Newborn care

A newborn baby or animal is one that has just been born.

Definition of terms
1. A fontanelle
is an anatomical feature of the infant human skull comprising any of the
soft membranous gaps (sutures) between the cranial bones that make
up the calvaria of a fetus or an infant.
Fontanelles allow for stretching and deformation of the neurocranium b
oth during birth and later as the brain expands faster than the surround
ing bone can grow.
“soft spot”
HAIR
LANUGO- fine, soft hair, especially that which covers the body and
limbs of a human fetus or newborn.
Lanugo plays a vital role in binding the vernix to the skin; this protects
the fetus from damaging substances found in amniotic fluid. Lanugo's
interaction with the vernix also results in an increased rate of fetal
growth during mid-gestation and a decreased rate of fetal growth at
the end of gestation.
SKIN
Vernix caseosa- also known as vernix or birthing custard, is the waxy
white substance found coating the skin of newborn human babies. It
is produced by dedicated cells and is thought to have some protective
roles during fetal development and for a few hours after birth.
• a white, creamy, naturally occurring biofilm covering the skin of the
fetus during the last trimester of pregnancy. Vernix coating on the
neonatal skin protects the newborn skin and facilitates extra-uterine
adaptation of skin in the first postnatal week if not washed away after
birth.
PLACENTA

• The placenta is an organ that develops in your uterus during

pregnancy. This structure provides oxygen and nutrients to your
growing baby and removes waste products from your baby's blood.
The placenta attaches to the wall of your uterus, and your baby's
umbilical cord arises from it.
APGAR SCORE
• The Apgar score describes the condition of the newborn infant
immediately after birth and, when properly applied, is a tool for
standardized assessment 18. It also provides a mechanism to record
fetal-to-neonatal transition. Apgar scores do not predict individual
mortality or adverse neurologic outcome.
INTRODUCTION 
• Essential care of the normal healthy neonates can be best provided by
the mothers under supervision of nursing personnel.
• About 80% of newborn baby’s require minimal care. The normal term
baby should be kept with their mother rather than separate nursery.
• Rooming in promotes better emotional bondage, prevents cross
infection and established breast feeding easily.
• Mother participates in nursing care of the baby and develops self
confidence in her.
• Nursing care of healthy new born baby after birth should be provided
as immediate care of neonate and daily routine care .
IMMEDIATE BASIC CARE OF
NEWBORN 
• As majority babies cry at birth and take spontaneous respiration, no
resuscitation required at birth in about 95-98% neonates.
• These healthy normal neonates need only warmth, breast feeding,
close observation for early detection of problems and protection from
infections and injuries.
• After cutting the umbilical cord aseptically the baby should be kept
dried, wrapped with dry and warm cloth, examine thoroughly and
quickly to assess normal characteristics, to detect congenital
malformation and then put the mother’s breast.
• Identification tag to be tied to the mother and baby.
• Recording to be done accurately about the event of the birth of the
baby (especially birth date, time, sex, examination findings or
presence of any problem etc) in the delivery record sheet.
• The mother and baby should transfer to ward usually after 1 hour of
observation in the delivery room and when the condition permits.
• Sick or at risk neonates need special care in special setting
DAILY ROUTINE CARE OF NEONATES
• The major goal of nursing care of the newborn is establish and
maintain homeostasis i.e. stability in the normal physiological status.
• Warmth is provided by keeping the baby dry with adequate clothing.
• Baby should be kept to the side of the mother, so that the mother’s
body temperature can keep the baby warm.
• Baby can be placed in skin to skin contact with mother (kangarooing)
to maintain temperature of infant and facilitate breast feeding.
• Bathing at first day is avoided to prevent hypothermia
BREAST FEEDING 
• The baby should be put to mother’s breast within half an hour of birth
as soon as possible .The mother has recovered from exertion of
labour .
• Colostrums feeding must be offered.
• Mother should be informing about the importance and techniques of
breast feeding.
• Demand feeding should be encouraged.
• Exclusive breast feeding procedure should be explained to the mother
and family members
SKIN CARE AND BABY BATH
• The baby must be cleaned off blood, mucus and meconium.
• No vigorous attempts should be met to remove the vernix caseosa, as
it provides protection to the delicate skin.
• Baby bath can be given in the hospital by using warm water in a warm
room gently and quickly.
• Bathing should be avoided in open place.
• During winter months the baby should have sponge bath rather than
deep bath to avoid hypothermia.
• Use of olive oil or coconut oil can be allowed after 3-4 weeks of age.
Oil massage improves circulation and muscle tone.
• Oil massage should be given before the bathing.
• Exposure to morning sunrays is an important source of vitamin D and
warmth.
• The talcum powder should be applied over the axillae , groins and
buttocks.
CARE OF UMBILICAL CORD
• The umbilical cord is cut about 2-3 inches from the navel with aseptic
precaution during delivery and tied with cotton thread or disposable
plastic clip.
• The cord must be inspected for bleeding afterwards which commonly
occurs due to shrinkage of cord and loosening of ligature.
• No dressing should apply and the cord should be kept open and dry.
• Normally it falls off after 5-10 days.
• Application of triple dye or junction violet is not advocated as a
routine any more.
CARE OF EYES
• Eye should be cleaned at the birth and once every day using sterile cotton
swabs soaked in sterile water.
• Each eye should be cleaned using a separate swab.
• Application of kajal in the eyes must be avoided to prevent infection or
lead poisoning.
• The eye should be observed for redness , discharge or the excessive tearin
• Newborns receive erythromycin eye ointment after birth to prevent pink
eye in the first month of life, also called ophthalmia neonatorum (ON).
The most common cause of ON is chlamydia, a sexually transmitted
infection.g for early detection of problems and prompt management.
CLOTHING OF BABY
• The baby should be dressed with loose, soft and cotton cloths.
• Large buttons synthetic frock and plastic or nylon napkin should be
avoided.
• A triangular shaped soft, absorbent cloth should be used as napkin.
• The cloths should not be tight especially around the neck or
abdomen.
• In winter woolen clothing should be used.
GENERAL CARE
• The new born should be kept with the mother for continues rooming
in a well ventilated room.
• Baby be should handled with gentle approach after hand washing.
• No infected person should take care or touch the baby.
• Baby should allow to sleep in a supine position which can prevent
sudden infant death syndrome.
• General cleanliness is to be maintained and surrounding to be kept
clean.
• Wet nappies should be change immediately.
OBSERVATION
• The baby should be thoroughly observed twice daily for early
detection of any abnormalities.
• Temperature, pulse, respiration, feeding behavior, stool, urine and
sleep pattern should be assessed .
• Mouth, eyes, cord, and skin should be looked for any infections.
WEIGHT RECORDING
• Assess daily weight gain in healthy term babies which is about
30gm/day.
• Most infants double their weight by 4-5 months but in first week of
life there is physiological loss of body weight because of removal of
vernix, mucus, blood, passage of meconium and reduction of
extracellular blood volume & also due to adaptation to new
environment.
• With adequate breast feeding majority of babies regain the weight
within 7-10 days of birth.
How to Suction
What are the 3 main functions of the placenta?

Functions of the placenta include 

The placenta is the interface between mother and fetus.
• gas exchange
• metabolic transfer - transfer of immunity by transfer of immunoglobulins from the
mother to the fetus;

• hormone secretion secretion of hormones which are important for fetal growth and
development.
• , and fetal protection.
• Nutrient and drug transfer across the placenta are by passive diffusion, facilitated
diffusion, active transport, and pinocytosis.