Initial Assessment and Care of New Born Babies

Initial Assessment and Care of New Born Babies

Care of newborn baby

The purpose of care of a newborn baby is to detect early sign of illness and abnormalities and treat it accordingly.

• Observation:
  • To avoid unnecessary exposure, the newborn should be inspected thoroughly but quickly, starting with the head and moving on to inspect the entire body for any congenital abnormalities.
• Temperature:
  • Temperature need to assess one hourly and if necessary 12 hourly or 6 hourly.
• Weight:
  • Weight is to be taken a 3rd day and should take with undress. Weight loss is normal in the first few days but more than 10% body weight losses are abnormal and require investigation.
• Respiration:
  • The normal rate of new born baby is 40 beats per minutes.
• General care:
  • Warmth needs to maintain for the baby according to the room temperature. Chilling must be avoided to prevent hypothermia. Baby must be handling properly. The temperature should be frequently recorded until it becomes stabilized.
• Baby bath:
  • The baby bath should be done after 24 hours after birth, the water should be at body temperature and a separate both tab should be gently performed using bland soap and the skin is dried with a soft towel.
• Eye care:
  • Eyes are cleaned with NS or boiled water. The method should be from inner canthus to outer of an eye and one swap is used for only once. If eyes are sticky, eye care should be done twice a daily.
• Care of umbilical cord:
  • Cleanliness of umbilical cord is essential. Hand washing is required before and after handling the cord.
• Skin care:
  • Promotion of skin integrity is enhanced by avoiding friction against hard fabrics or soiled or wet clothing and by minimizing the length of time the skin is in contact with irritants such as gastric contents, urine, and stools.
• Genital care:
  • The genital care should be appropriate for the climate. The extremities should be free for movements.
• Medication:
  • Vitamin k1 1mg should be given intramuscularly to minimize the risk of hemorrhagic disease.
  • Close observation should be done for 4-8 hours to detect any excessive mucus excretion from the mouth, any bleeding from the umbilical cord.

Continuing care and observation

• Skin:
  • Assess the baby’s skin daily. Assess for hydration, a condition of the skin, color or anything abnormal.
• Head:
  • Palpitation of a head for assessment of the anterior fontanel, resolution of caput succedaneum, moulding identification of any new swelling for e.g. Cephalohematoma should be noted.
• Eyes:
  • Eyes are to be inspected for evidence of early infection suggested by discharge.
• Mouth:
  • Mouth should be inspected daily for detection of early evidence of thrush, sucking blisters in the baby’s lips may be observed, especially if he has been fed recently.
• The umbilical cord:
  • It should be inspected daily for any inflammation and discharge, offensives smell must be reported.
• Bath:
  • Cleaning the skin may be reported daily or as frequently as required especially the buttocks, to remove the meconium passed.
• Stool:
  • Number and character of the stool and rough estimation of the amount of urine passed daily are to be noted. Napkin should be changed immediately following soiling and the local parts should be cleaned and dry.
• Feeding:
  • The baby should feed 2-3 hourly. Nurse must know how baby fed; any vomiting, distention, and abnormalities should be noted.
• Cry: 
  • This is the baby’s language , a reason for cry are hungry, thirst, pain, wet, too hot, too cold, uncomfortable, lack of love and attention etc so the midwife must know and provide necessary care.