3 Newborn Health

COMMUNITY
IMPLEMENTATION
OF DOH PROGRAMS
A. Pre-pregnancy Health Care

B. Maternal Health in Pregnancy
C.Newborn Health
D. Neonate and Infant Health
E. Child Health
F. Adolescent Health
G. Healthcare for Adults
H. Elderly
The Newborn Phase of the
life-cycle approach cover
discussions on the
different roles and
responsibilities of BHWs
in promoting Essential
Intrapartum and Newborn
Care (EINC), Newborn
Screening and
Breastfeeding Programs of
the DOH.
Community Program Implementation: Newborn Health (0-28 days old)

Essential Intrapartum and Newborn Care (EINC)
There are 4 important interventions during the
immediate post partum phase of pregnancy:
1. Immediate and thorough
drying
2. Skin-to-skin contact
3. Delayed cord clamping
4. Non-separation of the mother
and the baby

Role of the BHW
Under the Newborn Package Program, adequately trained

BHWs are expected to identify and record the eligible
population of their HH catchment areas who have newborn
babies.
BHWs can give health education, but comprehensive
counseling will be given by a health professional

WHAT BHWs NEED TO

DO?
1. All pregnancies are considered
high risk and should be
delivered only by adequately
trained health personnel in a
birthing facility.

However, in extreme cases where home or in transit delivery

is unavoidable, the BHWs may do the following while
waiting for the SBA:
a. Using a clean, dry cloth, thoroughly dry the baby and wipe
the face, eyes, head, front and back, arms and legs.
b. If a baby is crying and breathing normally, place the
newborn on the mother’s abdomen and cover the back with
a blanket and head with a bonnet. DO NOT manipulate or
clamp the umbilical cord. Neonatal infection or tetanus can
be caused by unsterile materials and environment.

Cont. WHAT BHWs NEED TO DO?

2. Using the latest family profiling and risk assessment form for newborns, gather
the following data during your 1st postpartum visit:
a. Name of the newborn
b. Place of delivery
c. Name of parents
d. Date of birth
e. Place of delivery
f. Type of delivery
g. Date registered at the Municipal Registry
h. Compliance to newborn health services (e.g. BCG and hep B vacc, NBS, BF)


3. Encourage mothers to have their newborn vaccinated and
screened on time.
4. To prevent neonatal sepsis, educate mothers on proper cord
care (keeping the umbilical cord dry without putting anything
– alcohol/betadine, or any dressing).


5. Immediately refer the newborn to your RHM or to the
nearest health facility if there are any of the following:
a. Poor suck, cry or activity
b. Foul-smelling discharge on the umbilicus
c. Yellowish discoloration in the skin and eyes
d. Difficulty of breathing

6. Educate mothers on the importance of breastfeeding and

proper breastfeeding techniques.
7. Assist the mothers in registering their newborn to the

local civil registry.

NEWBORN SCREENING
Newborn Screening is a practical

procedure to determine the possibility
of having a congenital metabolic
disorder that may lead to mental
retardation and death, if not detected
early and appropriately treated.

ROLE OF THE BHW
Under the NBS Program, BHWs are

expected to assist RHMs in
identifying within their household
catchment areas who are qualified to
undergo newborn screening, or those
who were born within 24-72 hours.
They are expected to assist in the
information campaign on newborn
screening.
WHAT BHWs NEED TO SAY?
What is Newborn Screening?
Newborn Screening is a practical procedure to

determine the possibility of having a congenital
metabolic disorder that may lead to mental
retardation and death, if not detected early and
appropriately treated. It uses heel prick method.

When should it be done?
It is done ideally after the 1st 24 hours of life and

not later than 3 days. The procedure is performed
only by a physician, nurse, trained midwife or
medical technologist.

Where can it be availed?
It is available in hospitals, lying-in clinics, rural

health units, health centers and some private
clinics.

WHAT BHWs NEED TO DO?
1. Assist the mother in identifying the nearest

newborn screening facility within the
community.
2. If mothers are residing in far flung areas or

geographically isolated areas, assist the mother
to follow up results (if necessary).

BREASTFEEDING
Exclusive breastfeeding is best for
babies during the first 6 months of life
and may be initiated within 30 minutes
after birth by initiating skin-to-skin
contact.
The first few drops of breastmilk,
called colostrum, contains high level of
antibodies which can increase the
baby’s resistance against common
infections.
ROLE OF THE BHW

Under the post partum and lactating
program, adequately trained BHWs are
expected to identify and record the
eligible population of their HH
catchment areas.
However, they are not expected to
be able to comprehensively discuss
breastfeeding and lactation.

Breastfeeding is still the best source of

nutrition for babies until 6 months of
age.
It may be continued until 2 years of age

and beyond.
It is always available, safe and

economical.

What do we mean by exclusive breastfeeding?
 only breast milk without water or any other

liquids for the 1st 6 months of life.
 For working mothers, they can still continue

breastfeeding by storing expressed breastmilk
in a clean, safe and cool place that is properly
labeled and covered .

How do we store breast milk?

Key points:
 Expressed breast milk can be stored for 8
hours at room temperature.
 When stored in a refrigerator, it is good for

24 hours; in a freezer compartment– 2 weeks,
in a freezer section – 3 months.

1. Teach the mother how to perform the proper

techniques for breastfeeding:
 Take a bath daily and wear clean clothes –

and you are ready to breastfeed any time of
the day.
 Breastfeed by demand (or when there are

breastfeeding cues: smacking/licking lips,
opening or closing mouth, sucking on lips,
tongue, hands, fingers, toes or clothing)
 Allow the baby to suck at the areola of the

mother’s breast and not just the nipples to
prevent nipple sores.
 At each feeding, encourage the baby to

empty the breast and then offer the other
breast.

2. Teach the mother breastfeeding

positioning and attachment.
Key Points:
 Baby’s head and body in line
 Baby’s head held close to the
mother’s body
 Baby’s whole body supported

Proper Breastfeeding Hold

•Look for a quiet place
•Find a most relaxed position for mother
•Provide adequate back support
•Support feet
•Do not hunch shoulders
•Do not “scissor” the breast

Cradle Hold

Cross Cradle Hold

• Football hold
• Baby is held like a
clutch bag
Underarm Hold
• Nose further away
from the breast
• Baby’s trunk is
secure beside
mother’s trunk
Breastfeeding after Cesarean Delivery

Side-Lying Position

Side-Lying Position

Don’t be afraid
that the baby
cannot breathe.
The nose bridge
allows space for
breathing.
SIGNS OF GOOD
ATTACHMENT
i. Mouth wide open

ii. Lower lip turned upward
iii. Chin touching the breast
iv. More of the areola is seen
above the baby’s mouth
than below it

Good and Poor Attachment
What Differences do you see?

3. Encourage the mother to

maintain good nutrition
and avoid alcohol and
tobacco, which can
decrease milk production.

Nutritional advice for lactating mothers:

 Eat at least 2 additional servings of staple food per day
 Eat at least 3 additional servings of calcium-rich foods (e.g. dark green leafy
vegetables, sardines, milk/dairy products) per day
 Drink at least 8 glasses of fluids (2 liters) each day
 Eat smaller, more frequent meals if unable to consume larger amounts in

fewer meals
 Take micronutrient supplements such as iodine through the use of iodized

salt as directed.

4. Encourage the mother to join breastfeeding

support groups within the community to help
her know more about the proper techniques
for breastfeeding, and some practical answers
to commonly asked questions about
breastfeeding.
5. Refer to the RHM if the mother experiences

difficulty in breastfeeding.

Any Questions?
CHT-48 38
THANK YOU!!!!
39

3 Newborn Health

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3 Newborn Health

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COMMUNITY

A. Pre-pregnancy Health Care

Community Program Implementation: Newborn Health (0-28 days old)

Community Program Implementation: Newborn Health (0-28 days old)

Role of the BHW

Under the Newborn Package Program, adequately trained

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO

Community Program Implementation: Newborn Health (0-28 days old)

However, in extreme cases where home or in transit delivery

Community Program Implementation: Newborn Health (0-28 days old)

Cont. WHAT BHWs NEED TO DO?

Community Program Implementation: Newborn Health (0-28 days old)

Cont. WHAT BHWs NEED TO DO?

Community Program Implementation: Newborn Health (0-28 days old)

Cont. WHAT BHWs NEED TO DO?

Community Program Implementation: Newborn Health (0-28 days old)

Cont. WHAT BHWs NEED TO DO?

6. Educate mothers on the importance of breastfeeding and

7. Assist the mothers in registering their newborn to the

Community Program Implementation: Newborn Health (0-28 days old)

Newborn Screening is a practical

Community Program Implementation: Newborn Health (0-28 days old)

ROLE OF THE BHW

Under the NBS Program, BHWs are

WHAT BHWs NEED TO SAY?

What is Newborn Screening?

Newborn Screening is a practical procedure to

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO SAY?

When should it be done?

It is done ideally after the 1st 24 hours of life and

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO SAY?

Where can it be availed?

It is available in hospitals, lying-in clinics, rural

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO DO?

1. Assist the mother in identifying the nearest

2. If mothers are residing in far flung areas or

Community Program Implementation: Newborn Health (0-28 days old)

ROLE OF THE BHW

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO SAY?

Breastfeeding is still the best source of

It may be continued until 2 years of age

It is always available, safe and

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO SAY?

What do we mean by exclusive breastfeeding?

 only breast milk without water or any other

 For working mothers, they can still continue

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO SAY?

How do we store breast milk?

 When stored in a refrigerator, it is good for

Community Program Implementation: Newborn Health (0-28 days old)

WHAT BHWs NEED TO DO?

1. Teach the mother how to perform the proper

 Take a bath daily and wear clean clothes –

 Breastfeed by demand (or when there are

WHAT BHWs NEED TO DO?

 Allow the baby to suck at the areola of the