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![ BATHING THE BABY
The room should be warm with windows closed and AC off
Always test the water first
Fill cold water first and then hot water
Hold the baby firmly by supporting the neck
Avoid getting water in to the ears
Give special attention for skin folds [ groin, armpit, back of
knees, neck]
Take baby away from bathing area and dry the baby](https://image.slidesharecdn.com/earlyneonatalcare-230202103158-93aaf49f/75/EARLY-NEONATAL-CARE-exclusive-newborn-care-ppt-37-2048.jpg)
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EARLY NEONATAL CARE.exclusive newborn care.ppt
This document provides information on newborn care, including immediate care at birth, establishing respiration, maintaining warmth and preventing infections. It discusses assessing the newborn's airway, breathing and circulation. Other topics covered include proper cord cutting and care, eye prophylaxis and skin care. The importance of early and exclusive breastfeeding is emphasized. The document also describes levels of newborn care from basic to intensive care needed for low birth weight or preterm infants.
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EARLY NEONATAL CARE.exclusive newborn care.ppt
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- 3. INTRODUCTION The transition fromintrauterine to extra uterine life is a complex one and demands considerable and effective nursing care for ensuring survival. The main goal of the nurse in the care of newborn is to establish and maintain homeostasis.
- 4. The 1st 24 hours ofLife The first 24 hours of life is a very significant and a highly vulnerable time due to critical transition from intrauterine to extrauterine life
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- 6. IMMEDIATE CARE OFNEWBORN • Clearing the airway/ maintenance of respiration • Apgar score • Maintenance of body temperature • Care against infection •Care of cord •Care of eyes •Care of skin • Breast feeding •Vitamin K injection • Screening
- 7. ESSENTIAL NEWBORN CARE •Care at birth • Care during immediate and early neonatal period • Care in the late neonatal period and beyond
- 8. NEONATAL CARE Warmth/ Thermalprotection Initiation and maintenance of respiration. Prevention of infection. Referral for appropriate care.
- 9. Warmth/Thermal Protection • Newbornphysiology – Normal temperature: 36.5–37.5°C – Hypothermia: < 36.5°C – Stabilization period: 1st 6–12 hours after birth • Large surface area • Poor thermal insulation • Small body mass to produce and conserve heat • Inability to change posture or adjust clothing to respond to thermal stress • Reasons of hypothermia – Newborn left wet while waiting for delivery of placenta – Early bathing of newborn (within 24 hours)
- 10. Heat Loss Mechanisms •Convection – the flow of heat from the body surface to cooler surrounding air – Eliminating drafts such as windows or air con, reduces convection • Conduction – the transfer of body heat to a cooler solid object in contact with the baby – Covering surfaces with a warmed blanket or towel helps minimize conduction heat loss
- 11. • Radiation –the transfer of heat to a cooler object not in contact with the baby – Cold window surface or air con; moving as far from the cold surface, reduces heat loss • Evaporation – loss of heat through conversion of a liquid to a vapor – From amniotic fluid; NB should be dried immediately
- 12. Hypothermia Prevention • Deliverin a warm room • Dry newborn thoroughly and wrap in dry, warm cloth • Keep the baby on a warm surface • Give to mother as soon as possible which helps – Skin-to-skin contact first few hours after childbirth – Promotes bonding – Enables early breastfeeding • Check warmth by feeling newborn’s feet every 15 minutes • Bath only when temperature is stable (after 24 hours)
- 13. Dry the baby immediately afterbirth….. Care at birth… Teaching Aids: ENC
- 14. Ensuring warmth atthe time of delivery: ‘Warm chain’ NC- 14 Teaching Aids: ENC
- 15. ‘Warm chain’: Atdelivery At delivery: 1. Ensure the delivery room is warm (25° C), with no draughts. 2. Dry the baby immediately; remove wet cloth 3. Wrap the baby with clean dry cloth 4. Keep the baby skin-to-skin with mother NC- 15 Teaching Aids: ENC
- 16. 1. Keep thebaby clothed and wrapped; cover the head 2. Postpone bathing particularly for small babies 3. Keep baby close to the mother 4. Use kangaroo care for stable LBW babies 5. Show mother how to avoid hypothermia and to recognize 6. Initiate breastfeeding NC- 16 Teaching Aids: ENC ‘Warm chain’: After delivery
- 17. Temperature • Dry immediately •Place in infant warmer or use droplight • Wrap warmly
- 18. ESTABLISHMENT AND MEINTENANCE OFRESPIRATION When babies are born they need to clear the mucous and amniotic fluid from their lungs As the head is born, excess mucous is wiped off gently from mouth Suctioning bulb syringes are commonly used. Aspirate the oropharynx prior to the nasopharynx Stimulate the baby to cry Position the infant that would promote drainage Trendelenburg position Side lying position
- 19. Airway & Breathing •Suction gently & quickly using bulb syringe or suction catheter • Starts in the mouth then, the nose to prevent aspiration
- 20. Airway & Breathing •Stimulate crying by rubbing • Position properly- side lying / modified t-berg • Provide oxygen when necessary
- 21. Initiation and maintenanceof respiration. Respiratory rate (> 30 breaths/min.) in most newborns – Gentle stimulation, if at all – clear airway: Routine oro-nasal suction – if the baby is not breathing or gasping, then skilled care in the form of positive pressure ventilation etc. (i.e. RESUSCITATION) would be required Newborn resuscitation may be needed in conditions – Fetal distress – Thick meconium staining – Vaginal breech deliveries – Preterm
- 22. Clearing the airway •Positioning : head low • Gentle suction • If natural breathing fails : – Resuscitation and active intervention
- 23. PREVENTION OF INFECTION Principlesof cleanliness essential in both home and health facilities childbirths Principles of cleanliness at childbirth – Clean hands – Clean perineum – Nothing unclean introduced vaginally – Clean delivery surface – Cleanliness in cord clamping and cutting – Cleanliness for cord care Infection prevention/control measures at healthcare facilities
- 24. Avoidance of infection •Care of the cord – Prevent tetanus – Prevent anemia • Care of eyes – Wipe with sterile swab – Silver nitrate/ tetracycline
- 25. Prevention of infections:‘Clean chain’ At delivery: WHO five POINTS/CLEANS Clean 1. Hands of attendants (washed with soap) 2. Surface for delivery 3. Cutting instrument for cord(i.e. razor, blade) 4. String to tie cord 5. Cloth to wrap baby and mother NC- 25 Teaching Aids: ENC
- 26. ‘Five cleans’ toprevent infection
- 27. Prevention of infections:‘Clean chain’ After delivery 1. Hand washing before handling the baby 2. Exclusive breastfeeding 3. Keep the cord clean and dry; do not apply anything 4. Use a clean cloth as a diaper/napkin 5. Hand wash after changing diaper/napkin NC- 27 Teaching Aids: ENC
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- 29. • Apply asterile tie tightly around cord or cord clamp at 2 cm and 5 cm from the abdomen • Cut between the ties/clamp with a sterile instrument • Observe for oozing blood every 15 minutes; if blood oozes, place a second tie • Do not apply any substance to the stump • DO NOT bind or bandage stump • Leave stump uncovered Cord care NC- 29 Teaching Aids: ENC
- 30. Daily Cord Care •Keep cord dry and clean & clamp secured • Apply 70% isopropyl alcohol to the cord with each diaper change and at least 2-3x a day. • DO NOT cover with diaper • Note for any signs of bleeding or drainage from the cord and other abnormalities
- 31. CORD CARE • UmbilicalCord – 2 arteries; 1 vein – White & gelatinous immediately after birth – Begins to DRY between 1-2 hrs following birth – Blackened or shriveled between 2-3 days – Dried & gradually falls off by 7 days
- 32. CUTTING THE CORD EarlyClamping Prevent overloading of placental blood Prevent Polycythemia Prevent Jaundice Delayed Clamping Prevent Anaemia Enabling better storage of iron Receive complete clotting factor Better O2 level so preventing RDS
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- 34. EYE CARE • Administereye medication within 1 hr after birth to prevent Ophthalmia neonatorum – Erythromycin 0.5% – Tetracycline 1% – Silver Nitrate 1% • From inner to outer canthus of the eye (conjunctival sac)
- 35. • Clean eyesimmediately after birth with swab soaked in sterile water • Use separate swabs for each eye; clean from medial to lateral side • Give prophylactic eye drops within 1 hour of birth (as per hospital policy) • Do not put anything else in baby’s eyes Eye care
- 36. SKIN CARE • Careof skin – First bath with soap and water( previous practice) – By nursing staff – ? Delay by 12-24 hrs
- 37. BATHING THEBABY The room should be warm with windows closed and AC off Always test the water first Fill cold water first and then hot water Hold the baby firmly by supporting the neck Avoid getting water in to the ears Give special attention for skin folds [ groin, armpit, back of knees, neck] Take baby away from bathing area and dry the baby
- 38. REFERRAL FOR APPROPRIATECARE Proper assessment of the child. Check the deviation as early as possible. Follow prompt interventions as per the the deviations. Refer appropriate agents. Through system wise assessment needs to be done
- 39. Early and ExclusiveBreastfeeding • Early contact between mother and newborn – Enables breastfeeding – Rooming-in policies in health facilities prevents noso- comial infection • Best practices – No prelacteal feeds or other supplement – Giving first breastfeed within one hour of birth – Correct positioning to enable good attachment of the newborn – Breastfeeding on demand – Psycho-social support to breastfeeding mother
- 40. Breast feeding • Withinan hour • Avoid supplementary feeds and bottle feeding • Breast milk – Creates bonding – Highly nutritive – Anti infective
- 41. IMMUNIZATION At birth: bacillusCalmette-Guerin (BCG) vaccine, oral poliovirus vaccine (OPV) and hepatitis B virus (HBV) vaccine (WHO) BCG vaccinations in all population at high risk of tuberculosis infection Single dose of OPV at birth or in the two weeks after birth HBV vaccination as soon as possible where perinatal infections are common
- 42. POINTS TO BEREMEMBERED • Identification band • Birth Registration • Birth record and documentation
- 43. Proper Identification • Afterdelivery, gender should be determined • Pertinent records should be completed including the ID bracelet • Before transferring to nursery, ID tag should be applied.
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- 46. LEVEL I CARE •NEONATES WEIGHING ABOVE 2000gm OR HAVING A GESTATIONAL MATURITY OF 37 WEEKS OR MORE BELONG TO THIS CATEGORY.THE CARE CAN BE PROVIDED AT HOME,PRIMARY HEALTH CENTRE LEVEL.
- 47. LEVEL II CARE •INFANT WEIGHING BETWEEN 1500- 2000gm OR HAVING A GESTATIONAL MATURITY OF 32-36 WEEKS NEEDS SPECIALIZED NEONATAL CARE SUPERVISED BY TRAINED NURSES & PAEDIATRICIANS.
- 48. LEVEL III CARE •LESS THAN 1500gm OR THOSE BORN BEFORE 32WEEKS OF GESTATION REQUIRE INVASIVE NEONATAL CARE.ONLY 3-5% OF ALL NEW BORN BABIES NEED THIS CARE BY SKILLD NURSES & NEONATOLOGISTS ESPECIALLY TRAINED IN NEONATAL INVASIVE CARE.
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