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Teaching Aids: NNF NC- 1 Care of Normal Care of Normal Newborn Newborn

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Page 1: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

Teaching Aids: NNF

NC- 1

Care of Normal NewbornCare of Normal Newborn

Page 2: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Principles of care at birthPrinciples of care at birth

Establishment of respiration Prevention of hypothermia Establishment of breastfeeding Prevention of infection Identification of at risk neonates

Page 3: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Care of normal newbornCare of normal newborn

Preparation before deliveryPreparation before delivery

Immediate care at and after birthImmediate care at and after birth

Essential postnatal careEssential postnatal care

Page 4: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Contents of clean delivery Contents of clean delivery kit (at home)kit (at home)

Soap for washing hands; ensure clean and boiled Soap for washing hands; ensure clean and boiled waterwater 2 to 3 sterilized cord ties2 to 3 sterilized cord ties A new clean blade / boiled at home A new clean blade / boiled at home

instrument to cut cordinstrument to cut cord Clean sun-dried cloth / sheet, small gauze Clean sun-dried cloth / sheet, small gauze

padspads A clean plastic envelope / cloth to keep A clean plastic envelope / cloth to keep

the kit in the kit in

Page 5: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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

Page 6: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Physical facilities for Physical facilities for resuscitation (at hospital)resuscitation (at hospital)

Resuscitation corner with warmerResuscitation corner with warmer

Contents of resuscitation kitContents of resuscitation kit

Suction catheter 10 Fr, De Lee trap, Suction catheter 10 Fr, De Lee trap,

suction machine suction machine

Resuscitation bag and masksResuscitation bag and masks

Page 7: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Physical facilities for Physical facilities for resuscitation (at hospital)resuscitation (at hospital)

Infant laryngoscope with bladesInfant laryngoscope with blades

Endotracheal tubes (2.5, 3.0, 4.0 mm)Endotracheal tubes (2.5, 3.0, 4.0 mm)

Medications – epinephrine, naloxone, Medications – epinephrine, naloxone,

normal saline, sodium bicarbonatenormal saline, sodium bicarbonate

Plenty of disposablesPlenty of disposables

Page 8: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Newer Newer guidelines guidelines

for for neonatalneonatal

resuscitationresuscitation

Page 9: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Concept ofRoutine Care,

Supportive care and

Ongoing Care

Page 10: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Page 11: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Immediate care after birthImmediate care after birth

Prevent hypothermiaPrevent hypothermia

Eye, skin, cord careEye, skin, cord care

Give injection vitamin K Give injection vitamin K

Breastfeed within ½ hour of birthBreastfeed within ½ hour of birth

Search for malformationsSearch for malformations

Page 12: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Increased risk of Increased risk of malformationmalformation

Single umbilical arterySingle umbilical artery

Simian creaseSimian crease

Dysmorphic featuresDysmorphic features

Asymmetric cry due to absence of Asymmetric cry due to absence of Depressor Angularis Oris Muscle Depressor Angularis Oris Muscle

Excessive drooling of salivaExcessive drooling of saliva

Page 13: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Quick screening for Quick screening for malformationsmalformations

Screen from top to bottom and in midlineScreen from top to bottom and in midline Orifice examination Orifice examination

Anal openingAnal opening Oesophagus patency*Oesophagus patency* Choanal atresiaChoanal atresia

** SFD baby, polyhydramnios, excessive SFD baby, polyhydramnios, excessive drooling, drooling,

single umbilical arterysingle umbilical artery

Page 14: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Essential postnatal careEssential postnatal care

Nurse in thermal comfortNurse in thermal comfort

(warm to touch, pink soles)(warm to touch, pink soles)

Check umbilicus, skin, eyesCheck umbilicus, skin, eyes

Good sucking at breast Good sucking at breast

Screen for danger signalsScreen for danger signals

Advice on immunizationAdvice on immunization

Page 15: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Care of umbilical stumpCare of umbilical stump

Inspect 2 to 4 hours after ligation for Inspect 2 to 4 hours after ligation for bleedingbleeding

Do not apply anything, keep cord Do not apply anything, keep cord clean and dryclean and dry

Inspect for discharge or infection till Inspect for discharge or infection till healing occurshealing occurs

Page 16: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Care of the skinCare of the skin

Dry using soft prewarmed clean clothDry using soft prewarmed clean cloth Bathing soon after birth is not Bathing soon after birth is not

recommended recommended Do not make vigorous attempts to Do not make vigorous attempts to

remove vernix caseosaremove vernix caseosa Inspect for superficial infections Inspect for superficial infections

Page 17: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Care of the eyesCare of the eyes

Clean at birth and subsequently dailyClean at birth and subsequently daily

No kajal applicationNo kajal application For sticky eyes use normal saline or For sticky eyes use normal saline or

appropriate medication appropriate medication Nasolacrimal duct blockage, Nasolacrimal duct blockage, Massaging helpsMassaging helps

Page 18: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Summary: care of normal Summary: care of normal neonates at homeneonates at home

Protect from cold/ heatProtect from cold/ heat

Keep umbilical stump clean and dryKeep umbilical stump clean and dry

Don’t apply anything on cordDon’t apply anything on cord

No application in eyesNo application in eyes

Exclusive breastfeeding - day and night Exclusive breastfeeding - day and night for six months for six months

Page 19: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Weight change pattern in Weight change pattern in term babyterm baby

May loss up to 5-7% during first 3-5 May loss up to 5-7% during first 3-5 daysdays

Regains birth weight by 7-10 daysRegains birth weight by 7-10 days

Gains 30 g/day during 1Gains 30 g/day during 1stst month month

Page 20: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Danger signsDanger signs

LethargyLethargy

HypothermiaHypothermia

Respiratory distressRespiratory distress

CyanosisCyanosis

ConvulsionsConvulsions

Abd distensionAbd distension

BleedingBleeding

Yellow palms/ soleYellow palms/ sole

Excessive wt lossExcessive wt loss

VomitingVomiting

DiarrhoeaDiarrhoea

Page 21: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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Follow up visit: ObjectivesFollow up visit: Objectives

Assess growth & developmentAssess growth & developmentEarly diagnosis and management of Early diagnosis and management of illnessillnessHealth educationHealth education

Exclusive breastfeeding for 6 monthsExclusive breastfeeding for 6 monthsComplementary feeds after 6 monthsComplementary feeds after 6 monthsSpacing of familySpacing of family

Page 22: Teaching Aids: NNF NC-1 Care of Normal Newborn. Teaching Aids: NNF NC-2 Principles of care at birth Establishment of respiration Prevention of hypothermia

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ImmunizationImmunizationAgeAge VaccineVaccine Optional Optional 0-7 days0-7 days BCG, OPV, Hep B BCG, OPV, Hep B 6 Weeks6 Weeks OPV,DPT, Hep B HibOPV,DPT, Hep B Hib10 Weeks 10 Weeks OPV,DPT, Hep B* HibOPV,DPT, Hep B* Hib14 Weeks 14 Weeks OPV, DPT, Hep B HibOPV, DPT, Hep B Hib9 months 9 months MeaslesMeasles15 months 15 months MMR MMR 18 months 18 months OPV, DPT HibOPV, DPT HibSchool entry(4-5 yrs) School entry(4-5 yrs) OPV, DTOPV, DT10 years 10 years Tetanus toxoid Tetanus toxoid (every 5 years)(every 5 years)

* May omit this dose of hepatitis B vaccine if birth dose is given