2.newborn care.indd - National Institute of health and family welfare

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2.newborn care.indd - National Institute of health and family welfare

Health Workers Information Series No. 2Newborn careNIHFWNorway 1 India Partnership Initiative (NIPI)


AcknowledgementsThis handout has been prepared by National Child HealthResource Centre (NCHRC) of National Institute of Healthand Family Welfare (NIHFW) for use by the frontlineworkers. We gratefully acknowledge the support providedby National Neonatology Forum (NNF) for technicalreview of the material. We also thank NIPI – UNOPS forevolving the idea to develop this resourse material and forproviding financial support for the initiative.2


Newborns care1. When is a baby called a ‘newborn’ baby?A baby between 0-1 month of life is known as newborn baby.The newborn period is a very important period, which requires alot of attention: about 2/3 rd of all deaths which occur in infants


3. What are the benefits of breast feeding thenewborn?• Breast milk is complete food that a newbornbaby requires and is easily digested andwell absorbed.• Breast milk is available at all times and is atright temperature• It improves physical and mental growth ofthe baby• It reduces post birth bleeding in mother andprevents anaemia.• It can help to delay next pregnancy.4. What are the important things mother should know aboutbreast feeding?• Start feeding the newborn within ½ to 1 hr after birth• Do not discard the initial yellow part of milk (colostrums). Itprotects the child against infections.• Give exclusive breast feeding till 6 months of age and thenadd semi-solid feeds.• Do not give water, honey, ghutti etc. They reduce the milk andincrease the chances of infection.• Feed the baby whenever baby demands and allow the baby tofeed till satisfied.• Continue breast feeds till the baby is 2 years old and alsobeyond 2 years, if possible.5. What is exclusive breast feeding and why is it important?Exclusive breast feeding means the baby should not be givenanything else (not even water) except breast milk till 6 months ofage. Breast milk contains all the nutrients in the right proportionwhich are needed for optimum growth and development ofthe baby during the first six months. Exclusive breast feedingis safe and protects the baby from infections. Giving the babyanything other than breast milk to the body increases the risk ofcontamination and infection which can be dangerous.4


6. How will mother know if her milk is suffi cient for her baby or not?Mother’s milk is suffi cient for her newborn, if the following areseen in the newborn:1. The baby passes urine at least 5 to 6 times in a day2. The baby sleeps for atleast 2 hours after taking breast feed3. Weight gain of the baby is normal4. When the mother feeds the newborn, there is a fl ow of milkfrom the other breast.7. What milk should be given to a newborn if the mother has fever?If mother is having fever and is able to feed, she should feed thebaby. This will additionally also protect the baby from infectionwhich the mother is having by protective factor which are passedthrough milk.8. Why is it important to keep newborns warm?• Warmth is essential in the care of newborns because they cannot maintain their own body heat. The baby can become coldwhen not clothed properly or because of practices such asbathing, even during summer months.• Low body temperature is harmful to the newborn and thisincrease the risk of sickness and death, so it is important toprevent low body temperature in a newborn.9. How can we keep me newborn warm?Make sure that the baby is warm at all times: Ensure that bothabdomen and the feet of baby are equally warm by touchingthem with the back of your hand.• Do not keep the baby wet for prolonged period. Dry thebaby with clean soft towel soon after the baby is bathed.• Wrap the baby in 2-3 layers of loose clothing, withhead and feet covered. In winter, give additional layerof woollens and wrap the baby in a blanket.• Do not bathe soon after birth.• Bathe the infant quickly and gently in a warm roomwith warm water.5


• Keep baby dry at all times, in a warm roomand close to the mother.10. When should a newborn be given his/her fi rstbath?• Bathing should be avoided immediately afterbirth. Preferably, normal baby should be givenbath on second day during summer. In winterbathing may be avoided for several days.• Ensure baby’s temperature is normal beforegiving a bath (Both abdomen & feet should beequally warm).• Bathe the baby in a warm room, and use warmwater.11. What is the kangaroo method and what are itsbenefi ts?The kangaroo method is a method in which motherand the newborn baby maintain skin to skincontact to provide warmth to baby and prevent thedevelopment of low body temperature. The methodis specially benefi cial for a LBW baby, who is at ahigh risk for developing low body temperature.• For this, the baby is placed, upright inside mother’s clothingagainst the bare skin over the chest. Cover the baby’s headby cap, feet by socks and hands by mittons. A loose blouse,sweater or wrap tied at the waist holds the baby.• Let baby suckle at breasts as often as he/she wants, but atleast once in every 2 hour. Mother should sleep propped up sothat the baby stays upright. Make sure the baby stays warmat all times.• If the weather is cold, dress the baby with extra clothing.• When the mother wants to bathe or rest, ask the father oranother family member to ‘Kangaroo’ the baby or wrap infantin several layers of warm clothing, covered with blankets andkeep in a warm place.6


Benefits of the Kangaroo Method(a) Assists in maintaining the temperature of the baby, preventslow body temperature(b) Facilitates breastfeeding(c) Improves mother- infant bonding12. If a newborn develops low body temperature what should be done?If a newborn appears cold, he/she should be placed in skin toskin contact with the mother (kangarooing). Ensure to cover thehead of the baby with a cap or any other warm cloth and makehim/her wear socks in the feet. The mother should continuebreastfeeding the baby. If the baby still appears cold, take thebaby to the nearest health facility. Ensure that newborn stays inskin to skin contact during referral.13. Why is it important to prevent infections in a newborn?• All newborn babies are vulnerable to get infection as theyhave less capacity to fight with infections.• These infections can spread rapidly and can lead to the deathof the newborn.14. How can we prevent infection in newborns?• Always wash hands with soap and water before handling thebaby and after cleaning the baby (whenever the baby passesa motion).• Give only breast milk and do not give anything else.• Do not apply anything in the eyes (eg. Kajal, surma)• Do not apply anything on the umbilical stump. Keep theumbilical stump clean and dry.• Do not allow people with cough, loose motions and skininfections to handle the baby.• Immunization is an effective way of preventing infections.Take the infant for immunization at 1 ½ months, 2 ½months, 3 ½ months, 9 months, 1 ½ years and 5 yearsof age.7


15. When should a newborn be taken to health facility immediately?The presence of any of the following is a danger sign for anewborn. If any of these signs are present, the baby must betaken to hospital immediately:• Lethargy – Reduction in activity or weak cry• Poor feeding – weak sucking ability• Fever or Cold to touch ( Abdomen cold)• Fast or diffi cult breathing• Yellow palms/soles• Bleeding from any site.16. When is a baby called Low birth weight (LBW)?A newborn baby is called as low birth weight when the birthweight is less than 2.5kg. In India over 1/3 rd newborns bornare LBW. A baby with low birth weight is at increased risk forcomplications and has a higher risk for dying as compared toa baby with normal birth weight. Nearly 3/4 of the neonataldeaths and 1/2 of the infant deaths occur among the low birthweight neonates.17. How can we maintain temperature of LBW baby?• Keep baby dry at all times and in a warm room.• Delay bathing after birth for several days• Wrap the baby in 2-3 layers of clothing with head and feetcovered• Given additional layer of woollens and blanket in winter.• Kangaroo method can be used to maintain temperature oflow baby18. How should LBW babies be fed?• All LBW babies must be given exclusive breast feeding atleast 10-12 times in a day (at least 4 times during the night).Avoid all pre lacteal feeds.• If baby is not sucking vigorously at the breast, after suckingthe baby on the breast, breast milk of the mother shouldbe expressed into a clean washed cup. The expressed milk8


should be fed to a baby with a spoon or traditional feedingdevice (eg. paladai, cup & spoon etc.) till baby acceptsbreast feeds well.19. How can we prevent infections in LBW baby?• Always wash your hands with soap and water after toilet andafter cleaning the baby.• Allow only one or two persons (other than the mother)to handle the baby.• Do not allow persons with diarrhoea, cough / cold tocome near the baby.• Give exclusive breast feeding. It protects the baby frominfection• Bring the infant for immunization as per schedule.The schedule of immunization is same as for normalbabies.• Look for danger signs. Seek medical help immediatelyif any of the danger signs are present.9


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vkjksX;e~ lq[klEinkNational Child Health Resource CentreNational Institute of Health and Family WelfareBaba Gang Nath Marg, Munirka, New Delhi-110067Phones: 26165959/26166441/26188485/26107773Fax: 91-1126101623Website: www.nihfw.orgii

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