Teaching Aids: NNF NC- 1 Care of Normal Newborn
Teaching Aids: NNF NC- 2
Principles of care at birth
Establishment of respirationPrevention of hypothermiaEstablishment of breastfeedingPrevention of infectionIdentification of at risk neonates
Teaching Aids: NNF NC- 3
Care of normal newborn
Preparation before deliveryImmediate care at and after birthEssential postnatal care
Teaching Aids: NNF NC- 4
Contents of clean delivery kit (at home)
Soap for washing hands; ensure clean and boiled water2 to 3 sterilized cord tiesA new clean blade / boiled at home instrument to cut cordClean sun-dried cloth / sheet, small gauze padsA clean plastic envelope / cloth to keep the kit in
Teaching Aids: NNF NC- 6
Physical facilities for resuscitation (at hospital)Resuscitation corner with warmerContents of resuscitation kitSuction catheter 10 Fr, De Lee trap, suction machine Resuscitation bag and masks
Teaching Aids: NNF NC- 7
Physical facilities for resuscitation (at hospital)
Infant laryngoscope with bladesEndotracheal tubes (2.5, 3.0, 4.0 mm)Medications – epinephrine, naloxone, normal saline, sodium bicarbonatePlenty of disposables
Teaching Aids: NNF NC- 11
Immediate care after birth
Prevent hypothermiaEye, skin, cord careGive injection vitamin K Breastfeed within ½ hour of birthSearch for malformations
Teaching Aids: NNF NC- 12
Increased risk of malformation
Single umbilical arterySimian creaseDysmorphic featuresAsymmetric cry due to absence of Depressor Angularis Oris Muscle Excessive drooling of saliva
Teaching Aids: NNF NC- 13
Quick screening for malformations
Screen from top to bottom and in midlineOrifice examination
Anal openingOesophagus patency*Choanal atresia
* SFD baby, polyhydramnios, excessive drooling, single umbilical artery
Teaching Aids: NNF NC- 14
Essential postnatal care
Nurse in thermal comfort(warm to touch, pink soles)Check umbilicus, skin, eyesGood sucking at breast Screen for danger signalsAdvice on immunization
Teaching Aids: NNF NC- 15
Care of umbilical stump
Inspect 2 to 4 hours after ligation for bleedingDo not apply anything, keep cord clean and dryInspect for discharge or infection till healing occurs
Teaching Aids: NNF NC- 16
Care of the skinDry using soft prewarmed clean clothBathing soon after birth is not recommended Do not make vigorous attempts to remove vernix caseosaInspect for superficial infections
Teaching Aids: NNF NC- 17
Care of the eyes
Clean at birth and subsequently dailyNo kajal applicationFor sticky eyes use normal saline or appropriate medication Nasolacrimal duct blockage, Massaging helps
Teaching Aids: NNF NC- 18
Summary: care of normal neonates at home
Protect from cold/ heatKeep umbilical stump clean and dryDon’t apply anything on cordNo application in eyesExclusive breastfeeding - day and night
for six months
Teaching Aids: NNF NC- 19
Weight change pattern in term baby
May loss up to 5-7% during first 3-5 daysRegains birth weight by 7-10 daysGains 30 g/day during 1st month
Teaching Aids: NNF NC- 20
Danger signs
LethargyHypothermiaRespiratory distressCyanosisConvulsionsAbd distension
BleedingYellow palms/ soleExcessive wt lossVomitingDiarrhoea
Teaching Aids: NNF NC- 21
Follow up visit: Objectives
Assess growth & developmentEarly diagnosis and management of illnessHealth education
Exclusive breastfeeding for 6 monthsComplementary feeds after 6 monthsSpacing of family
Teaching Aids: NNF NC- 22
ImmunizationAge Vaccine Optional0-7 days BCG, OPV, Hep B 6 Weeks OPV,DPT, Hep B Hib10 Weeks OPV,DPT, Hep B* Hib14 Weeks OPV, DPT, Hep B Hib9 months Measles15 months MMR 18 months OPV, DPT HibSchool entry(4-5 yrs) OPV, DT10 years Tetanus toxoid (every 5 years)
* May omit this dose of hepatitis B vaccine if birth dose is given