Newborn care

Prepared By:
Prof. AMYLINE T. Train,MPH,RN
Faculty /Clinical Instructor
 Newborn Care

• Newborn care consists of evaluation for the need of resuscitation , a

complete physical exam , administration of prophylactic medication and
vaccine, adequate feedings, safe hygiene of the newborn, & other important
areas for baby wellbeing.
• The importance of newborn care:
• 1. Improves the health & wellbeing of infants born preterm or low birth
weight
• 2. Promotes better bonding between mother & child
• 3. facilitates exclusive breastfeeding, which strengthens the baby’s immune
system.
• 4.Provides effective thermal control, reducing the risk of hypothermia.
 Five Steps of Newborn Care

• 1. Provide warmth
• 2. Dry
• 3. Stimulate
• 4. Position the head & neck
• 5. Clear secretions if needed

• With every newborn contact RESPIRATORY EVALUATION is necessary

& this is the highest priority in newborn care
 Nine Stages of the Newborn

• STAGES BEHAVIOURS
• 1. BIRTH CRY Intense cry just after birth
• Transition to breathing air
• 2. RELAXATION STAGE Infant rests. No activity of mouth, head, arms, legs & body
• 3. AWAKENING STAGE Infants begins to show signs of activity. Small
thrusts of head: up, down, from side-to-side . Small movement of limb & shoulder.
• 4. ACTIVE STAGE Infant move limbs &head , more determined
Movements. Rooting activity, pushing with limbs
Without shifting body.
 Stages of the newborn(cont)

• STAGES BEHAVIOURS
• 5. RESTING STAGE Infant rest with some activity such as mouth
activity, sucks on hand
• 6. CRAWLING STAGE Pushes/ slides/leap which results in shifting
• body to the breast & nipple
7. FAMILIARIZATION Infant has reached areola/ nipple with mouth
positioned to brush & lick areola/nipple
8. SUCKLING Infant has taken nipple in mouth &commences
suckling
9. SLEEPING STAGE Infant closes eyes & falls asleep
 PHASES OF NEWBORN CARE

• LEVEL I – low- risk care- The newborn is placed in a radiant warmer with
a temperature probe on the abdomen until body temperature is stabilized
• level II- Special care Nursery- For premature babies born at more than 32
weeks gestation & /or weighing 1500 gms( 3lbs 5oz) or more m fetal growth
restriction with low levels of amniotic fluid in the womb, anticipated minor congenital
abnormalities, a form of severe high blood pressure in the mother called PRE
ECLAMPSIA. A problem with the placenta called PLACENTA PREVIA or an
inflammation of the fetal membrane called CHORIOAMNIONITIS
level III – subspecialty care – It include : babies who require complex
care upon delivery, babies with serious birth defects, premature babies born at less
32 weeks of pregnancy , babies with a birth weight of le than 1500 gm(3 lbs 5oz)
 Essential Needs of Newborn Babies

• 1. SECURITY – Providing a safe & table environment for your newboren

• 2. CLOTHInG- Require special clothing for their sensitive skin.
• 3. ENOUGH SLEEP- the newborn baby will likely get by with around 18
hours of sleep on any given day in the first few months.
• 4. NUTRITIOUS FOOD – Many babies are breastfed, which is a great way
to get the nutrients they need . Breast milk contains all the nutrient a baby
need for the 1st six months of life. Babies can start eating solid food that
provide them with the nutrient they need.
• 5. SENSORY STIMULATION- It is up to the parents to provide newborns
with a stimulating environment that encourage development in all area of
their physical, mental, social, emotional; & cognitive being.
• 6. LOVE AND ATTENTION- To give them all the attention.to develop their
social skills
 Roles & responsibilities of the nurses in special areas

• Labor & delivery nurse job duties:

• Provide emotional & medical support for the mother during labor.
• Monitor the vitals of both the fetus & the mother
• Track the strength & timing of contractions
• Teaching childbirth preparation classes
• Coaching women, assisting with any complication & administering
medication during birth
• Providing guidance to new mothers on all aspect of recovery & infant care.
• Meeting with expectant mother for prenatal visits & providing care for
normal & problematic pregnancies
 ASSESSMENT FOR WELL- BEING

• APGAR SCORING –is done during the first 1 minute & 5 minute of life.
• The heart rate, respiratory rate, muscle tone, reflex irritability & color are
evaluated in an infant.
• APGAR SCORING is the baseline for all future observations
INDICATOR 0 1 2 3

A ACTIVITY ABSENT FLEXED ARMS ACTIVE

AND LEGS

P PULSE ABSENT BELOW 100 BPM OVER 100 BPM

G GRIMACE FLOPPY MINIMAL PROMPT

RESPONSE TO RESPONSE TO
STIMULATION STIMULATION
A APPEARANCE BLUE ; PALE
Pink body, blue
Extremities PINK

R RESPIRATION ABSENT SLOW & VIGOROUS CRY

IRREGULAR
 APGAR SCORING

• EACH PARAMETER can have the highest score of 2 and the lowest is O.
• The core of the parameters are added to determine the status of the infant
• Apgar scoring
• o-3 points = the baby is serious danger & need immediate resuscitation
• 4-6 points = the baby’s condition I guarded & may need more extensive
clearing of the airway & supplementary oxygen
• 7- 1o points= are considered good and in the bet possible health.
 Care of the newborn at birth

• 1. Keep the baby warm – a baby hould wear 1-2 layer more than an adult . If
cold, put a hat on the baby’ head.
• 2. Care for the umbilical cord. Do not put anything on the stump.
• 3. Keep the bay clean. It I not necessary to wash the baby everyday, but
wash baby’s face & bottom when needed. Make sure the room is warm
when undressing the baby.
• 4. Provide nothing but breat milk day & night.
• 5. You should ee a health worker on day 3 & between 7 & 14 days & 4-6 week
after birth. At the 6 week visit the baby will be immunized.
• 6. Let the baby leep on his/her back or ide.
• 7. Keep the baby away from smoke.
• 8. It I not recommended to expose the baby to direct un.
 Danger Signs for the Newborn

• Difficulty in breathing/ persistent crying

• Fever
• Feel cold/
• Bleeding/ umbilical cord infection
• Not feeding/ poor appetite
• Yellow palm & soles of the feet
• Diarrhea /vomiting
• Fits ( convulsion)
• Irregular stools/ urination
 8 Step of Essential Newborn Care

1. Deliver the baby onto the mother’s abdomen or a dry warm surgace close
to the mother.
2. Dry the baby’s body with a dry warm towel as you try to stimulate
breathing. Wrap the baby with another dry warm cloth & cover the head.
3. Assess breathing & colour; if not breathing, gasping or there are less than
30 breath per minute , then resuscitate
4. Tie the cord two fingers’ lenths from the baby’s abdomen & make another
tie two finger from the firt one. Cut the cord between the first & econd tie.
If the baby need resuscitation, cut the cord immediately. If not, wait for 3-
7 minutes before cutting the cord.
 (cont) Steps of essential newborn care

• 5. Place the baby in skin-to-skin contact with the mother, cover with a warm
cloth & initiate breastfeeding.
• 6. Give eye care( while the baby is held by it mother.
• 7. Give the baby Vitamin K , 1 mg by intramuscular injection(IM) on the
outside of the upper thigh( while the baby is held by it mother.)
• 8. Weigh the baby an hour after birth or after the first breastfeed. If the baby
weighs less than 1500 gms. You must refer the mother & baby urgently.
 Ways in which heat loses from the baby

• EVAPORATION- WHEN AMINOTIC FLUID EVAPORATE FROM THE SKIN

• CONDUCTION – WHEN THE BABY IS PLACED NAKED ON A COOLER
URFACE, SUCH AS THE FLOOR, TABLE, WEIGHING SCALE ,COLD BED
• CONVECTION- WHEN THE BABY IS EXPOSED TO COOL SURROUNDING
AIR OR TO A DRAUGHT FROM OPEN DOORS & WINDOW OR A FAN.
• RADIATION- WHEN THE BABY IS NEAR COOL OBJECT, WALLS, TABLE,
CABINETS, WITHOUT ACTUALLY BEING IN CONTACT WITH THEM.
 Steps to keep the newborn warm :

• THE Steps to keep the newborn warm are CALLED the WARM CHAIN
• 1. Warm the delivery room
• 2. Immediate drying
• 3. Skin-to-skin contact at birth
• 4. Breastfeeding
• 5. Bathing & weighing postponed
• 6. Appropriate clothing /bedding
• 7. Mother & baby together
• 8. Warm transportation for a baby that needs referral.
 Steps for giving the baby eye care

• First, wash your hand & then using TETRACYCLINE 1% EYE OINTMENT

• 1. Hold one eye open & apply a rice grain ize of ointment along the inside of
the lower eyelid. Make ure not to let the medicine dropper or tube touch the
baby’ eye or anything else
• 2. Repeat the steps to put medication into the other eye.
• 3. Do not rinse out the eye medication
• 4. Wash your hands again
 Normal range of the newborn Vital signs

• Normal BP – 64/71 Average- 7/42

• Systolic- 60 – 80 mmHg
• Diastolic- 40- 50 mmHg
• 1 month up to 2 yrs. Old – 95/58
• Heart rate- 100-160 beat per minute
• -100 while sleeping
• -160 while crying
• Respiration rate- 30-60
• Average – 40 per minute
• Temperature – rectal- 36.6 – 38
• tympanic- 36.8 – 38
• oral - 36.5 – 37.5
• Axillary - 36.5 – 37.5
•T
• H
• A
• N
• K y o u !!!