• Dry the baby with a clean cloth.
  • While drying observe breathing, muscle tone, and colour. If all normal remove the wet cloth, wrap baby in a dry one and give to
    mother to initiate breastfeeding.
  • Cover baby well to prevent over-cooling.
  • If not breathing, initiate resuscitation as shown in the chart below.

For babies not requiring resuscitation do the following:

  • Initiate breastfeeding within an hour of birth.
  • Wrap in dry linen.
  • Weigh the baby.
  • Keep warm next to mother (skin to skin is the best way of keeping baby warm).
  • Instill tetracycline eye ointment within 1 hr in both eyes and given only once.
  • Examine carefully to exclude congenital malformation.

Postnatal Care of the Normal Newborn

The infant should join the mother as soon as possible. The following are important:

  • Breastfeeding should start within the first hour of life to ensure good positioning and attachment
  • Encourage exclusive breastfeeding (no water).
  • Babies should be fed on demand at least 8–12 times/24 hours.
  • HIV positive mothers who have chosen not to breastfeed should be encouraged to cuddle their babies.
  • Observe cord for bleeding and keep it clean.
  • Give OPV 0 and BCG.
  • On discharge: Counsel the mother on cord care and breastfeeding at home and tell her to bring the baby back immediately if she notices a problem, e.g, poor feeding or jaundice.

What to Teach the Mother

  • All expectant mothers should be taught about cord care.
  • They need to know that babies often acquire infection through the cord.
  • If they deliver in the community, cutting of the cord with clean instrument is needed.
  • After delivery harmful practices need to be discouraged.
  • Mothers should keep the cord dry until it drops off.