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Essential new born care Dr Vikram Bedi
- 1. ESSENTIAL CARE OF NEWBORN NOEL ASHITA NAGAR NURSING FELLOW BEDI HOSPITAL, LEVEL IIIA NICU CHANDIGARH MENTOR: DR VIKRAM BEDI
- 2. HOPE EVERYONE IS DOING FINE STAY SAFE..!!
- 3. CARE OF NORMAL NEWBORN • Care at birth & resuscitation • Identification of at risk newborn • Establishment of Breastfeeding • Prevention of Hypothermia • Prevention of Infections • Newborn screening • Immunisation & discharge advice
- 4. Why Essential New Born Care??
- 5. 2.4 million newborns die each year (38% of all newborn deaths) occur in 4 countries of South Asia
- 7. When do they die? Up to 50% of neonatal deaths are in the first 24 hours 75% of neonatal deaths are in the first week
- 8. 2.4 million newborn deaths – Why? almost all are due to preventable conditions Two thirds of all neonatal deaths are in LBW infants
- 9. DEFINITION Essential newborn care is a comprehensive strategy to reduce the death of newborn through cost effective interventions before conception, during pregnancy, immediately after birth and postnatal period
- 13. The 6 Cleans’s for Safe Delivery
- 18. NORMAL NEWBORN • Birth Weight 2500 grams or more • Gestation 37 weeks or more • Appropriate for gestational age (between 10-90%) • Does not require active resuscitation • Infant does not suffer from postnatal illness • Mother not suffering from any serious complication
- 19. AT BIRTH Lustily Crying & Active Newborn Baby Is A Delight to the Mother Obstetrician Pediatrician
- 20. VIGOROUS NON- VIGOROUS Poor tone/cry/activity Needs Resuscitation
- 21. HAZAROUS WAYS TO STIMULATE THE BABY a. Hot & Cold Compression b. Squeezing the rib cage c. Forcing the thigh into the abdomen d. Dilating anal sphincter e. Blowing cold or room air on face/body
- 22. GENTLE WAYS TO STIMULATE THE BABIES a. Rubbing the back b. Flicking of the heel c. Flicking the sole of the foot
- 23. When a newborn is not breathing after birth, URGENT and SKILLED resuscitation is needed immediately
- 24. WAIT A LITTLE..!
- 27. SKIN TO SKIN CONTACT
- 34. COMMUNICATION WITH FAMILY • Congratulate • Show sex • Describe the Condition • Document / Foot Print
- 35. CARE BEYOND BIRTH Safe transfer to ward vis STS contact. Preshifting Counselling to Mother
- 37. • How to swaddle - Skin to skin
- 38. • In newborn temp is usually unstable • Warm chain should be maintained • May develop hypothermia/hyperthermia that may impose serious cold stress • Bath is not given at birth. • In winters clothes should be prewarmed • Mother should be trained to asses cold stress
- 43. • First 6 months • Every 2-3 hrs or on demand • Good latching Techniques EXCLUSIVE BREASTFEEDING
- 44. Suck for 15-20 min Emptying one breast in each feed Partially emptied breast to be fed first Active interaction during feed LATCHING
- 46. • Feeding to be done round the clock • Gradually night feeds can be reduced • Burping should be done after feed • Mother should take additional nutrients [450 kcal/day] DURING FIRST 4-6 WEEKS
- 47. NORMAL FINDINGS
- 48. WEIGHT RECORDING
- 49. • Recording to be done on electronic scale with resolution of +/- 1.0 or 5.0g • Baby losses weight (5-10%) during first 3-5days of life then regained by end of first week • Factor contributing to wt loss including removal of vernix, mucus, blood from skin, passes of meconium and reduction extra cellular fluid • Gains 30gm/day during 1st month WEIGHT CHANGES IN TERM BABY
- 60. • Vit K [1.0mg] given at birth by IM route to prevent hemorrhagic disease • Vit D supplement is started as breastfed babies can develop rickets at 3-4 months • Routine vit D dose should be 400 IU/day • Routine follow up to be done SUPPLEMENTS AND FOLLOW UP