Essential Newborn Care

This presentation includes content on Essential Newborn care, Low-birth weight and infant feeding practices.

1. ESSENTIAL NEWBORN CARE Dr. Ramya S

2. Fig.1. Causes of deaths in children under 5 years

3. Essential newborn care

4. Principles of essential newborn care

5. Components of essential newborn care Neonatal resuscitation Provision of warmth Infection prevention Initiation of breastfeeding within an hour of birth & exclusive breastfeeding Screening for congenital anomalies Newborn weighing GOI guidelines MOHFW

6. Eight steps of essential newborn c are

7. Step 1 Deliver the baby onto the mother’s abdomen or a dry warm surface close to the mother Step 2 Dry the baby’s body with a dry warm towel & wrap the baby with another dry warm cloth and cover the head Eight steps of essential new born care

8. Dry the Baby

9. Position the Baby

10. Suction the Airway

11. Step 3 Step 3 Assess breathing and colour If not breathing, gasping or <30 breaths per minute, then resuscitate Resuscitation must start within one minute of birth Golden 1 minute of resuscitation Eight steps of essential new born care

12. Evaluate the Baby

13. Step 4 Cord care Step 5 Care of the eyes Eight steps of essential new born care Clamp and cut cord with a sterile instrument. Do not apply any substance to the stump. Leave stump uncovered and dry Use sterile normal saline soaked swabs.

14. Eight steps of essential new born care Warm the delivery room Immediate drying Skin-to-skin contact at birth Breastfeeding Bathing and weighing postponed Appropriate clothing/bedding Mother and baby together Warm transportation for a baby that needs referral Step 6 Warm chain

15. Eight steps of essential new born care Step 7 Give the baby vitamin K 1 mg i.m . Step 8 Weigh the baby

16. Sign Score 0 1 2 Heart rate Absent Slow (below 100) Over 100 Respiratory effort Absent Slow irregular Good cry Muscle tone Flaccid Some flexion of extremities Active movements Reflex response No response Grimace Cry Colour Blue, pale Body pink, extremities blue Completely pink Total score 0-3 4-6 7-10 Severe depression Mild depression No depression APGAR Score

17. Color Pink Acrocyanosis Cyanosis

18. Neonatal examination Body size Body temperature Skin Cardio-respiratory activities Neuro-behavioural activity Head and face Abdomen Limbs and joints Spine External genitalia

19. Anthropometric measurements Birth-weight Length (height) Head circumference

20. Phenylketonuria Neonatal hypothyroidism Coomb’s test Sickle cell or other hemoglobinopathies Congenital dislocation of hip Neonatal screening

21. Sick newborn care

22. Abnormal breathing patterns Unable to suck or sucking poorly Fever or hypothermia Lethargy or Convulsions Jaundice Pallor/ bleeding/ Cyanosis Repeated vomiting and distended abdomen Red swollen eyelids / pus discharge from the eyes MOHFW- RCH manual New born danger signs

23. Birth weight <2.5 kg Twins Birth order 5 or more Artificial feeding Weight below 70% of expected wt. Failure to gain wt. during 3 successive months Children with PEM, diarrhoea Working mother/ one parent At-risk infants

24. Low Birth Weight Babies

25. Low Birth Weight Preterm <37 completed weeks of gestation Developed countries Small-for-date (SFD) / Intra Uterine Growth Restriction (IUGR) <10th percentile for gestational age Developing countries 25

26. Malnutrition Anemia Hypertension Infections Unregulated fertility Maternal factors Smoking Short maternal stature Close birth spacing Low economic status Heavy physical work

27. Placental Causes Placental insufficiency Placental abnormalities Foetal Causes Foetal abnormalities Intrauterine infection Chromosomal abnormality Multiple gestation Other Causes of LBW

28. LBW initiates a vicious cycle of malnutrition across the life cycle LBW gives our children a disadvantaged start to life

29. Prevention of LBW

30. Thermal Protection of LBW babies Well wrapped baby Radiant warmer 30 Skin-to-skin contact Kangaroo Mother Care

31. Assisted feeding of LBW neonates Gavage feeding Katori Paladai feeding

32. INFANT FEEDING AND WEANING

33. Optimal Infant and Young Child Feeding (IYCF) practices Initiation of breastfeeding within one hour of birth Exclusive breastfeeding for the first six months of life Timely introduction of complementary foods at 6-8 months Age appropriate complementary feeding for children 6-23 months Active feeding for children during and after illness

34. Breastfeeding World Breastfeeding week- 1 st week of August Gold standard feeding option Breastfeed “on cues” Breastfeeding support Baby friendly hospital initiatives (BFHI)

35. Signs of Good attachment

36. Sore nipple Breast engorgement P oor milk supply P oor weight gain If attachment is not good, check for correct positioning Check for baby’s sucking : If not sucking well, then look for ulcers or white patches in the mouth Effects of poor attachment

37. Advantages of breastfeeding

38. Complementary Feeding Appropriately thick homogenous foods made from locally available foods introduced at six completed months to all babies while continuing breastfeeding Complementary foods must be: Timely Adequate Appropriate Safe Properly fed

39. Thank You