NURSING ASPECT

1. ESSENTIAL
NEWBORN CARE
SHEBA SUSAN BENNY

2. CONTENTS OF THIS SECTION
• Introduction
• Definition
• Elements in essential newborn care
• Components in essential newborn care
• Early care and later care of newborn
• Care of newborn with problems

3. INTRODUCTION
In India,
2/3 under 5 deaths (66%) happens in 1st
year of life
2/3 infant deaths happens in 1st month /
neonatal period
¾ neonatal deaths happens in 1st day of life
• Birth asphyxia
• Infection
• Hypothermia
• Feeding problems

4. ELEMENTS
• BASIC PREVENTIVE NEWBORN CARE
– Care before and during pregnancy
– Clean delivery practices
– Temperature maintenance
– Eye & cord care
– Early & exclusive breast feeding
• Early detection of problems and appropriate
referral
• Treatment of key problems such as sepsis and
birth asphyxia

5. COMPONENTS
PHASES
Before
conception
Antenatal
period
During
birth &
Immediate
postnatal
Postnatal
period

6. 1. Before conception
• Adequate care of a girl child, including
nutrition, education & health care
• Immunization, including TT
• Folate supplementation
• Birth spacing
• Prevention of STD’s
• Avoidance of drug & substance abuse

7. 2. Antenatal period
• At least 4 antenatal visits
• TT injection
• Iron & folic acid supplements
• Adequate nutrition intake
• Adequate rest
• Iodized salt consumption
• Delivery preparations
• Identification of problems in mother & treatment

8. 3. During birth & early newborn period
• Clean delivery practices & skilled
birth attendant
• Early newborn care
– Respiratory system care
– Temperature regulation
– Proper breastfeeding technique
– Prevention of infection
• Detection of danger signs &
appropriate treatment

9. Early newborn care
Prevention of infection
Clean hands
Clean perineum
Nothing unclean introduced vaginally
Clean delivery surface
Cleanliness in cord clamping & cutting
Cleanliness in cord care
Eye care
Hand hygiene before & after handling
baby

10. Breathing initiation & respiratory care
If baby is crying
• Receive baby in a dry, clean, warm towel
• Dry the baby, but don’t wipe off vernix
• Replace wet towel with clean, dry, warm towel
• Cut cord within 1-3 minutes

11. If baby is not crying
• Look for meconium
1. If meconium absent
o Dry the baby- drying up by warm clean cloth
stimulates & helps in initiation of breathing, baby
starts crying
2. If meconium present
o Gentle suction to remove mucus and meconium
from mouth & nose

12. If baby still not crying
• Cut the cord
• Place on a flat, firm warm surface
• Position baby with neck slightly extended
• Suction mouth & then nose
• Stimulate and reposition
……………… If baby still not crying

13. Contd…..
• Resuscitate the baby to prevent hypoxemia,
brain damage & death

14. Temperature regulation
• Deliver in a warm room
• Dry baby thoroughly & wrap in a warm, clean
cloth.
• Wrap head & body completely
• Give to mother as soon as possible
• Check warmth by feeling newborn’s feet every 15
minutes
• Bathe only after 24hrs
• Maintain temp of 36.5-37.5 degree C

15. Feeding technique & exclusive
breastfeeding
• Early contact between mother & newborn
enables breastfeeding
• Best practices are:
– No prelacteal feeds
– Colostrum is very important
– Give first feed within 1 hour of life
– Correct position to enable good attachment
– On demand feeds

16. Danger signs of newborn
• Poor sucking/not sucking
• Lethargy
• Fever / hypothermia
• Respiratory distress
• Convulsions
• Vomiting
• Severe umbilical infection
• Abdominal distension
• Jaundice reaching palms & soles
• Swollen eyelid with pus discharge
• Extensive pustules or skin infection

17. Other care during 1st 6 hours

18. Other care contd….

19. 4.Postnatal period (after 6hrs)
• Consultation with mother & baby within day 3
• Continue essential preventive newborn care
• Bathe
• Immunization
• Appropriate monitoring
• Detect danger signs

20. CARE OF NEWBORN WITH PROBLEMS
• Low birth weight & preterm babies are at
increased risk of hypothermia, hypoglycemia,
& poor growth
• Main principles while caring them are:
– Warmth
– Feeding
– Detection & management of complication
• Babies with any other condition needs
neonatal centre care

22. SUMMARY
Essential newborn care is a comprehensive
strategy, designed to improve the health of
newborns through interventions before
conception, during pregnancy, at & soon after
birth & in postnatal period

25. REFERENCE
• WHO ‘PRACTICAL GUIDE FOR CARE IN
NORMAL BIRTH’, GENEVA
• USAID, ‘BEST PRACTICES IN MATERNAL &
NEWBORN CARE-A LEARNING RESOURCE
PACKAGE’, 2008, BALTIMORE
• INDIRA NARAYANAN & MANDY ROSS ‘THE
COMPONENTS OF ESSENTIAL NEWBORN
CARE’, USAID