COMMUNITY HEALTH

NURSING-II
• By:
• ANWAR ALI MALIK,
• BSN (G) M.ED, MPH
• V.PRINCIPAL
• HIMAS CON
• malikstar2000@gmail.com
• 03333398310
Objectives:
• At the end of session, learner’s will be
able to understand;

1. Explain the care of newborn baby,

2. and underline the infant Feeding, it’s
types.
3. To know about normal birth weight and
Low Birth Weight, it’s causes, prevention
and Treatment.
 CARE OF THE NEWBORN BABY
• High-quality universal newborn health care is
the right of every newborn everywhere.
• Babies have the right to be protected from
injury and infection, to breathe normally, to be
warm and to be fed.
• All newborns should have access to essential
newborn care, which is the critical care for all
babies in the first days after birth.
• Essential newborn care involves immediate
care at the time of birth, and essential care
during the entire newborn period.

• It is needed both in the health facility and at

home.
Maternal and newborn data

• About 295 000 women died during and following

pregnancy and childbirth in 2017 and 5.1 million
babies are stillborn or die in their first month of life.

• To achieve the ambitious goals world leaders have

committed to and achieve universal health coverage,
quality data on births, deaths, causes of death, and
coverage of life-saving interventions are critical.
 Specialized Areas of Work in Newborn Baby Care
1. Essential newborn care
2. Preterm and low-birth weight
3. Newborn infections
4. Perinatal asphyxia
5. Congenital abnomalies
6. Global data on newborn health
7. Research on newborn health
8. Policy and Strategy
9. MCA and COVID-19: pregnancy, childbirth, postnatal
care and breastfeeding
1. Essential Newborn Care
 Immediate care at birth (delayed cord clamping,
thorough drying, assessment of breathing, skin-to-
skin contact, early initiation of breastfeeding).
 Thermal care
 Resuscitation (CPR) when needed
 Support for breast milk feeding
 Nurturing care
 Infection prevention
 Assessment of health problems
 Recognition and response to danger signs
 Timely and safe referral when needed
2. Preterm and Low Birth Weight (LBW)
Infants

• Preterm infants are born at less than 37 weeks

gestational age and low birth weight infants are
born with a birth weight below 2.5kg.

• An estimated 15 million newborns are born

preterm and more than 20 million are born low
birth weight each year.
• Prematurity and low birth weight remains the
leading cause of death in newborns and children
under-five years.
• Preterm and LBW infants have a higher risk of
developmental disabilities including cerebral palsy.
• Cerebral palsy (CP) is a group of disorders that
affect a person’s ability to move and maintain
balance and posture) and retinopathy of
prematurity.
• The consequences of prematurity and low birth
weight may continue into adulthood, increasing the
risk of adult onset chronic conditions such as
obesity and diabetes.
• Retinopathy of prematurity (ROP) is an eye disease
that can happen in babies who are premature (born
early) — or who weigh less than 3 pounds at birth.

• ROP happens when abnormal blood vessels grow in

the retina (the light-sensitive layer of tissue in the
back of your eye).

• This is called retinal detachment — and it can cause

vision loss and blindness.
3. Newborn Infections
• Neonatal infections are primarily bacterial in
origin, and include pneumonia, sepsis, and
meningitis.
• Neonatal infections result in over 550 000
neonatal deaths every year.
• Most of these deaths can be prevented by
preventive measures, early diagnosis, timely
care-seeking, treatment with appropriate
antibiotics, and follow up.
• Early diagnosis requires early recognition of
clinical signs, symptoms and syndromes.

• Possible serious bacterial infection (PSBI) is

the most important clinical syndrome in low
and middle income countries (LMICs).

• An estimated 6.9 million episodes of PSBI

occur in in young infants aged 0-59 days in
LMICs every year.
4. Perinatal Asphyxia
• Birth asphyxia, defined as the failure to establish
breathing at birth, accounts for an estimated 900,000
deaths each year and is one of the primary causes of
early neonatal mortality.
• The most common cause of perinatal asphyxia is
complications during childbirth.
• Guidelines for neonatal resuscitation emphasise the
importance of drying, stimulating and warming
babies with birth asphyxia.
• Babies who still have problems need help with
breathing using a bag-and-mask or equivalent device
which is felt by many to be the critical step in
managing asphyxiated babies.
5. Congenital Conditions
• Congenital conditions can be defined as structural or
functional abnoamalties that occur during intrauterine life
and may be detected before birth, at birth or in some cases
only in later infancy. They vary in severity and may or may not
affect life expectancy.

• Of the 5 million children under-5 years who died in 2020,

approximately 400,000 died from congenital conditions,
representing nearly 8% of total under-5 deaths globally. A
large proportion of children with congenital conditions (over
90%) are born in low- and middle-income countries.

• A small proportion of these conditions are genetic i.e.

chromosomal abnormalities (e.g. Patau’s Syndrome or trisomy
13).
• Environmental factors like maternal infections
(rubella, Zika), exposure to radiation, certain
pollutants, maternal nutritional deficiencies (e.g.,
iodine, folate), illness (maternal diabetes) or certain
drugs (alcohol, phenytoin), also increase the risk.
• The cause of most birth defects is unknown.
• Complex genetic and environmental interactions are
proposed but these have not yet been clearly
clarified.
• Public health prevention measures (like food
fortification) are needed as well as ensuring that
systems are in place to detect, treat and provide the
long-term care that children born with these
conditions may require.
CARE OF NEW BORN BABY
• Care of an infant is also very important.
• The immediate care of the newborn comprises the following.
• 1. RESUSCITATION;
• It becomes necessary if natural breathing fails to establish within
a minute.
• In such cases, resuscitation may require suction, application o
oxygen mask, intubation and assisted respiration.
• All labour wards should be equiped with resuscitstion equipment
inluding mucous extractors, suction apparatus, infant
laryngoscope, endotracial tube, etc.
2. CARE OF THE CORD:
Umlical cord should be cut and tied when
it has stopped pulsating, because in this
way baby drives about 10ml extra blood
from mother.
• The umbilical cord is the connection
between a mother and her baby.
• It is pretty big, averaging about 50 cm (20
inches) in length and 2 cm (about ¾ inch)
in diameter in a full-term baby.
• Blood passes through the umbilical cord
from baby to the placenta and then back
to baby by way of a single vein and two
arteries.
• Baby’s umbilical cord will gradually dry
up, become hard stiff tissue, and fall off
within 1 to 2 weeks.
• But as a new parent, you have the option
of cutting off the umbilical cord.
3. CARE OF THE EYES:
• Lid margin should be cleaned with sterile swabs.
• Instal a drop of freshly prepared Silver Nitrate Solution (1%)
to prevent Gonococcal conjunctivitis*.
• *This is an infection that is transmitted by contact of the eyes
with infected genital secretions from a person with genital
gonorrhea infection.).
• Don’t apply kajal.
• Use natural eye drops if eyes are sticky.
4. CARE OF THE SKIN:
• Clean the skin with a sterile cloth.
• First bath to child is given with soap and warm water
to remove meconuim (amniotic fluid) and blood
clots.
5. Examination of the Abnormalities:
I. Cynaosis (when skin, lips or nails turn blue due to a
lack of oxygen in blood),
II. imperforate anus,
III. any dificulty in breathing,
IV. congenital heart abnormalities
must be examined after birth.
Imperforate Anus or Anal Atresia