Care of the Newborn at Birth

Newborn Identification and Registration

• It is important to avoid the babies being handed to the wrong parents

• Also to avoid kidnapping of babies

Identification Band

• It is a plastic bracelet with permanent locks that require cutting to be removed

• It has the same number as the mother’s hospital number, the mother’s full name, date & time of infant’s birth

• 2 bands should always be used

Birth Registration

• The physician or nurse-midwife who delivered the infant must be certain that a birth registration is filed to the corresponding agency where the infant was born

• It contains the correct infant’s name, mother’s name, father’s name, birthdate and place of birth.

Footprinting

• It should be taken with care because it will be part of the child’s permanent record

Birth Record Documentation

• Be certain that the birth record lists the ff:– Time of birth– Time the infant breathed– Whether respiration is spontaneous or

aided– Apgar score at 1 and 5 minutes of life– Whether eye prophylaxis was given– Whether vitamin K was administered

Birth Record Documentation

– General condition of the infant– Number of vessels in the umbilical cord– Whether cultures were taken– Whether the infant voided and passed

a stool

Apgar Scale

Sign 0 1 2

Heart rate Absent Slow (<100) >100

Respiratory effort Absent Slow, irregular, weak cry

Good, strong cry

Muscle tone Flaccid Some flexion of extremities

Well flexed

Reflex Irritability: Response to catheter in nostril lap to sole of foot

No response

No response

Grimace

Grimace

Cough or sneeze

Cry and withdrawal of foot

Color Blue, pale Body normal pigment, extremities blue

Normal skin coloring

Initial Feeding

• May give breastfeeding immediately after birth

• If formula feeding will be done, it would be after 2-4 hours after birth

• Fed as often as every 2 hours

Metabolic Screening Test

• Every infant must be screened for phenylketonuria (a disease of defective protein metabolism) and hyperthyroidism

• This is a simple blood test in which 3 drops of blood from the heel are dropped onto a special filter paper

• The baby should have received milk before the test for it to be accurate

Hepatitis B Vaccination

• All newborns received a 1st vaccination against hepatitis B within 12 hours after birth

• Second dose: 1 month

• Third dose: 6 months

Vitamin K Administration

• Newborns are at risk for bleeding disorders during the 1st week of life because their gastrointestinal tract is sterile at birth and unable to produce Vitamin K, necessary for blood coagulation

• Vitamin K stimulates the liver to produce factors II, VII, IX and X

• A single dose of 0.5 to 1.0 mg of Vitamin K is administered intramuscularly within the first hour of life