Essential Newborn Care (ENC)How was the

ENC Protocol developed?

How was the ENC Protocol developed?
Name of Office: NCDPC

The ENC Protocol was developed the Newborn Care Technical Working Group
(TWG) that conducted a systematic search and critical appraisal of foreign and local
medical and allied health literature on practices in the immediate newborn period. An
evidence-based draft was then developed and reviewed by the Department of Health
(DOH), United Nations Children’s Fund (UNICEF), United Nations Population Fund
(UNFPA), the Philippine Obstetrical and Gynecological Society (POGS), the
Philippine Society of Newborn Medicine (PSNbM, a subspecialty society of the
Philippine Pediatric Society, PPS), other health professional
organizations/associations, Save the Children, the academe and other stakeholders.

What are the four (4) time-bound

interventions involved in ENC?
Name of Office: NCDPC

At the heart of the protocol are four (4) time-bound interventions:

1) immediate and thorough drying,

2) early skin-to-skin contact followed by,

3) properly-timed clamping and cutting of the cord after 1 to 3 minutes, and

4) non-separation of the newborn from the mother for early breastfeeding initiation
and rooming-in.

 
What do these four (4) time-bound
interventions do to the newborn?
Name of Office: NCDPC

1. Immediate and thorough drying of the newborn prevents hypothermia which is

extremely important to newborn survival

2. Keeping the mother and baby in uninterrupted skin-to-skin contact prevents

hypothermia, hypoglycemia and sepsis, increases colonization with protective
bacterial flora and improved breastfeeding initiation and exclusivity

3. Properly timed cord clamping and cutting until the umbilical cord pulsation stops
decreases anemia in one out of every seven term babies and one out of every three
preterm babies. It also prevents brain (intraventricular) hemorrhage in one of two
preterm babies.

4. Breastfeeding initiation within the first hour of life prevents an estimated 19.1% of
all neonatal deaths.

What has the government done to ensure

implementation of the Essential Newborn
Care Protocol?
Name of Office: NCDPC

The signing of the Administrative Order 2009-0025 last Dec. 1, 2009 institutionalizes
policies and guidelines for government and private health facilities to adopt the
essential newborn care protocol. Advocacy and dissemination for a have been done
since its launch. Scale-up implementation in all health facilities and social marketing
are both in the pipeline to ensure that the policy is implemented all over the country.

 
What is the relationship of the ENC Protocol
with regard to the Maternal, Newborn and
Child Health Nutrition (MNCHN) Strategy?
Name of Office: NCDPC

The Maternal, Newborn, Child Health and Nutrition (MNCHN) Strategy is in line
with the DOH Administrative Order 2008-0029 that seeks to rapidly reduce maternal
and newborn morbidity and mortality. Foremost to this is the provision of Basic and
Comprehensive Emergency Obstetric and Newborn Care (BEmONC and CEmONC)
capability of health facilities to meet the UN MDGs 4 and 5. Newborn care has been
incorporated in the provision of these service capabilities. The Administrative Order
2009-0025 formalized the adoption of policies and guidelines on essential newborn
care.

What is the relationship of the ENC Protocol

with regard to the Mother-Baby Friendly
Hospital Initiative (MBFHI), Infant and
Young Child Feeding Strategy, and the
Republic Act 10028?
Name of Office: NCDPC

The ENC Protocol seeks to provide a firm foundation for an environment that
complies with the “Ten (10) Steps to Successful Breastfeeding” of the Mother-Baby
Friendly Hospital Initiative (MBFHI), breastfeeding initiation crucial to the IYCF
WHO global strategy and in the implementation of the R.A. 10028.

What newborn care practices in the delivery

room should no longer be continued?
Name of Office: NCDPC
The following practices should never be done anymore to the newborn:

 Manipulation such as routine suctioning of secretions if the baby is crying and

breathing normally. Doing so may cause trauma or introduce infection.
 Putting the newborn on a cold or wet surface.
 Wiping or removal of vernix caseosa if present
 Foot printing
 Bathing earlier than 6 hours of life
 Unnecessary separation of the newborn primarily for weighing, anthropometric
measurements, intramuscular administration of vitamin K, Hepatitis B vaccine
and BCG vaccine
 Transferring of the newborn to the nursery or neonatal intensive care unit
without any indication

Who are involved in Essential Newborn Care

Protocol?
Name of Office: NCDPC

Healthcare professionals, either in government or in private facilities, involved in

maternal and newborn care not limited to obstetrician-gynecologists,
pediatricians/neonatologists, nurses, midwives, but also the hospital administration
officials, anesthesiologists, hospital infection control officers, hospital
PhilHealth/Quality officers, clinical nutritionists, clinical pharmacists, nursing
attendants, health promotion and information officers.

At the community level, the local government up to the barangay officials, together
with their health workers, nutrition scholars, community health teams and volunteers,
mothers’ groups are likewise enjoined to ensure proper information is disseminated to
pregnant women and women of the reproductive age group.

Why is there a need for Essential Newborn

Care Protocol?
Name of Office: NCDPC
The wide variations in newborn care practices in health facilities, both government
and private, and also the proper sequence or order of newborn care services need to be
standardized based on current evidences that show reduction in neonatal mortality and
morbidity. This is to achieve the United Nations Millennium Development Goal 4 of
Reducing Under 5 Child Mortality (through reduction of neonatal deaths).