1. Neonatal care involves care of infants from birth to 28 days of life, and focuses on essential care like maintaining temperature, establishing feeding, and avoiding infections.
2. Key indicators of neonatal health are infant mortality rate, neonatal mortality rate, and perinatal mortality rate, which have all declined in India but still account for a significant portion of deaths.
3. Major causes of infant deaths are low birth weight, prematurity, sepsis, and pneumonia. Essential newborn care practices promote immediate care, examinations, and measurements to identify issues and prevent complications.
Chhaya is an oral contraceptive pill which does not contain any hormone. It is available in the market in some places as 'Saheli' tablet. It has been introduced in the public health system in the name of 'Chhaya' to benefit more women at no cost. It is a safe spacing option for both breast feeding and non-breast feeding women and needs to be taken only twice a week for the first 3 months and then once a Week.
This slide contain detail description of basic terminologies, neonatal (head to toe examination) assessment, neonatal reflexes, minor physiological handicaps of newborn
Chhaya is an oral contraceptive pill which does not contain any hormone. It is available in the market in some places as 'Saheli' tablet. It has been introduced in the public health system in the name of 'Chhaya' to benefit more women at no cost. It is a safe spacing option for both breast feeding and non-breast feeding women and needs to be taken only twice a week for the first 3 months and then once a Week.
This slide contain detail description of basic terminologies, neonatal (head to toe examination) assessment, neonatal reflexes, minor physiological handicaps of newborn
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
Theoretical framework of infant physiotherapyAnwesh Pradhan
MPT class- Theoretical framework of infant physiotherapy. Require 3 class. Help us to decide the paediatric physiotherapy approach for paediatric patient.
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
Theoretical framework of infant physiotherapyAnwesh Pradhan
MPT class- Theoretical framework of infant physiotherapy. Require 3 class. Help us to decide the paediatric physiotherapy approach for paediatric patient.
This presentation is all about how to run a high risk follow up clinic for newborns discharged from a level II/III newborn care unit. It has been prepared mainly based on NNF protocol & AIIMS protocol.
Prematurity and Early Intervention: Prevalence, Issues, and Trendsearlyintervention
This webinar will explore the prevalence of premature births in Virginia as well as trends and issues related to premature birth. Information will include Part C eligibility determination for premature babies including one local system’s experience with eligibility determination and child count. Current research on the impact of prematurity on child development will also be explored.
This webinar featured Beth Tolley, Part C Technical Assistance Consultant, Nancy Farmer Brockway, pediatric occupational therapist, Tina Hough, pediatric physical therapist, and Ginny Heuple, physical therapist and local system manager.
This topic was presented by me in Neonatal Nursing Workshop in GUJNEOCON' 14. This presentation highlights some issues in the management of extremely low birth weight babies (<1000gm) from Nursing care point of view. Transport, Aseptic precautions, feeding issues are important aspects of cere which are not discussed here because were discussed by others. I had mainly focused on delivery room management, temperature and humidity maintenance, skin care and develpmental care because these are important aspects of ELBW care but often neglected.
It was presented at the third OU-BEAUMONT BIOMEDICAL RESEARCH SYMPOSIUM, held on Nov-14th, 2012 at Oakland University, Rochester, MI. For more information on the symposium, please visit : http://www.oakland.edu/?id=23465&sid=313
Management of Preterm And Low Birth Weight
Dr. Raheel Ahmed FCPS Pediatrics
Children Hospital, Chandka Medical College Larkana
Definitions
Prevalent
Etiology
Assessment of gestational age
Problems of prematurity
Management
Antenatal (Prevention)
Natal (Delivery room care)
Post natal (after birth care)
Prognosis
Discharge criteria
Definitions
Term?
Preterm?
Immature?
LBW? VLBW?ELBW? ILBW?
SGA?
IUGR?
Gestational Age
Full-term
infant born after 37 completed menstrual weeks of pregnancy
Preterm (or premature) infant
infant born before 37 completed weeks of gestation
Late preterm infant (a recently identified category)
infant born between 34 and 36 weeks gestation
Moderately preterm infant
infant born between 32 and 34 completed weeks of gestation
Very preterm infant/ Early preterm
infant born before 32 completed weeks of gestation
Immature < 28 weeks
ELGAN: Extremely Low Gestational Age Newborn < 26 weeks
Weight
Low birth weight (LBW)
infant who weighs less than 2,500 grams at delivery
Very low birth weight (VLBW)
infant who weighs less than 1,500 grams at delivery
Extremely low birth weight (ELBW)
infant who weighs less than 1,000 grams at delivery
Incredible Low birth weight
infant who weighs less than 750 grams at delivery
This presentation is the analysis of current newborn care in India. It focuses on the Hospital birth scenario and Factors contributing to newborn death. It further highlights , how the Midwives can make a difference.
At the end of the session, the students shall be able to
What are the various measurements in assessing the growth and maturity of the baby
Describe the purpose of neonatal screening
Identify at-risk infant
Define low birth weight. Enumerate the causes of LBW and discuss the prevention and treatment of LBW babies.
2. Phases of Infancy
• Perinatal Period – 28 wk- 7 days
• Early Neonatal Period- Birth- 7 days
• Late Neonatal Period- 7 days – 28 days
• Post Neonatal Period- 28 days – 1 year
4. Indicators
1. Perinatal Mortality Rate (PMR) –
• Deaths between 28 wks upto 7 days of life
per 1000 live births.
• Wt > 1000 gm, CRL > 35 cm
• Ideally should include all births > 1000 gm
• Sensitive indicator of essential Maternal and
New born care.
• Factors responsible for Stillbirths and early
neonatal deaths are often similar.
5. Infant Mortality Rate
• No of Infant deaths in a given year to
total no. of live births, expressed in per
1000.
• It measures health status and level of
living of community.
• One of the parameter for calculating
PQLI.
• Deaths are due to specific causes
different from those in adults.
7. • Deaths in 1st year of life accounts for 18.7
% of total deaths
• Of these > 60% occurs in 1st month of life.
• Of this 40% of neonatal deaths occur in
1st week of life.
• 50% of these in first 48 hours.
• The above fact underlies the importance
of early neonatal care in child survival.
8. Causes of Infant Mortality
Neonatal Post Neonatal
LBW & prematurity ADD
Birth Injury ARI
Sepsis Other Infectious diseases (eg.-
Measels, Malaria)
Congenital Anomalies Malnutrition
Hemolytic diseases Congenital Anomalies
Conditions of Placenta and cord Accidents
ADDs
ARI
9. Prevention
Direct Indirect
Safe & clean delivery Family Planning
Essential New born care Nutritional status of mother
Infection control measures Education of mother (women
empowerment)
EBF ANC
Early diagnosis & management Growth monitoring of child
Special care for LBW babies Prevention of Malnutrition
ORT for ADDs Vit. A prophylaxis
Antibiotics for ARIs Improved Sanitation/ Safe water
Immunization Access to primary health care
Socio-economic development
10. Essential Newborn Care
• Cardiopulmonary maintenance
• Body temperature maintenance
• Avoidance of Infections
• Establishment of a satisfactory feeding
regimen
• Early detection and Rx of any abnormalities
or infections
12. IMMEDIATE CARE
• Clearing the airway
• APGAR score
• Maintenance of body temperature
• Care against infection
•Care of cord
•Care of eyes
•Care of skin
• Breast feeding
13. Clearing the airway
• Positioning : head low
• Gentle suction
• If natural breathing fails :
– Resuscitation and
active intervention
15. Apgar score
Sign 0 1 2
Muscle tone Flaccid Some flexion of Active
(A) extremities movements
Heart rate (P) Absent <100 >100
Reflexes (G) No response Grimace Cry
Colour (A) Blue, pale Body pink, Completely pink
extremities blue
Respiratory Absent Slow irregular Good crying
effort (R)
Total Severe Mild depression No depression
depression(0-3) (4-6) (7-10)
16. Avoidance of infection
• Care of the cord
– Prevent tetanus
– Prevent Anemia
• Care of eyes
– Wipe with sterile swab
– Silver nitrate/
tetracycline
17. Care of Skin
– First bath with soap
and water
– By nursing staff
– ? Delay by 12-24 hrs
18. Maintenance of body temperature
• Little thermal control
lesser in preterm and
LBW babies
• Dry and wrap in a clean
dry cloth
• Skin to skin contact with
mother
“Kangaroo care method” (strategy for
LBW babies in IMNCI)
19. Breast feeding
• Within an hour
• Whenever the baby
wants
• Avoid supplementary
feeds and bottle
feeding
• Breast milk
– Creates bonding
– Highly nutritive
– Anti infective
20. NEONATAL EXAMINATIONS
• First examination
– Rule out injury
– Detect malformations
• Second examination
– Within 24 hours
– Systematic head to foot
examination
21. • Infections
– Neonatal tetanus
– Cong. Syphilis
– Newborn with HBV+ mother
– Newborn with HIV+ mother
PPTCT
ART (Zidovudine) to mother during pregnancy, child
birth and to child
No Breast feeding..??
Elective LSCS
Reassess baby after 6 months
22. MEASUREMENTS
• Birth weight
– Within 1 hr
– Wt. > 2.5 kg
• Length
– Within 3 days
– Using Infantometer
– CRL- 50 cm
• Head circumference
- HC - 34 cm
24. Management of LBW Babies
• Care at birth – delivery at well equipped
facilities
• Maintaining Warm Chain
• Appropriate place of care – acc. to
weight
• Feeding regimen
• Early detection and management of
complications
• Kangaroo mother care (KMC)
25.
26. Delivery
Normal High risk infant
infant
Without With
complications complications
Temporary observation
unit
Regular Special care nursery with
nursery neonatal ICU
Home Special procedures
27. Schemes in India
• UIP (1985)
• CSSM (1992)
• RCH I (1997)
• JSSK/ NSSK (2005)
• RCH II (2005) – New Born Care Corners,
NBSU, SNBCU
• Verbal autopsy for every death
• IMNCI plus (Includes care between 0-7
days)