NEWBORN CARE

INTRODUCTION

The first week of life is the most crucial period in the life of an infant. In India 50-60

percent of all infant deaths occur within the first months of life. Of this half may die during the

first week of birth. This is because the newborn has to adopt itself rapidly and successfully to an

alien external environment. The risk of death is the greatest during the first 24-48 hours after birth.

The problem is more acute in rural areas where expert obstetric care is scarce. And the home

environment conditions, in which the baby is born, are unusually unsatisfactory.

OBJECTIVES OF NEW BORN CARE

 Establishment and maintenance of cardio-respiratory functions

 Maintenance of body temperature

 Avoid of infection

 Establishment of satisfactory feeding regimen

 Early detection and treatment of congenital and acquired disorders, especially infections.

IMMEDIATE CARE OF NEWBORN

Cleaning of airway:

Immediately after birth the baby should cry and breathe. In order to promote breathing the

airway to be cleared of mucus and any other secretions. The secretions can be drained by lowering

the head of and gently patting at the back if necessary, gentle suction of mucus should be done. If

the baby does not cry and breathe within a minute, resuscitation must be done using various

alternative measures such as suction ventilation by mouth to mouth breathing or bag mask.

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APGAR Scoring:

APGAR Scoring is a device to monitor physical condition of the baby. It is determined by

immediate observation of the heart rate, respiration, muscle tone reflex response and color of the

infant. The observation is done at 1 minute and again 5 minutes after birth.

Sign 0 1 2

Respiration Absent Slow/ Good,

Regular Cries

Heart rate Absent Slow, Over 100

below 100

Colour Blue, pale Body pink, Complete

Extremities pink

blue, Grimace

Muscle Flaccid Some Active

Tone flexion of movement

extremities

Reflex No Grimace Cries

Response response

Total Severe Mild No

Score 10 Depression depression Depression

0-3 7-10

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Care of the umbilical card:

The umbilical card should be cut after it stops pulsating so that child has the benefit of

getting blood. The cord should be legated in two places, 6 cms and 9 cms from the umbilicus and

cut in between with sterilized scissors or blade and tied with sterilized cord tie to prevent tetanus.

It is essential to apply an antiseptic preparation on the cord stump and the skin around the base.

The cord should be kept dry. Special instructions should be given to the mother and family not to

apply anything e.g. any oil, ash or cow dung on the cord. Such customs cause increases the danger

of tetanus infection. The cord dries, shrinks and falls off within 5-8 days by aseptic necrosis.

Care of the eye:

It is very important to take care of the eye as child is born to prevent ophthalmic neonatrum

due to variety of infections especially nisseria gonorrhea and Chlamydia trochomatis in mothers.

The care of eyes include wiping of each eye from inside to outside with boiled cooled swabs, one

for each eye as the child is born before he opens the eye. A single application of either 1% freshly

prepared silver nitrate or 1% tetracycline ointment is applied within one hour of delivery.

Care of the skin

The care of the skin is very important to protect the child from any infection and keep the

baby clean and warm. The bath is given with soap and warm water to remove the

vernix, meconeum and blood clots etc.

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Maintenance of body temperature

As soon as the baby is born, he is exposed to an environment which is colder in winter and

hot in summer. The newborn baby has the risk of hypothermia or hyperthermia because of

immature heat regulating system. The hypothermia also results because of evaporation of amniotic

fluid from the baby surface. The risk of hypothermia is greatly reduced if the newborn baby is

immediately and carefully dried with towel or clean cloth, wrapped in a clean cloth, kept close to

the mother for soon as possible preferably within an hour of birth. In case of severe hypothermia

the child should referred immediately to hospital

Breast feeding

The breast feeding should be started as soon as possible preferably within an hour of the

birth. This helps in mother – child bonding and in establishing feeding. The colostrums which is

secreted out for a few days is rich in proteins, other nutrients and anti infective agents. The breast

feeding during this period provides good nourishment, immunity against infections. The baby

should be fed on demand. Bottle feeding should not be done as it is neither required nor safe for

the baby. Strict instructions should be given to the mother and family.

BIBLIOGRAPHY

1. Park K. “Preventive and Social medicine”, 18th edition, Jabalpur, Banarasidas Bhanot
Publication, Page no. 391-393.
2. Stanhope M, Lancester J. “Community and public health nursing”, 6th Edition, New York,
Mosby’s publication, Page no. 618-619.
3. Rao S. “Principle of community medicine”, 4th edition, AITBS Publication, P.394-395.
4. Park K. “Essentials of community health nursing”, 3rd edition. Jabalpur, Banarasidas

Bhanot Publication, Page no. 207-209.