HEALTH EDUCATION ON

NEWBORN CARE

SUBMITTED TO: MRS. VINUTHA CHRISTABEL

SUBMITTED BY: MR.TEJASVI T.

 STUDENT PROFILE

NAME OF THE STUDENT : Mr. TEJASVI T.

NAME OF THE EVALUATOR : MRS.VINUTHA CHRISTABEL
YEAR : 1ST YEAR MSC
TOPIC : NEWBORN CARE

General objectives
Specific objective

At the end of the class mothers will be able to;

 introduce the topic

 to define new born care
 explain about essential new born care
 describe the maintenance of respiration in new born
 describe the maintenance of circulation in new born
 explain the process of clamping and cutting the cord
 understanding the importance of initiation of infant parent attachment and feeding
 discuss the immunization for new born
 explain the maintenance of hygiene for new born
TIME SPECIFIC CONTENTS A.V. TEACHER STUDENTS EVALUATION
OBJECTIVES AIDS ACTIVITY ACTIVITY
2mts To introduce the INTRODUCTION Teacher
topic introduces the
The baby’s birth is a topic
moment of joy. But to sustain the
joy it is essential to know if the
newborn is free from any congenital
anomalies and have a proper growth
and development. To diagnose any
such deviations from normal it is
necessary to have a proper initial
and daily assessment. This
assessment would include reflexes,
vitals, growth and development etc.

1mts DEFINITION flip Teacher explains Students listen and Define newborn
To define new charts with the help of contributes. care.
born care New born care is defined as FLIP CHARTS
management of neonate during the .
transition to extra uterine life and
subsequent period of stabilization.
 ESSENTIAL NEWBORN CARE Teacher explains Students are What is the normal
1mts flip listening and posture of new
To explain about INITIAL CARE charts copies. born?
essential new born
care As the baby’s head is born,
excess mucus may be wiped gently
from his/ her mouth taking care not
to touch the nerves as it may cause
reflex inhalation. The time of baby’s
birth and the sex are noted &
recorded soon after the baby is
expelled from his/her mother.

5mts MAINTENANCE OF Flip Teacher explains Mothers are describe the

To describe the RESPIRATION charts with the help of listening maintenance of
maintenance of flip charts respiration in new
respiration in new Maintenance of patient . born
born airway for respiration is a priority.
As the infants head is delivered
secretion are squeezed out of the
mouth and nose by the pressure of
the birth canal. The infant’s airway
may be occluded by the respiratory
secretion mucus and blood from the
maternal birth canal or amniotic
fluid mixed with the meconium &
vernix. To prevent aspiration, the
mouth and the nose can be
auctioned with the baby syringe
before the rest of the infant is
delivered and the first breath is
taken.

After the baby is born the infant is

placed in a 15 degree, head
dependent, side lying position to
promote drainage of secretions. The
infant is positioned either on the
mother’s abdomen or under a
radiant warmer. Care is taken in
positioning not to extend the infants
neck too far because over extension
can cause compression of the soft
trachea.

The following signs indicate the

airway has become clear:

-An irregular respiratory rate of 40-

60breaths/min with periods of apnea
lasting less than 5 seconds

-Symmetric rise and fall of the chest

and abdomen with each breath
 -Absent or minimal nasal flaring,
grunting or retraction

-Pink mucus membrane and

tongue(absence of central cyanosis)

-Spontaneous activity with good

muscle tone/a reliable sign of
adequate oxygenation

MAINTENANCE OF flip Teacher explains Students listen describe the

5mts CIRCULATION charts with the help of maintenance of
flip charts circulation in new
A patent airway and adequate born
To describe the respiration are indicated by an epical
maintenance of heart rate of 110-160 beats/min.
circulation in new easily heard on the left side of the
born chest near the nipple & absence of
central cyanosis. Spontaneous
activity with good muscle tone is a
reliable sign of adequate
oxygenation. Infant who cannot
maintain airway breathing &
circulation are at high risk &
includes those with low apgar scores
or other problems that interrupts this
process.
 students listen
5mts CLAMPING & CUTTING THE Flip Teacher explains explain the process
CORD charts. with the help of of clamping and
flip charts cutting the cord
Separation of the baby from the
placenta is achieved by cutting the
To umbilical cord between two clamps,
explain the which should be applied
process of approximately 8-10 cm from the
clamping and umbilicus with enough space
cutting the cord between them to allow easy cutting.
Some centers advocate delay in
cutting the cord until respiration is
established and pulsation has
ceased, thus ensuring that the infant
receives placental transfusion of
about 70ml of extra blood.

Leboyer advocated delayed cord

clamping for an entirely different
reason. He believed that this
allowed the newly born baby to
have two sources of oxygen during
transition. Firstly, from the lungs
and secondly, from the placenta
through the cord. Then, when the
gradual transition from dependence
on the placenta to dependence on
the lungs in completed as evidenced
by cessation of cord pulsation the Students listen and
cord is clamped & cut. copies
 INITIATION OF INFANT chart Teacher explains What is the
10mts PARENT ATTACHMENT AND with the help of importance of
FEEDING Chart initiation of infant
. parent attachment
Assisting the new family in and feeding?
the acquaintance process is an
important part of maternal-infant
To understand the nursing care. Ideally the nurse
importance of facilitates the following measures to
initiation of infant encourage further bounding
parent attachment
and feeding  Skin to skin and eye to eye
contact.
 Privacy and comfort of both
parents.
 Initial breastfeeding
 The first hour of life is an
ideal time for the initial
infant parent interaction
because the infant is quite
and alert and may be eager
to nurse or may be at least
make an attempt to nurse.
Skin to skin contact is
promoted by encouraging
mother to hold the infant.
The infant can be placed on
mother’s abdomen soon after
birth. During this period the
 nurse looks for positive
interaction signs, keeping in
mind the individual
differences in behavior.
 Feeding the baby can be
started as soon as possible.
The baby’s breastfed in the
first hour of birth are more
likely to continue students listen and
breastfeeding longer. copies

flip Teacher explains What vaccinations

5mts charts with the help of are given at birth?
board.
IMMUNIZATION

Vitamin K dependent factors are

low in newborn leading to
hemorrhagic disease of the newborn.
A routine procedure is to administer
To discuss the 1mg of vitamin K within 6hours of
immunization for birth. It can also be given in last
new born week of pregnancy with expected
preterm births as it can cross the
placenta.

Hepatitis Prophylaxis

The centers for disease control

 recommend hepatitis B vaccine to
be given for newborns within 48
hours of birth. Infants born to
mothers with hepatitis B positively
are also given hepatitis B
immunoglobulin within 12 hrs of
birth.

Others
students listen and
B.C.G. vaccine, OPV can be given copies
at birth according to institutional
policies Teacher explains
10mts with the help of
flip charts

HYGIENE

The infant does not have protective

skin flora at birth and is exposed to
To explain the a variety of infectious agents.
maintenance of Abrasions from forceps or umbilical
hygiene for new stump wounds can provide entry
born point for such agents. The newborns
passive immunity will not protect
him against all organisms. Acquired
agents such as HIV can also be
transmitted to infants and other
health personals. Therefore all the
supplies used in case of newborn
must be medically clean and not
interchanged with other infants
supplies.

Bath

Removing birth bloods and fluids

from the infant’s skin is the first line
of defense in the post birth period.
This should be done before eye or
parental medication is given to the
newborn. If the complete bath is to
be delayed due to unstable body
temperature, then only the face is
washed after eye medication is
instilled. By 6 hours the temperature
should have been stabilized enough
to wash the infant under overhead
radiant warmer.

Bathing at home

Sponge bath is given until the cord

detaches. The sequence is the same;
hair wash is done the last. Parents
should be instructed to use very
little of a mild soap.
The room in which the bath is given
should be pre warmed; all bathing
articles and the infant’s change of
cloth should be ready beforehand.
Parents should be taught how to
handle the baby gently and in a
secure manner.

Cord Care

The cord stump and clamp may be

painted with bacteriostatic agent
such as triple dye or alcohol, which
colors the cord and adjacent skin
dark purple. Daily care in the
nursery involves the application of
triple dye or alcohol and folding the
diaper under the umbilicus to
prevent wetting from urine.

The plastic clamp is removed when

the cord appears shriveled and drier,
usually on the second day. The cord
usually falls at 10-14 day. If it
remains soft and red or begins to
have a foul smell the infant should
be checked by the primary care
provider. Omphalitis is the infection
of the umbilical cord. It is
potentially dangerous and can lead
to septicemia.

Elimination

Meconium is usually passed within

the first 24 hrs and is
characteristically dark greenish
black. As feeding is established,
Meconium stools are gradually
replaced by a stool that is light
greenish brown in color. The color
and consistency of the stool,
changes with the type of feeding. A
breastfed infant may pass four or
more variable stools in 24 hrs but
also may have as little as one stool
in 3 days. The stool may be looser
and pasty than the bottle fed infants
and will also depict changes in
mother’s diet.

Most of the infants void

within the first 12hrs and will wet 6-
8 diapers a day. Actual urine output
varies with intake. Parents should
understand the connection between
intake and output.

Perinial Hygiene

Cloth or paper diapers may be used.

Diaper changes should be done with
each feeding and as necessary. The
perennial area should be cleaned
from front to back using a wash
cloth with plain water or a
commercial cleansing wipe. Soap
that removes normal skin flora
should not be used.

Rashes

The treatment of diaper rash

involves exposing the rash to
warmth and air. Immediately
washing and drying the wet and
soiled area and changing the diaper
after voiding or stooling prevents
diaper rash and helps treat any
existing rash. Parents can be taught
placing the infant in a warm room
with its buttocks exposed to air or to
filtered sunlight can be of great help.
Diaper should not be used until the
healing occurs. The most sever type
of diaper rash occurs when the area
becomes infected, indurated and
tender. If this occurs medical advice
should be taken.

Clothing

The child should be dressed as the

parents dress themselves i.e. adding
and removing clothes as necessary.
Overdressing in warm temperature
can cause prickle heats and
discomfort and under dressing in
cold whether can also cost
discomfort, frostbite on fingers,
toes, and cheeks.

Infant linens

Care of infant cloths and bedding is

directed towards minimizing cross
infection and removing residue of
soap, feces or urine that may be
 irritant to infant skin. Infant linen
and bedding should be washed
separately and autoclaved if in
hospital. At home the linen should e
dried in direct sun light.

Hot water and double rinsing

removes the traces of cleansing
agent or the acid residue from the
urine or feaces. Bedding should be
changed frequently. The plastic
coated firm mattress must be
washed daily and the crib should be
damp dusted. The infant’s toilet
articles may be kept separately and
ready for use in a box is basket.

2mts

Nutritional needs

The newborn needs to be

exclusively breastfed on demand.

To summarize the SUMMARY

topic
Today we have seen the definition
 of new born care, essential new
born care,
maintenance of
respiration in new born,
maintenance of circulation in new
born, process of clamping and
cutting the cord, importance of
initiation of infant parent attachment
and feeding, the immunization for
new born, maintenance of hygiene
for new born and nurses’
responsibility.

BIBLIOGRAPHY

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1997. P. 35-45..
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6. Fraser DM, Cooper MA. Myles textbook of midwives.14 ed. Edinburg; 2003.P.99-101.
7. Jacob A. A comprehensive textbook of midwifery. New Delhi: Jaypee; 2005. P. 476-82,463