[RLE] CARE OF MOTHER, CHILD, AND ADOLESCENT (WELL CLIENTS)

IMMEDIATE NURSING CARE OF THE NEWBORN

The first 24 hours of life is a very significant and a highly o Do not suction unless the mouth/nose are blocked
vulnerable time due to critical transition from intrauterine to with secretion or other material
extra-uterine life. o Do not wipe off vernix
o Do not bathe the newborn
How well the newborn makes these major adjustments o Do not do foot printing
depends on his or her genetic composition, the competency o No slapping
of the recent intrauterine environment, the care received o No hanging upside-down
during the labor and birth period, and the care received during o No squeezing chest
the newborn or neonatal period – from birth through the first
28 days of life (Adele Pilliteri, 2007) TIME BAND: AFTER 30 SECOND OF DRYING (EARLY
SKIN-TO-SKIN CONTACT)
ESSENTIAL INTRAPARTUM NEWBORN CARE • If the newborn is breathing or crying:
• The essential intrapartum and newborn care (EINC) o Position the newborn prone on the mother’s
process are evidence-based standards that are abdomen or chest
recommended for adoption in Philippine Hospitals with o Cover the newborn’s back with a dry blanket
maternal and newborn care services and birthing o cover the newborn’s head with a bonnet
facilities, both in the government and private sector
– By the Department of Health (DOH), Philippine NOTE:
Health Insurance Corporation (PhilHealth) and o Avoid any manipulation, e.g., routine suctioning that
the World Health Organization may cause trauma or infection
o Place identification band on ankle (not wrist)
WHAT ARE THE IMMEDIATE NEWBORN CARE o Skin-to-skin contact is doable even for caesarean
PRACTICES WILL SAVE LIVES? section newborns

TIME BAND: AT PERINEAL BULGING (PREPARING FOR TIME BAND: 1-3 MINUTES (PROPERLY TIMED CORD
THE DELIVERY) CLAMPING)
• Check temperature of the delivery room (25-28º C, free • Remove the first set of gloves
of air drafts) • After the umbilical pulsations have stopped, clamp the
• Notify appropriate staff cord using a sterile plastic clamp or tie at 2cm from the
• Arrange needed supply in linear fashion umbilical base
• Check resuscitation equipment • Clamp again at 5cm from the base
• Wash hands with clean water and soap • Cut the cord close to the plastic clamp
• Double glove just before delivery
NOTE:
4 CORE STEPS OF ESSENTIAL NEWBORN CARE o Do not milk the cord towards the baby
o After the 1st clamp, you may strip the cord of blood
before applying the 2nd clamp
1. Immediate and Thorough Drying
o Cut the cord close to the plastic clamp so that there is
2. Early skin-to-skin contact
no need for a 2nd trim
3. Properly timed cord clamping
o Do not apply any substance to the cord
4. Non-separation of the newborn and mother for early
initiation of breastfeeding
TIME BAND: WITHIN 90 MINUTES (NON-SEPARATION
OF NEWBORN FROM THE MOTHER FOR EARLY
ENC TIME-BOUND INTERVENTIONS BREASTFEEDING)
• Leave the newborn in skin-to-skin contact
• Observe for feeding cues, including tonguing, licking,
and rooting
• Point this out to the mother and encourage her to nudge
the newborn towards the breast
• Counsel on positioning
o Newborn’s neck is not flexed nor twisted
o Newborn is facing the breast
o Newborn’s body is close to mother’s body
o Newborn’s whole body is supported
• Counsel on attachment and suckling
o Mouth wide open
o Lower lip turned outwards
TIME BAND: WITHIN 1ST 30 SECONDS IMMEDIATE, o Baby’s chin touching breast
THOROUGH DRYING o Suckling is slow, deep with some pauses
• Call out the time of birth • Weighing, bathing, eye care, examinations, injections
• Dry the newborn thoroughly for at least 30 seconds (Hepatitis B, BCG) should be done after the first full
• Wipe the eyes, face, head, front and back, arms and legs breastfeed is completed
• Remove wet cloth • Postpone washing until at least 6 hours after delivery
• Do a quick check of breathing while drying
NOTE:
NOTE: o Minimize handling by health workers
During the first seconds o Do not give sugar water, formula or other prelactics
o Do not give bottles and pacifiers
o Do not ventilate unless the baby is floppy/limp and not
breathing o Do not throw away colostrum