IDOL KO SI NANAY

Learning Sessions for the First 1000 Days of Life

MODULE 5 (NEWBORN
0-28 DAYS)
SESSION 11

Care for
newborns
 ESSENTIAL NEWBORN CARE

 Essential Newborn Care routine consists of

simple, evidence-based interventions, such
as ensuring warmth, breastfeeding, love
and safety, and infection control which are
equally important for the survival of all
newborns and young infants.
 ESSENTIAL NEWBORN CARE
 These steps are timed and sequenced methodically and include thefollowing:
 Drying the baby to prevent low body temperature
 Skin-to-skin contact to keep the baby warm and initiate breastfeeding
with in one hour after birth.
 Delayed cord clamping to increase blood volume and birth iron stores
 Vitamin k injection to prevent bleeding in the newborn
 Antibiotic eye drops or ointment (CREDESPROPHYLAXIS) to prevent
gonococcal infection of the eyes
 Complete physical assessment to identify any medical conditions and
abnormalities, and weighing to assess birth weight
 Birth dose of BCG and Hepatitis B vaccination to prevent TB and
Hepatitis B infection.
 Cord care to prevent entry of infection through the umbilicus.
 Rooming-in of mother and baby immediately after the care routine
 ESSENTIAL NEWBORN CARE
The following practices should never be done anymore to the
newborn:
 Manipulation such as routine suctioning of secretions
if the baby is crying and breathing normally. Doing
so may cause trauma or introduce infection.
 Putting the newborn on a cold or wet surface.
 Wiping or removal of vernix caseosa if present
 Foot printing
 Bathing earlier than 6 hours of life
 Unnecessary separation of the newborn primarily for
weighing, anthropometric measurements,
intramuscular administration of vitamin K, Hepatitis
B vaccine and BCG vaccine
 Transferring of the newborn to the nursery or
neonatal intensive care unit without any indication
 NEWBORN SCREENING
 NBS is a simple procedure to find out if the baby has
congenital metabolic disorder that may lead to mental
retardation or if left untreated, death

 It is ideally done 24 hours from birth

 Most babies with metabolic disorders look ”normal” at birth,

thus it is important for babies to undergo NBS to detect
metabolic disorders before clinical signs and symptoms are
present

 Through NBS treatment can be provided early to prevent

consequences of untreated conditions
 Metabolic problems.
 Metabolism is the process that converts food into energy
the body can use to move, think, and grow.
 Enzymes are special proteins that help with metabolism by
speeding up the chemical reactions in cells.
 Most metabolic problems happen when certain enzymes
are missing or not working as they should. Metabolic
disorders in newborn screening include:
• phenylketonuria (PKU)
• methylmalonic acidemia
• maple syrup urine disease (MSUD)
• tyrosinemia
• citrullinema
• medium chain acyl CoA dehydrogenase (MCAD)
deficiency
NEWBORN SCREENING
Hormone problems.

 Hormones are chemical messengers

made by glands.
 Hormone problems happen when glands
make too much or not enough hormones.
 Hormone problems in newborn screening
include:

• congenital hypothyroidism
• congenital adrenal hyperplasia
NEWBORN SCREENING
Hemoglobin problems

 Hemoglobin is a protein in red

blood cells that carries oxygen
throughout the body.
 Some of the hemoglobin problems
included in newborn screening
are:

• sickle cell disease

• hemoglobin SC disease
• beta thalassemia
 NEWBORN SCREENING
Other problems
 Other rare but serious medical problems
included in newborn screening are:

• galactosemia
• biotidinase deficiency
• cystic fibrosis
• severe combined immunodeficiency (SCI
D)
• Pompe disease (glycogen storage
disease type II)
• mucopolysaccharidosis type 1
• X-linked adrenoleukodystropy
• spinal muscle atrophy (SMA)
HEARING SCREENING

 Hearing loss is known to be one of the most

common disabilities among newborn

 All newborns in the Philippine, with the

consent of the parent/s or guardian, should be
subjected to universal hearing screening

 This is in accordance with the international

clinical practice guidelines and provision in
Republic Act 9709 (UNIVERSAL HEARING
SCREENING ACT)
 HEARING SCREENING
 Republic Act 9709 or the Universal Newborn
Hearing Screening and Intervention Act of 2008 it
established a program whose primary trust is for the
prevention, early diagnosis, and early intervention of
hearing loss through requiring all newborn to have
access to hearing screening

 The right time to screen is 24 hours afterbirth, before

the infant is discharged if born in the hospital

 If infant is born out of the hospital, the newborn

should be screened not more than 3 months of age
 HEARING SCREENING
 For purpose of philhealth reimbursement,
babies must be screened within two months
(60days) of age.

 Babies need to undergo hearing screening due

to the following:
 An infant born with hearing impairment
does not show obvious symptoms
 Hearing is important so that a child will
be able to talk
 A child who grows up deaf will have
difficulty in speaking and learning
SIGNS THAT A BABY IS SICK

Feels hot or
unusually cold
SIGNS THAT A BABY IS SICK

Stop feeding well

SIGNS THAT A BABY IS SICK

Has difficult or fast

breathing
SIGNS THAT A BABY IS SICK

Have convulsions or
fits
 When the baby is observe to have the following signs, bring the baby
immediately to a health facility.

 Feeding the sick baby under 6 months of age

 When the mother is sick, she can continue to breastfeed her baby. She may
need extra food and support during this time.
 SESSION 12

Feeding newborns
 BREASTFEEDING

 Breastfeeding has health benefits for both

babies and mothers.

 Breast milk provides a baby with ideal nutrition

and supports growth and development.

 Breastfeeding can also help protect baby and

mom against certain illnesses and diseases.
 BREASTFEEDING
 LEGAL RIGHTS OF BREASTFEEDING

 Executive Order 51(EO51)- MilkCode

 Republic Act 7600 (RA7600)- Rooming-in and Breastfeeding Act

 RepublicAct10028(RA10028)-Expanded Breastfeeding Promotion Act

 BREASTFEEDING

 Breastfeed on demand or as often as the baby

wants

 The baby should be fed for at least eight (8)

times in 24 hour, day and night.

 Exclusively breast feed the young infant up to 6

months of age. A diet of only breastmilk is best
for infants.
 BREASTFEEDING
 BENEFITS OF BREASTFEEDING

 Breast milk provides ideal nutrition for babies

 Breast milk contains important antibodies
 Breastfeeding may reduce disease risk
 Breast milk promotes baby’s healthy weight
 Breastfeeding may make children smarter
 Breastfeeding may help you lose weight
 Breastfeeding helps the uterus contract
 Mothers who breastfeed have a lower risk for depression
 Breastfeeding reduces your disease risk
 Breastfeeding may prevent menstruation
 It saves time and money
 BREASTFEEDING
 THE RISK OF NOT BREASTFEEDING

• For infants, not being breastfed is associated with an increased

incidence of infectious morbidity, including otitis media,
gastroenteritis, and pneumonia, as well as elevated risks of
childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden
infant death syndrome (SIDS).

• Among premature infants, not receiving breast milk is associated

with an increased risk of necrotizing enterocolitis (NEC).

• For mothers, failure to breastfeed is associated with an increased

incidence of premenopausal breast cancer, ovarian cancer, retained
gestational weight gain, type 2 diabetes, and the metabolic
syndrome.
BREASTFEEDING
BREASTFEEDING

 Four points to check if the baby’s

attachment is correct:

 The baby’s mouth is wide open

 The baby’s chin touching the breast

 The baby’s lower lip turned outward

 More areola is seen above than

below the breast
 BREASTFEEDING
 Signs that the baby has effective suckling:

 The baby takes slow deep suckles,

sometimes pausing.
 The mother may be able to see or heart
he baby swallowing after one or two
suckles.
 Suckling is comfortable and pain free for
the mother.
 The baby releases the breast and looks
contented and relaxed after feeding.
 The breast is softer after the feed.
 BREASTFEEDING

 When breastfeeding, both the mother

and the baby should be in a comfortable
and relaxed position.

 This is to ensure successful

breastfeeding

 The mother should have her back, feet

and breast supported during
breastfeeding
 BREASTFEEDING POSITIONS

CRADLE POSITION
 BREASTFEEDING POSITIONS

SIDE LYING POSITION

 BREASTFEEDING POSITIONS

UNDERARM POSITION
 BREASTFEEDING POSITIONS

CROSS-ARM POSITION
BREASTFEEDING PROBLEMS AND FEEDING DIFFICULTIES
 If you have any problems
with breastfeeding, it's
important to ask for help
from your midwife, health
visitor or a breastfeeding
specialist as soon as
possible.
 That way issues like sore
nipples or breast
engorgement can be sorted
out early.
 BREASTFEEDING CHARACTERISTICS
PROBLEM
 One of the most common reasons
for stopping breastfeeding is when
the mother loses confidence that
Mother’s perception she can breastfeed.
or notion on “not  Events that cause a mother to
having milk think that her breast milk is
insufficient:
 The baby crying a lot, and
seeming not be satisfied with
feeds;
 The baby wanting to feed very
often or for a long time at each
feed;
 The breasts feeling soft; not being
able to express her milk
MANAGEMENT
 Counsel mothers and her support
team and assure them of the
following;
 Newborns cry for different reasons
(wet diapers, feeling of too cold or
too hot, wanting to be hold, noise
around them)
 The more frequent the mother
breast feds, the more breast milk is
produced.
 Feeding time of babies from one
baby to another.
 BREASTFEEDING CHARACTERISTICS
PROBLEM
 The most common cause of sore
nipples and a nipple fissure is poor
attachment to the breast.
Nipple fissure/Sore  If a baby is poorly attached,
nipple he/she pulls the nipple in and out
as he/she sucks and rubs the skin
of the breast against his mouth.
 This is very painful for the mother.
 If the baby continue to suckle this  Avoid use of medicated lotions and
way it damages the nipple skin and
causes a fissure
MANAGEMENT
 Check if the baby has good
attachments to breast.
 Do not wash breast more than once
a day and do not use soap or rub
the breasts hard with a towel.
Washing removes natural oils from
the skin and makes soreness more
likely.
ointments because these can
irritate the skin.
 Rub a little expressed breast milk
over the nipple and areola with a
finger to promote healing. Have it
air-dried.
BREASTFEEDING CHARACTERISTICS MANAGEMENT
PROBLEM
 The breast become engorged if;  Let the baby feed as soon as
 There has been a delay in possible after delivery, make
Engorged breast starting breastfeeding after sure that the baby is well
birth. positioned and attached to the
 There is poor attachment to breast.
the breast so breast milk is not  Do not rest the breast. It is
removed effectively. essential to express milk
 There is infrequent removal of through hand expressions or use
milk due to not breastfeeding of breast pump if the mother is
on demand, or restricted not able to breastfeed.
length of breastfeeding.  If milk is not expressed
regularly, mastitis may develop.
 After a feed, put a cold
compress on the breasts.
BREASTFEEDING CHARACTERISTICS MANAGEMENT
PROBLEM
 The nipple is retracted or  Use an inverted syringe without
pulled inside the breast. needle attached to suck nipple
Flat or Inverted out before breastfeeding.
nipples
 Breastfeed frequently.
BREASTFEEDING CHARACTERISTICS MANAGEMENT
PROBLEM
 Mastitis is an infection of the  Consult a doctor for possible
breast. medication.
Mastitis  A women with mastitis has  Breastfeed frequently. This
 Severe pain helps the blocked area to clear
 Fever up
 Feels ill  Gently massage the breast while
 Breast is swollen, hard and red the baby is suckling.
 Apply warm compress to the
breast in between feeds.
 SESSION 13
Expressing breast
milk and cup
feeding
When to express breast milk
 The oxytocin reflex or let-down refelex is
what makes the breast milk flow.
 These are the ways to stimulate oxytocin
or let down reflex;
 Build her confidence
 Reduce any sources of pain or anxiety.
 Hold the baby with skin-to-skin contact
 Warm her breast or stimulates her nipples
 Massage or stroke her breast lightly
 Ask a helper to rub her back
 Steps in expressing breast milk
STEPS
1. Hand Washing Thoroughly

2. Find a comfortable Position

3. Put the thumb and the pointing

fingers above and below the areola in
“C” position
 Steps in expressing breast milk
STEPS
4. Press inward towards the chest
wall

5. Express one breast for at least 3-5

minutes until the flow slows: then
express the other side and then
repeat both sides
Using a Pump in Expressing Milk
 Cup Feeding
METHOD OF GIVING REASON FOR
EXPRESSED MILK CHOOSING THE
FEEDING METHOD
 Minimal
 SPOON FEEDING
equipment
 CUP FEEDING needed
 Recommended
 BOTTLE FEEDING
by
 FINGER FEEDING
doctor/nurse/
midwife
 SYRINGE FEEDING  Recommended
by family
members
 Due to baby’s
condition
Advantages of Cup-Feeding
 Cups are easy to clean
 Cups are less likely to be carried
around
 Cupfeeding is associated with less risk
of diarrhea
 Using of cup does not interfere with
baby’s suckling at the breast
 Use of cup enables a baby to control
his own intake
 Steps in cupfeeding
1. Prepare the cup and wash it
2. Wash hands thoroughly
3. Hold the baby sitting upright or semi-
upright on the lap
4. Place an estimated amount of milk
5. Hold the small cup of milk to the
baby’s lips
6. The baby becomes alert and open
mouth and eyes
THANK
YOU!