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 ½ 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 dryDon’t 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