Immediate Newborn Care

Immediate Care of the Newborn

• Care given to the newborn immediately after delivery to keep them healthy
• Purpose: to keep the newborn in good health, assess their condition, detect any abnormalities, prevent asphyxia, and provide cardiac care

Objectives of Immediate Care

• Establish and maintain respiratory function
• Provide warmth and prevent hypothermia
• Ensure safety from injury and infection
• Identify actual and potential problems that might require immediate action

Equipment Needed

• Suction apparatus or thin-rubber catheter
• Radiant warmer (servo)
• Cordclamp
• Eyedrop
• Alcohol
• Stethoscope
• Identification sheet
• Scissor
• Alcohol swap
• Normal saline
• Babyclothes
• Paper bag
• 2 sterile towels
• Vitamin K

ABC of Resuscitation

• A: Airway
• B: Breathing
• C: Circulation
• Position the infant on their back or side with the head slightly extended in a neutral position
• Clear the airway and gently suck mucus from the oro-pharynx with a suction catheter or mucus extractor
• Dry the infant thoroughly with a preheated towel to prevent heat loss
• Initiation of breathing may be stimulated by drying and suctioning
• If the infant does not breathe immediately, slapping the soles of the feet or rubbing the infant's back with a warm blanket can be an effective measure to stimulate rhythmic breathing

Apgar Score

• Definition: a time schedule measuring the general baby condition to keep the baby in good health
• Measured at 1 minute to assess the general condition of the newborn, and at 5 minutes to assess the prognosis of the baby
• Score ranges from 0 to 10
• Normal score: 7-10
• Mild asphyxia: 4-6
• Severe asphyxia: 0-3

Apgar Score Components

• Heart rate
  • Absent: 0
  • Slow below 100: 1
  • Fast above 100: 2
• Respiration
  • Absent: 0
  • Weak crying: 1
  • Good crying: 2
• Muscle tone
  • Limp of flaccid: 0
  • Some flexion: 1
  • Active flexion: 2
• Reflex irritability
  • No response: 0
  • Grimace: 1
  • Good response: 2
• Color
  • Blue and pale: 0
  • Body pink and extremities blue: 1
  • Completely pink: 2

Means of Identification

• Mother should be notified of the sex of her baby immediately after delivery
• Wristband containing mother's name, hospital number, infant name, date and time of birth, infant sex, race, and weight and length
• Footprint

Male Circumcision

• Should not be performed immediately after delivery, but rather a day or two later, after the infant has been demonstrated to be healthy

The Baby's Bath

• At birth, baby's skin is covered with greasy vernix casosa, which provides a natural barrier against infection
• Excess vernix in the neck folds and groin may cause skin irritation
• Bathing the baby immediately after delivery is not recommended, only wiping the baby's skin with a sterile moistened swab before clothing
• One complete bath given by the mother under instruction on the second or third day before discharge is all that is required

Physical Examination

• Must be thorough to assess the newborn, detect any congenital anomalies, birth trauma, and specific neonatal problems
• General appearance and measurements:
  • Weight: ranges from 2.5-4.0 kg, with an average of 3 kg
  • Length: average length of male and female is 47.5-53.5 cm, with growth of approximately 1 inch per month for the first six months