(Until 1 hour after birth)

ObjectivesObjectivesTo describe evidence-based routine care of a newborn baby at and soon

after birth

NC- 2Teaching Aids: ENC

FOUR basic needs at birth:

• Thermal protection• Normal breathing• Mother’s milk• Protection from infection

Basic needs of a baby at birthBasic needs of a baby at birth

NC- 3Teaching Aids: ENC

Care of normal baby at birth Care of normal baby at birth

The birth of Meghna

NC- 4Teaching Aids: ENC

Care at birth Care at birth

1. Call out time of birth

2. Receive the baby onto a warm clean towel and place on

mother’s chest

3. Clamp and cut the umbilical cord

4. Dry the baby with a warm, clean towel or piece of cloth

5. Assess baby’s breathing while drying

NC- 5Teaching Aids: ENC

Steps

Dry the baby Dry the baby immediately after immediately after birthbirth

Care at birth… Care at birth…

NC- 6Teaching Aids: ENC

Care at birth… Care at birth…

6. Wipe both eyes (separately) with sterile gauze pieces

7. Put the baby between mother’s breasts for skin-to-

skin contact

8. Place an identity label on the baby

9. Cover mother and baby with warm cloth; put a cap on

the baby’s head

10. Initiate breastfeeding

NC- 7Teaching Aids: ENC

Care at birth… Care at birth…

Immediate Immediate skin-to-skin skin-to-skin contact & contact & breastfeedingbreastfeeding

NC- 8Teaching Aids: ENC

Ensuring warmth at the time of Ensuring warmth at the time of delivery: ‘Warm chain’delivery: ‘Warm chain’

NC- 9Teaching Aids: ENC

‘‘Warm chain’: At deliveryWarm chain’: At delivery

At delivery: 1. Ensure the delivery room is warm (25° C), with no

draughts.

2. Dry the baby immediately; remove wet cloth

3. Wrap the baby with clean dry cloth

4. Keep the baby skin-to-skin with mother

NC- 10Teaching Aids: ENC

Assess baby’s breathing at the time of drying: If the baby is crying vigorously or

breathing adequately, then no intervention is needed

if the baby is not breathing or gasping, then skilled care in the form of positive pressure ventilation etc. (i.e. RESUSCITATION) would be required

Helping the baby breatheHelping the baby breathe

NC- 11Teaching Aids: ENC

1. Keep the baby clothed and wrapped; cover the head

2. Postpone bathing particularly for small babies

3. Keep baby close to the mother4. Use kangaroo care for stable LBW

babies5. Show mother how to avoid

hypothermia and to recognize6. Initiate breastfeeding

NC- 12Teaching Aids: ENC

‘‘Warm chain’: After deliveryWarm chain’: After delivery

Keep the baby in skin-to-skin contact between mother’s breasts immediately after drying

Help the mother in her first few attempts to breastfeed

Make her and the baby comfortable Explain and show her proper positioning

and attachment

Initiating breastfeedingInitiating breastfeeding

NC- 13Teaching Aids: ENC

Ensure skin to skin contact after birth

NC- 14Teaching Aids: ENC

Baby shows feeding cues…

NC- 15Teaching Aids: ENC

..and is ready for breastfeeding

NC- 16Teaching Aids: ENC

Prevention of infections: ‘Clean Prevention of infections: ‘Clean chain’chain’

At delivery: WHO five cleans Clean

1. Hands of attendants (washed with soap)

2. Surface for delivery

3. Cutting instrument for cord(i.e. razor, blade)

4. String to tie cord

5. Cloth to wrap baby and mother

NC- 17Teaching Aids: ENC

‘‘Five cleans’ to prevent infectionFive cleans’ to prevent infection

Prevention of infections: ‘Clean Prevention of infections: ‘Clean chain’chain’

After delivery1. Hand washing before handling the baby

2. Exclusive breastfeeding

3. Keep the cord clean and dry; do not apply anything

4. Use a clean cloth as a diaper/napkin

5. Hand wash after changing diaper/napkin

NC- 19Teaching Aids: ENC

Apply a sterile tie tightly around cord at 2 cm and 5 cm from the abdomen

Cut between the ties with a sterile instrument

Observe for oozing blood every 15 minutes; if blood oozes, place a second tie

Do not apply any substance to the stumpDO NOT bind or bandage stumpLeave stump uncovered

Cord careCord care

NC- 20Teaching Aids: ENC

Clean eyes immediately after birth with swab soaked in sterile water

Use separate swabs for each eye; clean from medial to lateral side

Give prophylactic eye drops within 1 hour of birth (as per hospital policy)

Do not put anything else in baby’s eyes

Eye careEye care

NC- 21Teaching Aids: ENC

Do not leave the mother and baby alone in the first hour after birth

Monitor three parameters every 15 minutes: Breathing: Grunting, chest in-drawing, fast

breathing (>60/min)

Warmth: Check if the baby’s feet are cold (by using your hands)

Color: Evaluate the color of trunk and extremities

Monitoring the babyMonitoring the baby

NC- 22Teaching Aids: ENC

Special situationsSpecial situations

Mother has HIV/AIDS1. Follow universal precautions as with any other delivery2. Baby can have immediate skin-to-skin contact as any

other mother and baby3. Breastfeeding can begin when the baby is ready*4. If mother chooses replacement feeding, prepare

formula for the first few feeds5. All other care (including cord care and eye care)

remain the same

NC- 23Teaching Aids: ENC

Key messages Key messages

Four basic needs at birth: warmth, normal breathing, breastfeeding, prevention of infections

Ensure warmth by skin to skin contact with mother’s chest/abdomen

Help the mother to initiate early breastfeeding Follow ‘WHO five cleans’ to prevent infections

NC-Teaching Aids: ENC 24