Contents
Introduction
Care that every newborn baby needs regardless of where it is born or its size.
Sequence of care
Preparation for birth
- Warm & drought free delivery room
- Pre-heated radiant warmer
- 2x clean warm towels
- Asepsis:
- Hand washing, sterilised gloves
- Sterilized delivery kit
- Functional bag & mask
Immediate newborn care
First 60-minutes of birth
- Record time of birth
- Rule out meconium
- If meconium present, or baby not crying:
- Suction before drying
- Put baby on mother’s abdomen. Check for breathing and dry the baby
- Remove wet towel and ensure skin-to-skin contact. Cover baby with dry & warm towel
- Ensure cord-cutting (within 1-3 minutes)
- Rule out major malformations & birth injury
- Support mother in initiating breastfeeding (within 30 minutes)
- Place identity tag on baby
Early newborn care
60 min – 6 hours
- Weigh the baby (ensure proper function prior)
- Administer Vitamin K IM (1 mg)
- Examine for vital signs& ruole out danger signs
- Vaccinate:
- BCG
- OPV-0
- HepB- birth dose
- Rooming-in with mother
Care prior to discharge
6 hours – 48 hours
- Continue monitoring
- Ensure successful establiishment of breastfeeding & rule out any feeding difficulty
- Counsel mother for exclusive breastfeeding
- Continue to keep baby warm
Care at discharge
Discharge criteria
- Screening tests done
- Nutritional supplements started
- Immunization completed
- Weight gain is consistent
- Baby is feeding well
- Absence of danger signs
- Treatment completed (if any)
Danger signs
- History of difficulty in feeding
- Movement only when stimulated
- Temperature below 35·5°C or 37·5°C or more
- Respiratory rate over 60 breaths per minute
- Severe chest indrawing
- History of convulsions
Note:
- DO NOT:
- Suction (unless nose/mouth is blocked)
- Separate newborn from mother
- Place newborn on wet/cold surface
- Wipe off vernix
- Bathe the baby (till discharge)
- Feed anything other than breastmilk
- Discharge (if baby is not feeling well)
Follow-up
Within 3-7 days of discharge