Care of a normal baby at birth
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Care of a normal baby at birth. (Until 1 hour after birth). Objectives. To describe evidence-based routine care of a newborn baby at and soon after birth. 2. Basic needs of a baby at birth. FOUR basic needs at birth: Thermal protection Normal breathing Mother’s milk

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Care of a normal baby at birth

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Care of a normal baby at birth

Care of a normal baby at birth

(Until 1 hour after birth)


Objectives

Objectives

To describe evidence-based routine care of a newborn baby at and soon after birth

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Care of a normal baby at birth 1283330

Basic needs of a baby at birth

FOUR basic needs at birth:

Thermal protection

Normal breathing

Mother’s milk

Protection from infection

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Care of normal baby at birth

The birth of Meghna

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Care at birth

Care at birth

  • Call out time of birth

  • Receive the baby onto a warm clean towel and place on mother’s chest

  • Clamp and cut the umbilical cord

  • Dry the baby with a warm, clean towel or piece of cloth

  • Assess baby’s breathing while drying

Steps

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Dry the baby immediately after birth

Dry the baby immediately after birth

Care at birth…

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Care at birth1

Care at birth…

  • Wipe both eyes (separately) with sterile gauze pieces

  • Put the baby between mother’s breasts for skin-to-skin contact

  • Place an identity label on the baby

  • Cover mother and baby with warm cloth; put a cap on the baby’s head

  • Initiate breastfeeding

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Care at birth…

Immediate

skin-to-skin

contact &

breastfeeding

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Ensuring warmth at the time of delivery: ‘Warm chain’

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‘Warm chain’: At delivery

  • At delivery:

  • Ensure the delivery room is warm (25° C), with no draughts.

  • Dry the baby immediately; remove wet cloth

  • Wrap the baby with clean dry cloth

  • Keep the baby skin-to-skin with mother

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Helping the baby breathe

Assess baby’s breathing at the time of drying:

  • If the baby is cryingvigorously or breathing adequately, then no intervention is needed

  • 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

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‘Warm chain’: After delivery

Keep the baby clothed and wrapped; cover the head

Postpone bathing particularly for small babies

Keep baby close to the mother

Use kangaroo care for stable LBW babies

Show mother how to avoid hypothermia and to recognize

Initiate breastfeeding

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Initiating breastfeeding

  • Keep the baby in skin-to-skin contact between mother’s breasts immediately after drying

  • Help the mother in her first few attempts to breastfeed

  • Make her and the baby comfortable

  • Explain and show her proper positioning and attachment

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Ensure skin to skin contact after birth

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Baby shows feeding cues…

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..and is ready for breastfeeding

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Prevention of infections: ‘Clean chain’

At delivery: WHO five cleans

Clean

Hands of attendants (washed with soap)

Surface for delivery

Cutting instrument for cord(i.e. razor, blade)

String to tie cord

Cloth to wrap baby and mother

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‘Five cleans’ to prevent infection


Care of a normal baby at birth 1283330

Prevention of infections: ‘Clean chain’

After delivery

Hand washing before handling the baby

Exclusive breastfeeding

Keep the cord clean and dry; do not apply anything

Use a clean cloth as a diaper/napkin

Hand wash after changing diaper/napkin

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Cord care

  • Apply a sterile tie tightly around cord at 2 cm and 5 cm from the abdomen

  • Cut between the ties 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

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Eye care

  • Clean eyes immediately 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

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Monitoring the baby

  • Do not leave the mother and baby alone in the first hour after birth

  • Monitor threeparameters every 15 minutes:

    • Breathing:Grunting, chest in-drawing, fast breathing (>60/min)

    • Warmth:Check if the baby’s feet are cold (by using your hands)

    • Color:Evaluate the color of trunk and extremities

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Special situations

Mother has HIV/AIDS

Follow universal precautions as with any other delivery

Baby can have immediate skin-to-skin contact as any other mother and baby

Breastfeeding can begin when the baby is ready*

If mother chooses replacement feeding, prepare formula for the first few feeds

All other care (including cord care and eye care) remain the same

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Key messages

Key messages

  • Four basic needs at birth: warmth, normal breathing, breastfeeding, prevention of infections

  • Ensure warmth by skin to skin contact with mother’s chest/abdomen

  • Help the mother to initiate early breastfeeding

  • Follow ‘WHO five cleans’ to prevent infections

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