The document outlines essential newborn care procedures that should be performed immediately after birth and in the first few hours and days of life. These include drying the baby with a clean cloth, keeping the baby warm, examining for breathing and muscle tone, waiting 3 minutes before cutting the umbilical cord or until pulsations stop, maintaining skin-to-skin contact, initiating breastfeeding within the first hour, and providing routine care such as keeping the baby warm and preventing heat loss. The document also discusses additional procedures such as vitamin K administration and eye prophylaxis according to national guidelines.

1. Early Essential Newborn Care

2. Objectives
1. Immediate Newborn Care
• The First 90 minutes
2. Essential Newborn Care
• From 90 min to 6 hours
3. Care Prior to Discharge
• After the first 90 minutes
4. Care After Discharge
• Discharge to 7 days
5. Additional Care
• Newborn Resuscitation

3. Case study: Baby Musonda
Mrs Musonda is about to give birth to a term baby in a
remote clinic. Her pregnancy and labour have been
uncomplicated.
The next video is about preparation:
How will you prepare for the baby’s arrival?
What basic equipment will you need?

4. Immediate Newborn Care
• Clean cloths, towels, blanket, cord ties and blades
• Wash hands
• Check resuscitation equipment

5. Immediate Newborn Care
• Clean cloths, towels, blanket, cord ties and
blades
(ref p37)
• Wash hands with soap and water
• Check resuscitation equipment
• Check room temperature
(ref p1-3)

6. Immediate Newborn Care
Baby of Musonda is born, appears a normal size for
gestation. Which intervention should you do in the
first 30 seconds?
• Slap, blow, pour cold water on the baby
• Hold the baby upside down
• Suctioning of the mouth and nose of the baby
routinely
• Heavy suctioning of the back of the throat of baby
• Dry baby with clean cloth, keep warm and check
baby

7. Immediate Newborn Care
Dry baby with a clean cloth,
keep warm,
examine.

8. Immediate Newborn Care
What do you look for?
Breathing or crying YES
Good muscle tone YES
Colour pink YES
Breathing or crying NO
Good muscle tone NO
Colour pink NO
Ref. p2
Neonatal
Resuscitation
Skin to skin
contact

9. Routine Care of the Newborn
Baby of Musonda is crying and active. There are
some nasal secretions but the baby is comfortable.
The midwife is attending to the mother and asks
you when to cut the umbilical cord.
How long should you wait before cutting the cord?
How would you care for the cord?

10. Cord Care
Wait 3 minutes or until the cord stops pulsating before
cutting the cord. (Ref. p4)
•Wash hands
•Put nothing on the cord stump; keep it dry
•Fold the nappy (diaper) below the level of the stump
•Keep cord stump loosely covered
•If the stump is soiled, wash with clean water and
soap.
(Ref. p8)

11. Immediate Newborn Care
Properly timed cord clamping

12. Routine Care of the Newborn
The baby is now 2 minutes of age pink, crying and
active. A warm cloth is placed over the baby on
mother. It is cold outside.
How will you keep this baby warm?
What may happen if the baby becomes cold?

13. Routine Care of the Newborn
Which of the following should you do?
• Keep baby with mother
• Wash baby within 6hrs
• Put newborn on cold/wet surface
• Wipe off vernix
• Footprinting

14. Immediate Newborn Care
Skin to skin contact

15. Provide Support for Breastfeeding
The newborn is having skin to skin contact and starts
to show feeding cues.
How will you support this mother?

16. Immediate Newborn Care
Initiate breastfeeding

17. Immediate Newborn Care
Practice immediate newborn care.
“the first 90 mins” in turns as a group of three:
1) Health worker
2) Mother
3) Observer

18. • Dry baby with a clean cloth, keep warm, examine
• Properly time cord clamping
• Wait for up to 3 mins or until pulsations stop. Keep
umbilical cord clean and dry.
• Maintain skin-to-skin contact
• Give the baby to mother as soon as possible, place on
chest or abdomen
• Cover the baby to prevent heat loss
• Breastfeeding
• Initiate within the first hour
Summary: Early Essential Newborn Care

19. Further Management after the first hour of life:
• Give vitamin K (phytomenadione), according to national
guidelines 1 ampoule IM once
• Apply antiseptic ointment or antibiotic eye drops (e.g.
tetracycline) to both eyes once (prophylaxis), according to
national guidelines
• There is no need to bathe baby immediately after birth
(Ref. p. 46, p. 50)
Summary: Early Essential Newborn Care