Definition:

It refers to the care that is given to the newborn infant from the time of delivery all the way through the first month of life.

Objectives:

• To evaluate and assess the newborn
• To establish respiration
• To prevent infection
• To prevent hypothermia
• To establish breastfeeding
• To identify at risk neonates
• To promote relationship between infant and parents
• To provide a safe environment for the newborn and the mother.

Care of the normal newborn:

It can be described as following-

1. Preparation for delivery
2. Immediate care after birth
3. Late care after birth
4. Necessary postnatal care.

1. Preparation for delivery:

i) Preparation for home delivery-

I) Selection of a clean part of the home for delivery which must be well lighted and ventilated
II) Ensuring enough linen that has been washed and sun-dried for use at the time of delivery.
III) Ensuring that clean and boiled water is readily available before or during delivery.
IV) Ensuring that a new boiled blade is on hand for cutting the cord at birth
V) Ensuring that a clean sheet is spread on the floor of the selected room
VI) Ensuring that a trained health personnel is contacted before delivery so that the birth is attended by a trained personnel.
VII) Providing mother with information as to when she should seek medical help during her pregnancy.

ii) Preparation for institutional delivery

I) As a part of preparation for delivery in a institute – the delivery room should have a well-lighted, well-ventilated and warm environment to receive the newly born baby.
II) The room should have a room thermometer, warming device, wall clock with seconds hand, cord clamps, cord tying material, cord cutting instruments, cotton swabs, gauze pieces, clean sterile linen (e.g. two towels, bed sheets, baby caps, blankets etc), oxygen supply, resuscitation equipments, tape, suction device, scissors, weighing scales, identification tags, clinical thermometers, measuring tapes etc
III) There should a tray of medication that may contain tetracycline or erythromycin ointment, spirit for cord dressing, distilled water or normal saline for cleaning eyes, silver nitrate, vitamin K injections and medication needed during resuscitation i.e. epinephrine, 7.5% sodium bicarbonate, injection syringes 2cc, 5cc and insulin syringes for small dosages.

2. Immediate care after birth

I) The umbilical cord should be clamped as early as the infant is fully delivered.
II) Examining the baby for respiratory distress. If there is no sign of such then the baby is put over mother’s chest and wiped dry.
III) Both of the baby and mother should be covered by dry warm linen
IV) The airway of the baby can be cleared by wiping his/her nose and mouth (if needed).

3. Late care after birth

Late neonatal care after birth includes-

I) The newborn baby should be resuscitated under a radiant warmer or any other heat source and should be adequately covered subsequently.
II) The baby’s eyes should be cleaned with sterile normal saline using one swab for each eye.
III) Umbilical cord should be tied using two sterile ligatures or a disposable clamp.
IV) Inj. Vitamin K -1 mg is given IM to the babies weighing more than 1 Kg, and 0.5 mg to the babies weighing less than 1 Kg at birth
V) Rapid clinical screening is necessary to identify life threatening congenital anomalies and birth injuries.

4. Necessary postnatal care:

I) The baby should be kept in thermo-neutral environment
II) The umbilical stump should be checked either it is clean, dry or not
III) The skin should be checked for any pyoderma
IV) The baby should be checked for good sucking, well crying, breathing difficulty
V) Exclusive breastfeeding for the baby till six months, frequently, day and night
VI) Giving advice to the mother about the immunization schedule.