Eight Steps of Immediate Newborn Care

Subject: Midwifery II (Theory)

Overview

The first eight steps of urgent newborn care are to promptly dry the infant, including the head, and to rub up and down the baby's back with a clean, warm cloth. Examine the baby's breathing and color; a baby's pink color indicates proper breathing and circulation. A bluish color Only the color of the hands and feet may be present for 1-2 days after birth and usually does not indicate a lack of oxygen, then decide if the baby requires resuscitation, tie and cut the cord, tie or clamp the cord securely in two places, place the baby in skin to skin contact with the women, then have the women begin breastfeeding if everything is normal, and finally provide eye care.
  1. Dry and stimulate the baby:
    Immediately dry the infant, including the head, and rub up and down the baby's back with a clean, warm towel. Avoid removing the vernix because it protects the skin and may help avoid infection.
     
  2. Assess the baby's breathing and color
    Check to see if the infant is: i. breathing, ii. having difficulty breathing, or iii. not breathing as you dry the baby. Take a look at the baby's skin tone. Pink should be used for the face and chest, not gray or blue. You can check the color of the tongue, lip, and mucous membrane in dark-skinned neonates; they should be pink, not gray or blue. The pink tint of a baby indicates proper breathing and circulation. Bluish coloration of only the hands and feet may occur for 1-2 days after birth and does not usually indicate a lack of oxygen.
     
  3. Decide if the baby needs resuscitation
    If the infant is not breathing, is breathing at less than 30 breaths per minute, or is gasping, resuscitation is required. In that scenario, swiftly clamp or tie the cord and cut it, leaving a stump at least 10 cm long for the time being. Place the baby on a flat, warm surface and begin resuscitation as soon as possible. Call for assistance because the woman requires the assistance of a second person. Proceed to the next stages if the baby does not require resuscitation.
     
  4. Tie and cut the cord.
    * Tie or clamp the cord tightly in two places: 
    - Tie the first one: two fingers (5 cm) away from the baby's tummy.
    - Tie the second one four fingers away from the baby's belly
    * Cut the cable between the ties as follows:
    - Use sterilized scissors, a new razor blade, or a boiled razor blade.
    - Cover the section of the chord with a little piece of gauze to prevent blood from splashing on you.
    - Take care not to injure or cut the baby.
    - Nothing should be placed on the cord stump.
     
  5. Place the baby in skin-to-skin contact with the mother.
    The warmth of the women quickly transfers to the baby and aids in temperature regulation.
    - Place the infant on the woman's chest for skin-to-skin contact.
    - Wrap a warm cloth or blanket around both the woman and the baby.
    - Place a cloth over the baby's head.
     
  6. Help the mother begin breastfeeding within the first hour of birth.
    Assist the women with their first feeding. Ascertain that the infant is in a good position, connection, and suck. Do not limit the amount of time the infant feeds; early and unrestricted breastfeeding provides the newborn with energy to stay warm, nourishment to grow, and antibodies to combat infection.
     
  7. Give eye care
    Antibacterial treatment is administered to the newborn's eyes shortly after breastfeeding and within one hour of birth. Eye care keeps the newborn safe from dangerous eye infections.
     
  8. Explain both normal and abnormal findings to mother and family.
    - If the newborn is healthy, move him or her to the ward with a mother.
    - If a newborn is acting abnormally, refer him or her to a specialist and follow up.

References

  • Tuitui, Roshani, and S. N. Dr. Suwal. Manual of Midwifery II (Intrapartum Care). Bhotahity, Kathmandu: Vidyarthi Pustak Bhandar, 2014.

  • moodle.digital-campus.org/mod/page/view.php?id=13453

  • http://moodle.digital-campus.org/mod/page/view.php?id=13453
Things to remember
  • Immediately dry the infant, including the head, and rub up and down the baby's back with a clean, warm towel.
  • Check to see if the infant is: i. breathing, ii. having difficulty breathing, or iii. not breathing as you dry the baby. Take a look at the baby's skin tone.
  • If the infant is not breathing, is breathing at less than 30 breaths per minute, or is gasping, resuscitation is required.
  • Cut and tie the cord.
  • Securely tie or clamp the cord in two locations.
  • Make skin-to-skin contact between the infant and the women.
  • If everything is normal, have the women begin nursing.
  • Separate the women and the baby for weighting after the infant has breastfed.
  • Assist the mothers in starting breastfeeding within the first hour.
Questions and Answers

Eight Steps of Immediate Newborn Care

  • Dry and stimulate the baby :

With a clean, warm cloth, quickly dry the infant, paying special attention to the head. Rub the infant's back from top to bottom. The vernix protects the skin and might be able to help prevent infection, so try your best to leave it in place.

  • Assess the baby's breathing and color

Check to see whether the infant is breathing, having problems breathing, or not breathing as you dry the baby. Look at the infant's skin tone. Instead of gray or blue, the face and chest should be pink. You can tell if a baby has darker skin by looking at the tongue, lip, and mucous membrane; they should all be pink, not gray or blue.

The color pink in a baby is a reliable indicator of healthy breathing and circulation. It's possible for hands and feet to be blue for 1-2 days after birth, but this usually doesn't mean the baby isn't getting enough oxygen.

  • Decide if the baby needs resuscitation

The infant requires resuscitation if it is not breathing, is breathing at a rate of fewer than 30 breaths per minute, or is gasping. In that scenario, immediately clamp or knot the cord before cutting it, leaving a stump that is at least 10 cm long. Place the infant on a warm, flat surface and begin CPR right away. Call for assistance because the woman requires the assistance of another person.

Continue with the next steps if the baby does not require resuscitation.

  • Tie and cut the cord.
  • Tie or clamp the cord securely in two places :
    • Tie the first one -two fingers (5 cm ) away from the baby abdomen.
    • Tie the second one four fingers away from the baby's abdomen.
  • Cut the cord between the ties :
    • Use sterile scissors or a new razor blade or boiled one.
    • Use a small piece of gauze to cover the part of cord to prevent blood splashes on
    • you.
    • Be careful not to cut or injury the baby.
    • Do not put anything on the cord stump.
  • Place the baby in skin to skin contact with the women.

The warmth of the women passes easily to the baby and help stabilize the baby's temperature.

  • Put the infant on the woman's chest so they may touch skin to skin.
  • Wrap a warm blanket or cloth around the mother and child at the same time.
  • Shield the infant's head.
  • If all is well, have the woman begin nursing.
  • When weighing the mother and infant, wait until the infant has finished nursing.
  • Within an hour of giving delivery, assist the new mothers in starting to breastfeed.
  • Assist the women at the first meal. Make sure the infant is in a favorable posture and is attached and sucking. Limitless breastfeeding gives a newborn the energy to stay warm, the nutrition they need to grow, and the antibodies they need to fight infection.
     
  • Give eye care

Shortly after breastfeeding and within one hour after birth give the newborn eye care with an antimicrobial medication. Eye care protects the baby from a serious eye infection.

  • Explain both normal and abnormal findings to mother and family.
    • If the baby is normal, transfer to a ward with a mother.
    • If a baby is not normal, refer to an appropriate place with special instructions and follow up.

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