NURSING CARE OF A NEWBORN AND FAMILY IN THE
POST PARTAL PERIOD
THE INITIAL FEEDING
 The Baby-Friendly Hospital Initiative (BFHI) is a global
program sponsored by the World Health Organization and
the United Nation Children’s Fund, to encourage and
recognize hospitals and birthing centers that promote
optimal level of care for infants that promotes
breastfeeding.
TO QUALIFY AS A BABY-FRIENDLY-DESIGNATED
FACILITY, A SETTING MUST:
1. Maintain a written breastfeeding policy that is routinely
communicated to all healthcare staff.
2. Educate all healthcare staff in skills necessary to implement
the written policy.
3. Inform all pregnant women about the benefits and
management of breastfeeding.
4. Help mothers initiate breastfeeding within one hour of birth.
5. Show mothers how to breastfeed and how to maintain their
milk supply.
6. Offer breastfed newborns no food or drink, other than
breastmilk, unless medically indicated.
7. Practice “rooming-in” or allow mothers and infant to remain
together 24h/day.
8. Encourage unrestricted or “on-demand” breastfeeding.
9. Give breastfeeding infants no pacifiers or artificial nipples.
10. Foster the establishment of breastfeeding support groups
and refer mothers to them on discharge from the birth
setting.
BATHING
 The World Health Organization, through the Unang Yakap
Program recommends that newborns receive a complete
bathing no later than 6 hours.
 There is no need to use antibiotic cleanser and no need to
remove all vernix.
 Babies of mothers with HIV infection should have a
thorough bath immediately to decrease the possibility of
HIV transmission.
 Give the bath before feeding to prevent spitting up or
vomiting and possible aspiration
 Check and make sure that the room is warm, at about 24
degrees Celsius, to prevent chilling.
 Supply bath water at about 37-38 degrees Celsius, a
temperature warm to the elbow or wrist.
 Bathing should proceed from the cleanest parts of the body,
to the most soiled areas- that is, from the eyes and face, to
the trunk and extremities, and lastly to the diaper area.
 Wipe a newborn’s eyes with clear water from the inner
canthus, to the outer canthus, using a clean portion of the
washcloth for each eye, to prevent spread of infection.
 Give particular attention to the creases of the skin where
milk tends to collect if the child spits up after feedings.
 If the mother want to use soap, be sure to rinse well so no
soap is left on the skin (soap has drying effect), and also to
dry well.
 Soap the hair while bay is still in the bassinet.
 Then, hold the infant in one arm over then basin, as you
would hold a football.
 Pour water from the basin over the hair to rinse.
 Dry the hair well to prevent chilling.
 Lather and gently massage all parts of the head, including
soft spots to prevent scaling.
 In male infants, the foreskin of the uncircumcised penis,
should not be forced back while washing the penis, or
constriction of the penis may result.
 Wash the vulva of a female infant, wiping from front to back
to prevent contamination of the vagina or urethra.
 It is not advisable to put on lotions or powders, as infants
may be allergic to the products, and breathing in powder
can cause respiratory distress.
 If a newborn skin is extremely dry, lubricants may be
applied on the bath or skin, as directed by the physician.
SLEEPING
 Sudden Infant Death Syndrome (SIDS) is the sudden,
unexplained death of an infant younger than 1 year of age.
Although the specific cause of SIDS cannot be explained,
these interventions have been shown to decrease the
incidence of the syndrome:
1. Place the infant on it’s back to sleep
2. Use a firm sleep surface
3. Breastfeeding
4. Room sharing, without bed sharing
5. Routine immunization
6. The use of pacifiers.
7. Avoidance of soft beddings.
8. Overheating
9. Exposure to tobacco, alcohol and illicit drugs.
DIAPER CARE
 Preventing diaper dermatitis or diaper rash, is a practice
parents need to start from the very beginning.
 Advise parents to change diapers frequently, and with each
diaper change to wash the dry the area.
 For the health practitioner, wear gloves in changing the
diaper.
NEWBORN SCREENING/ METABOLIC SCREENING TESTS
 Newborns born in a hospital or birthing center are routinely
screened for more than 30 metabolic or inherited disorders
by a screening technique that requires a small blood
sample obtained by a heel stick, and dropped into a special
filter paper.
 Ideally, a baby should have received formula or breast milk
for 24H before the blood is obtained for best results.
 If blood testing is not done before discharge, they need to
schedule screening within 2-3 days time.
CIRCUMCISION SLEEP PATTERN
 Surgical removal of the foreskin of the penis.  A newborn sleeps an average of 16H/day, sleeping about
 Phimosis is an indication of circumcision in the newborn, 4H at a time, so it is tiring for parents to wake up at night for
but otherwise parents elect not to have the procedure feeding.
because the operation is painful and increases the risk for  Advise that newborns needs fluid and nutrition, so it is not
infection. recommended to eliminate night feedings.
 Scientific evidence shows that circumcision reduces the  It is important not to put formula fed infants to sleep with a
risk of HIV, human papillo virus, and cancer in a male or bottle.
cancer in female partner, suggesting that the preventive
health benefits may outweigh the risks. CRYING
 But routine circumcision was declined, therefore parents  Newborns typically cry an average of 2H/day during the first
are free to make the decision for their child. 7 weeks of life. The frequency seem to peak at age 6 or 7
 Circumcision is performed as a religious right among weeks then tapers off.
groups such as Jewish and Muslims communities.  Infants have periods during the day when they are wide
 Contraindication for circumcision include history of bleeding awake and invariably fussy, help parents to recognize that
tendency, hypospadias or epispadias. this is common for most newborns so they don’t worry that
 The procedure is best performed during the first or second it means that their child is ill.
day of life , after the baby has synthesized enough Vitamin  Unfortunately, most typical time for wakefulness is between
K to reduce the chance of faulty coagulation. 6 and 11pm, when parents are tired and least able to
 Complications that can occur from circumcision include tolerate crying.
hemorrhage, infection and urethral fistula formation.  Remind parents importance of break from care, as it can be
 Circumcision site appears red but should not have a strong the difference between a parent shaking a baby from
odor or discharge. But a light yellow mucus often covers the frustration, and being rested and be able to effectively meet
glands by the second day, but should not be removed the infant’s needs.
because it serves a protective function.  Use of pacifiers.
 Teach patients to clean area from feces and should refer if
redness or tenderness, or constant pain is noted as it may CAR SAFETY
indicate infection.  For protection in automobiles, newborns should always be
transported in rear facing car seats placed in the back.
ASSESSMENT OF THE FAMILY’S READINESS TO CARE
FOR A NEWBORN AT HOME CONTINUED HEALTH MAINTENANCE FOR A NEWBORN
 It is important to assess how prepared each family is to care  Make certain that parents make and keep their healthcare
for their newborn at home, ensuring the newborn will appointments.
remain safe and develop a sense of security.
 Parents may need to plan changes in their routine, such as
shifting meal times, and sleep patterns.
 The physical environment of the home is also important to
explore with the parents. Questions may include the
following:
o How many other people live in the home? (infection
may be spread rapidly in a crowded home)
o Are there any pets at home?
o Is there a separate bed for the baby?
o Who will be the primary caregiver? (discharge
instructions will be given to them)
o Does the mother have anyone to turn to if she has
questions about the baby?
o Is there a refrigerator in the home?
o Is there adequate heat? (an infant needs a
temperature of 70-75 degrees during the day and 60-
65 degrees farenheit during the night.
o Are the windows draft free, and screened to keep out
insects such as mosquitos?
o Are there rodents in the house?
o Is there danger of lead poisoning?
o Does the family have a source of income?
o Does the mother have concrete plan for continuing
health care for the infant?

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