Well Newborn Care
* Place the infant skin to skin with the mother, once he is stable.
* Assess the Apgar score, at 1 and 5 min after birth.
* Perform a brief physical examination to check that the infant is
healthy (has no major anomalies or birth injuries, his/her tongue &
body appear pink, and has normal breathing).
* Examine the hips to rule out dislocation.
* Umbilical cord care.
► Fix the cord clamp 3-5 cm away from the umbilicus, and cut the
cord using a scalpel.
► Examine for any abnormality (single umbilical artery).
► Wipe the umbilical stump with ethyl alcohol 70%.
* Identification: take footprints and record in the medical record,
and place 2 bracelets with identical hospital numbers (one on the
wrist and the other on the ankle).
Transitional Care (first 4-6 hrs after birth)
* Common signs of disordered transitioning
► Respiratory distress
► Poor perfusion with cyanosis or pallor
► Need for supplemental oxygen
► Hypothermia
* Evaluate every 30-60 min
► Assess HR, RR, axillary temperature, color & tone.
* With suspicion of disordered transitioning
► If stable → observe closely for a period of time.
► If persistent signs → transfer to a higher level of care.
Routine Care
* Keep newborn with mother all the time (rooming-in).
* Perform proper hand washing before handling the newborn.
* Maintain newborn’s temperature
► Encourage skin to skin contact with the mother
► Use hats and proper clothes
* Assess GA using the expanded Ballard Score. Measure and
record the newborn's weight, head circumference, and length,
and then plot against the estimated GA.
* Bathing
► Do not bathe immediately after birth; vernix caseosa does not
need to be removed.
► The first bath can be given with non-medicated soap and
warm tap water once infant's temperature has stabilized (4-6
hrs after delivery).
► Do not bathe the infant in a basin until after the umbilical
stump has fallen off.
* Examine skin for trauma or signs of infection.
* Umbilical cord care
► Keep the cord dry and loosely covered with clean sterile gauze.
► Fold the diaper below the umbilicus.
► If soiled, wash with soap and clean water and dry it well.
► Apply alcohol after each diaper change.
* Place the newborn infant supine (on the back) to sleep and not
prone (on the stomach).
* Routine medications
► Give vitamin K1 (0.5-1 mg IM) within 2 hrs of life.
* Feedings
► Support immediate and exclusive breastfeeding during the
first hr postpartum preferably in the Delivery Room.
► Offer standard term formula to infants for whom breastfeeding
is contraindicated at least every 3-4 hrs.
Instructions to the Mothers or Other Care-Givers
* Observe baby’s temperature, respiration & effort at feeding.
* Observe for passage of urine and stools.
Vaccination
* Educate parents about vaccination schedule.
* Administer HBIG (0.5 ml/kg IM) to all newborns of HBsAg positive
mothers as soon as possible after birth (within 12 hrs),
followed by HBV vaccine (0.5 ml IM).
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