care at birth enc

8/3/2019 Care at Birth ENC

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ObjectivesTo describe evidence-based routine care of a

newborn baby at and soon after birth

NC- 2Teaching Aids: ENC


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FOURbasic needs at birth:

Thermal protection Normal breathing

Mothers milk

Protection from infection

Basic needs of a baby at birth



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Care of normal baby at birth

The birth ofMeghna



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Care at birth

1. Call out time of birth

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

on mothers chest

3. Clamp and cut the umbilical cord

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

5. Assess babys breathing while drying


Steps


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Dry the babyimmediately afterbirth

Care at birth



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Care at birth

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

7. Put the baby between mothers 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 babys head

10. Initiate breastfeeding



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Care at birth

Immediateskin-to-skincontact &

breastfeeding



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Ensuring warmth at the time of

delivery: Warm chain



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Warm 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



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Assess babys breathing at the time of drying:

If the baby is cryingvigorously 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 berequired

Helping the baby breathe



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1. Keep the baby clothed and

wrapped; cover the head

2. Postpone bathing particularly for

small babies

3. Keep baby close to the mother

4. Use kangaroo care for stable LBW

babies

5. Show mother how to avoidhypothermia and to recognize

6. Initiate breastfeeding


Warm chain: After delivery


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Keep the baby in skin-to-skin contact between

mothers 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 breastfeeding



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Ensure skin to skin contact after birth



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Baby shows feeding cues



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..and is ready for breastfeeding



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Prevention of infections: Clean

chain

At delivery: WHO five cleans

Clean1. 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



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Prevention of infections: Clean

chain

After delivery

1. Hand washing before handling the baby2. 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



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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 stump DO NOT bind or bandage stump

Leave stump uncovered

Cord care



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Clean eyes immediately after birth with swab soaked in

sterile water

Use separate swabs for each eye; clean from medial tolateral side

Give prophylactic eye drops within 1 hour of birth (as

per hospital policy) Do not put anything else in babys eyes

Eye care



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Do not leave the mother and baby alone in the first

hour after birth

Monitor threeparameters every 15 minutes: Breathing:Grunting, chest in-drawing, fast breathing

(>60/min)

Warmth:Check if the babys feet are cold (by usingyour hands)

Color:Evaluate the color of trunk and extremities

Monitoring the baby



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Special situations

Mother has HIV/AIDS

1. Follow universal precautions as with any other delivery

2. Baby can have immediate skin-to-skin contact as any

other mother and baby

3. Breastfeeding can begin when the baby is ready*

4. If mother chooses replacement feeding, prepare

formula for the first few feeds

5. All other care (including cord care and eye care)

remain the same



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Key messages

Four basic needs at birth: warmth, normal

breathing, breastfeeding, prevention of infections

Ensure warmth by skin to skin contact with motherschest/abdomen

Help the mother to initiate early breastfeeding

Follow WHO five cleans to prevent infections

NC-Teaching Aids: ENC 24

care at birth enc

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