Among infant deaths more than half percent new born died in first 28 days. Most of these deaths occur during first week of life. The major causes of these deaths are due to birth asphyxia, hypothermia and infection. Care of the mother during antenatal period and delivery, provision of essential care to the newborn at birth and during the neonatal period will have a significant impact on neonatal and infant mortality rates.
Where the delivery takes place that room should be clean, well ventilated and adequately lighted. During delivery period clean hands, clean surface, clean scissors and blade, clean cord tie and clean cord stump. Newborn should be place under heating sources, radiant may warmer and newborn should be received at birth in a dry, warm and clean cloth. The wet cloth of newborn should be discarded to prevent hypothermia after drying the newborn. The head of the baby should be wiped first, but not the vernix caseosa and also baby should be wrapped in a clean and dry cloth.
The umbilical cord of the baby must be cut with a sterile scissors about 2.5 cm from the abdominal skin surface. Baby’s cord should be tied with a sterile cord tie. Take care for stump for bleeding. Use another cord tie if bleeding. But do not use antiseptic or dressing and anything to the cord. Clean the eyes with clean cotton swabs using one for each eye. Clean from medial to the lateral side of the eye. Do not bathe the newborn; bathing may be delayed for one week but wipe the baby with soft cloth. Keep the labour room warm during this procedure or it can be lead to hypothermia. Weight the baby by using infant weighing scale. Wrap the baby in a single layer of linen during weighing. If the baby weight is less than 2500 gms then the baby is low birth weight. Baby should be kept with the mother for skin to skin contact and put to the breast immediately, if the baby’s weight is more than 2000 gms and less than 2500 gms. If the baby is very small that less than 2000 gms weight, baby must be examined by medical officer. The baby with birth weight above 1800 gms and less than 2000 gms who are sucking well and do not show any signs of illness can be managed at home atmosphere.
Breast feeding begins early as soon as possible after birth if the newborn do not show any signs of illness. It should be initiated within an half an hour after birth. This will provide nutrition, warmth and emotional bonding to the baby. This will also ensure early involution of the uterus and decreased risk of post partum bleeding of mother. Feeding is given whenever the baby demands. Encourage the mother to continue feeding as long as the baby needs. Advise her to feed the baby alternately on both breasts. At births, amniotic fluid, which covers the body of the newborn, evaporates causes heat loss. This can be prevented by dying, wrapping and putting the baby under heated environment or by close contact covered with a cap and the feet with shocks. The temperature should be within 36.5 to 37.5 c.
Be careful for infection and injury. Use clean cloth linen and equipment, also practice to minimize risks of infection. Baby should not be taken to the crowded areas, the zero dose of OVP and BCG should be given to the baby , mother must be informed about the immunization schedule and she need to bring her baby regularly for vaccination. If a baby does not cry or breathe till the time taken for drying and wrapping within 20-30 seconds after delivery or the baby is blue or limp then the resuscitation must be initiated immediately. But attention about this, most newborns cries spontaneously after birth. Do not slap the baby or hang it upside.
Attention:
All newborn less than 1800 gm need special care.
Take care for lethargy, fast breathing or chest indrawn, apnoea, abdominal distension, cyanosis, pathological jaundice, diarrhea, convulsions etc.
Danger Sign:
Not able to feed, increased drowsiness, difficult breathing or fast breathing, cold or hot touch, yellow staining of palm and soles, convulsions.