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Health Workers Information Series No. 2

Newborn care

Norway India Partnership Initiative (NIPI)NIHFW

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Acknowledgements

This handout has been prepared by National Child Health Resource Centre (NCHRC) of National Institute of Health and Family Welfare (NIHFW) for use by the frontline workers. We gratefully acknowledge the support provided by National Neonatology Forum (NNF) for technical review of the material. We also thank NIPI – UNOPS for evolving the idea to develop this resourse material and for providing financial support for the initiative.

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1. 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 a lot of attention: about 2/3rd of all deaths which occur in infants <1 year take place in the newborn period. This means that special attention must be given to the newborns, to bring about a reduction in infant mortality. Newborns have special needs and require supportive care for their healthy survival.

2. What are the important aspects of care of a newborn?

The important components of care of a newborn are:1. Breast feeding2. Keeping the baby warm and prevention of low body

temperature3. Prevention of infection4. Immunization5. Detection of danger signs and early referral6. Care of low birth weight baby

Newborns care

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3. What are the benefits of breast feeding the newborn?

• Breast milk is complete food that a newborn baby requires and is easily digested and well absorbed.

• Breast milk is available at all times and is at right temperature

• It improves physical and mental growth of the baby

• It reduces post birth bleeding in mother and prevents anaemia.

• It can help to delay next pregnancy.

4. What are the important things mother should know about breast feeding?

• Start feeding the newborn within ½ to 1 hr after birth• Do not discard the initial yellow part of milk (colostrums). It

protects the child against infections.• Give exclusive breast feeding till 6 months of age and then

add semi-solid feeds.• Do not give water, honey, ghutti etc. They reduce the milk and

increase the chances of infection.• Feed the baby whenever baby demands and allow the baby to

feed till satisfied.• Continue breast feeds till the baby is 2 years old and also

beyond 2 years, if possible.

5. What is exclusive breast feeding and why is it important?

Exclusive breast feeding means the baby should not be given anything else (not even water) except breast milk till 6 months of age. Breast milk contains all the nutrients in the right proportion which are needed for optimum growth and development of the baby during the first six months. Exclusive breast feeding is safe and protects the baby from infections. Giving the baby anything other than breast milk to the body increases the risk of contamination and infection which can be dangerous.

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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 are seen in the newborn:

1. The baby passes urine at least 5 to 6 times in a day 2. 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 milk

from 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 the baby. This will additionally also protect the baby from infection which the mother is having by protective factor which are passed through milk.

8. Why is it important to keep newborns warm?

• Warmth is essential in the care of newborns because they can not maintain their own body heat. The baby can become cold when not clothed properly or because of practices such as bathing, even during summer months.

• Low body temperature is harmful to the newborn and this increase the risk of sickness and death, so it is important to prevent 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 both abdomen and the feet of baby are equally warm by touching them with the back of your hand.• Do not keep the baby wet for prolonged period. Dry the

baby with clean soft towel soon after the baby is bathed.• Wrap the baby in 2-3 layers of loose clothing, with

head and feet covered. In winter, give additional layer of woollens and wrap the baby in a blanket.

• Do not bathe soon after birth.• Bathe the infant quickly and gently in a warm room

with warm water.

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• Keep baby dry at all times, in a warm room and close to the mother.

10. When should a newborn be given his/her fi rst bath?

• Bathing should be avoided immediately after birth. Preferably, normal baby should be given bath on second day during summer. In winter bathing may be avoided for several days.

• Ensure baby’s temperature is normal before giving a bath (Both abdomen & feet should be equally warm).

• Bathe the baby in a warm room, and use warm water.

11. What is the kangaroo method and what are its benefi ts?

The kangaroo method is a method in which mother and the newborn baby maintain skin to skin contact to provide warmth to baby and prevent the development of low body temperature. The method is specially benefi cial for a LBW baby, who is at a high risk for developing low body temperature.

• For this, the baby is placed, upright inside mother’s clothing against the bare skin over the chest. Cover the baby’s head by 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 at least once in every 2 hour. Mother should sleep propped up so that the baby stays upright. Make sure the baby stays warm at all times.

• If the weather is cold, dress the baby with extra clothing.• When the mother wants to bathe or rest, ask the father or

another family member to ‘Kangaroo’ the baby or wrap infant in several layers of warm clothing, covered with blankets and keep in a warm place.

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Benefits of the Kangaroo Method

(a) Assists in maintaining the temperature of the baby, prevents low body temperature

(b) Facilitates breastfeeding(c) Improves mother- infant bonding

12. If a newborn develops low body temperature what should be done?

If a newborn appears cold, he/she should be placed in skin to skin contact with the mother (kangarooing). Ensure to cover the head of the baby with a cap or any other warm cloth and make him/her wear socks in the feet. The mother should continue

breastfeeding the baby. If the baby still appears cold, take the baby to the nearest health facility. Ensure that newborn stays in skin 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 they have less capacity to fight with infections.

• These infections can spread rapidly and can lead to the death of the newborn.

14. How can we prevent infection in newborns?

• Always wash hands with soap and water before handling the baby and after cleaning the baby (whenever the baby passes a 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 the

umbilical stump clean and dry.• Do not allow people with cough, loose motions and skin

infections to handle the baby.• Immunization is an effective way of preventing infections.

Take the infant for immunization at 1 ½ months, 2 ½ months, 3 ½ months, 9 months, 1 ½ years and 5 years of age.

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15. When should a newborn be taken to health facility immediately?

The presence of any of the following is a danger sign for a newborn. If any of these signs are present, the baby must be taken 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 birth weight is less than 2.5kg. In India over 1/3rd newborns born are LBW. A baby with low birth weight is at increased risk for complications and has a higher risk for dying as compared to a baby with normal birth weight. Nearly 3/4 of the neonatal deaths and 1/2 of the infant deaths occur among the low birth weight 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 feet

covered• Given additional layer of woollens and blanket in winter.• Kangaroo method can be used to maintain temperature of

low baby

18. How should LBW babies be fed?

• All LBW babies must be given exclusive breast feeding at least 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 sucking the baby on the breast, breast milk of the mother should be expressed into a clean washed cup. The expressed milk

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should be fed to a baby with a spoon or traditional feeding device (eg. paladai, cup & spoon etc.) till baby accepts breast feeds well.

19. How can we prevent infections in LBW baby?

• Always wash your hands with soap and water after toilet and after 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 to come near the baby.

• Give exclusive breast feeding. It protects the baby from infection

• Bring the infant for immunization as per schedule. The schedule of immunization is same as for normal babies.

• Look for danger signs. Seek medical help immediately if any of the danger signs are present.

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Notes

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Notes

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National Child Health Resource CentreNational Institute of Health and Family Welfare Baba Gang Nath Marg, Munirka, New Delhi-110067

Phones: 26165959/26166441/26188485/26107773Fax: 91-1126101623

Website: www.nihfw.org

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