Essential newborn care involves a comprehensive set of interventions before conception, during pregnancy, at birth, and in the postnatal period to improve newborn health outcomes. It includes clean delivery practices, temperature maintenance, early and exclusive breastfeeding, detection and treatment of problems, and special care for low birth weight babies. The goal is to reduce the major causes of newborn deaths like birth asphyxia, infection, and hypothermia through basic preventative measures and early detection and management of complications.

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