 1st month

  • Teaching Aids: NNF NC- 20

    Danger signs

    LethargyHypothermiaRespiratory distressCyanosisConvulsionsAbd distension

    BleedingYellow palms/ soleExcessive wt lossVomitingDiarrhoea

  • Teaching Aids: NNF NC- 21

    Follow up visit: Objectives

    Assess growth & developmentEarly diagnosis and management of illnessHealth education

    Exclusive breastfeeding for 6 monthsComplementary feeds after 6 monthsSpacing of family

  • Teaching Aids: NNF NC- 22

    ImmunizationAge Vaccine Optional0-7 days BCG, OPV, Hep B 6 Weeks OPV,DPT, Hep B Hib10 Weeks OPV,DPT, Hep B* Hib14 Weeks OPV, DPT, Hep B Hib9 months Measles15 months MMR 18 months OPV, DPT HibSchool entry(4-5 yrs) OPV, DT10 years Tetanus toxoid (every 5 years)

    * May omit this dose of hepatitis B vaccine if birth dose is given